The effect of acupressure and back massage on lactation after caesarean delivery: A randomized controlled study

Objective: This study was conducted to examine the effects of acupressure and back massage on lactation after caesarean delivery. Material and Methods: As a randomized controlled study experimental study, this study was carried out between June 2021-January 2022 Ali Kahya Campus of Health Sciences University Derince Teaching and Research Hospital. The population included women who had had caesarean section in these hospitals and the sample consisted of a total of 97 women (acupressure n: 34, back massage n: 31 and control group n: 32). Data were collected using an Introduction Information Form, Baby Follow-up Form, Maternal Follow-up Form, and a Visual Analogue Scale by which the mothers evaluated lactation onset symptoms. Once on post-op day 0, twice on post-op day 1, and once on post-op day 2, a total of four sessions of a six-minute-acupressure for the acupressure group and a three-minute-back massage for the back massage group were given to the women. Nothing was done for the control group. 15 minutes after the interventions, the baby was weighed while hungry and breastfed for at least 20 minutes under the control of the researcher. The babies were weighed again after breastfeeding to measure the amount of milk ingested. The women in the control group received routine care and the amount of milk was measured by the researcher by providing breastfeeding support to the women. One-Way Analysis of Variance, Kruskal-Wallis test and chi-square tests were used in the statistical analysis, and Bonferroni test and Mann Whitney U test with Bonferroni Correction were used in post hoc analyses. The Friedman test was applied in the comparisons of follow-ups with more than two dependent structures, and the Wilcoxon test for two-paired samples was used in the post hoc analysis. 0,05 was taken as type 1 error level. Results: In our study, the mean age of women in the acupressure group was 24,18±4,16, 26,39±3,66 in the back massage group, and 24,63±4,28 in the control group. The amounts of breast milk of the women in the acupressure, back massage and control groups were similar in the first and second follow-up, while the mean amounts of breast milk of the women in the acupressure and back massage groups were statistically significantly more in the third (10,88±4,99, 10,97±5,06 and 7,03±4,18 grams respectively, p=0,001) and fourth (12,50±5,11; 13,39±5,22 and 9,53±5,29 grams respectively, p=0,005) follow-ups compared to the women in the control group. The tension, temperature increase and pain levels felt by the women in the acupressure, back massage and control groups were similar in the first and second follow-ups. However, in the third follow-up, the level of tension felt in the breasts was statistically significantly higher in the back massage group (5,43±2,70) compared to the control group (4,03±2,44), and the level of temperature increase in the acupressure and back massage groups was statistically significantly higher compared to the control group (5,44±1,89, 5,29±1,68 and 3,68±1,83 respectively) (p=0,039 ve p<0,001 respectively). Conclusion: It was observed that acupressure and back massage increased the amount of breast milk and had similar effects after caesarean deliveries. Additionally, in terms of signs of onset of lactation, while acupressure was effective only for temperature increase in the breasts, back massage was effective for both tension and temperature increase.