Effects of Southern Thai Traditional Massage and Warm Compression in the Early Postpartum on Lactation and Breast Engorgement Among Primiparous Mothers

Abstract

The common breastfeeding problems including delayed onset of lactation, insufficient milk volume, and breast engorgement are important barriers to successful exclusive breastfeeding among primiparous mothers. These problems can cause primiparous mothers to stop exclusive breastfeeding early. It is necessary to develop an intervention for promoting the onset of lactation, increasing milk volume, and decreasing breast engorgement in primiparous mothers to improve the success of exclusive breastfeeding. Therefore, this study investigated the effects of Southern Thai traditional massage and warm compression in the early postpartum on lactation and breast engorgement among primiparous mothers. The study design was a randomized controlled trial. Participants were primiparous mothers who met the inclusion criteria. A minimized randomization program was used to assign the participants into the Southern Thai traditional massage and warm compression (STMW), the Southern Thai traditional massage (STM), and the control groups and to control for the confounding variables. The total number of participants in this study was 63. The STMW group (n = 21) received 5 minutes of the Southern Thai traditional massage per breast and 15 minutes of warm compression. The STM group (n = 21) received 5 minutes of the Southern Thai traditional massage per breast. Both interventions were provided 4 times (the 1st time of intervention: at 4-5 hours, the 2nd time of intervention: 10-11 hours, the 3rd time of intervention: 28-29 hours, and the 4th time of intervention: 34-35 hours after giving birth). The control group (n = 21) received the routine care. The onset of lactation was measured by the primiparous mothers who were observed and interviewed every 3 hours after giving birth in the daytime. Milk volume and breast engorgement were measured after finishing the intervention at the 1st time of observation (10-11 hours after giving birth), the 2nd time of observation (28-29 hours after giving birth), and the 3rd time of observation (34-35 hours after giving birth). Descriptive statistics were used to analyze the characteristics of the sample. The chi-square test was used to analyze the differences of nominal data. One-way ANOVA was used to analyze the differences across groups for the continuous data and compare the duration of time after giving birth until the onset of lactation. Repeated-measures ANOVA was used to compare milk volume and breast engorgement across three time points. The results showed that the onset of lactation was significantly earlier in the STMW group (M = 37.00, SD = 2.56) than in the STM group (M = 40.57, SD = 2.94) and in the control group, and significantly earlier in the STM group than in the control group (M = 45.71, SD = 2.49) (p < .001). In terms of milk volume, comparisons of mean score of milk volume among groups revealed that STMW group was significantly higher than the STM group (p < .001) and the control group (p < .001), the STM group was significantly higher than the control group (p = .009). In addition, the mean score of milk volume within group showed that the milk volume in all group measured at the 3rd time of observation was significantly higher than that at the 1st and the 2nd time of observations (p < .001) and milk volume at the 2nd time of observation was significantly higher than that at the 1st time of observation (p < .001). The interaction between treatments and times of milk volume was significant (p < .001). Breast engorgement of the STMW group was significantly lower than that in the STM group (p < .05) and the control group (p < .05), and that in the STM group was significantly lower than that in the control group (p < .05). Moreover, the mean score of breast engorgement measured at the 1st time of observation was significantly lower than that at the 2nd time (STMW, STM, and control groups, p = .005, .001, and < .001, respectively) and that at the 3rd time of observation (p < .001), and that measured at the 2nd time of observation was significantly lower than that at the 3rd time of observation (p < .001). The interaction between treatment and time of breast engorgement was significant (p < .001). In conclusion, the STMW intervention applied in the early postpartum at 4 times: at 4-5 hours, 10-11 hours, 28-29 hours, and 34-35 hours after giving birth, can promote lactation and prevent breast engorgement. Therefore, the STMW intervention be a useful contributing for nurse practitioners and nurse educators in promoting lactation and preventing breast engorgement.