Background and purpose: The World Health Organization (WHO) recommends that breastfeeding is the best ideal method to provide newborns with nutrients. Exclusive breastfeeding is recommended up to 6 months of age, with continued breastfeeding along with appropriate complementary foods for up to two years of age or beyond. There are many advantages of breastfeeding. However, the pain caused by breast engorgement is one of the reasons women discontinue breastfeeding. The general management of breast engorgement is to encourage early breastfeeding and increase breastfeeding frequency. However, non-rooming-in mothers are unable to relieve breast engorgement due to low suction frequency. The pain caused by breast engorgement discourages mothers to keep breastfeeding. Acupressure has the effect of removing obstructions from meridians to facilitate breast milk ejection, and reduce pain caused by breast engorgement. The purpose of this study is to determine the effect of acupressure to relieve breast engorgement.
Methods: A randomized controlled trial was conducted on 60 postpartum non-rooming-in women in a postpartum care center at a Chiayi regional teaching hospital. Participants had been randomized equally to experimental and controlled group (each group had 30 persons). The member of each group signed the different kind of agreement to make sure they didin’t know another intervention ,to avoid placebo effect .In the experimental group, the women received acupressure and hand expression of breast milk daily for 3 days. The acupoints were 屋翳 (Wu-Yi, ST15) , 膺窗 (Ying-Chuang, ST16) , 乳根 (Ru-Gen, ST17) and 膻中 (Dan-Zhong, CV17). In the control group, the women proceeded with only hand expression of breast milk. The assessment of the subjects included recording their basic characteristics, completion of a subjective breast engorgement scale, and physiological measurements. Interventions was performed by the same researcher with the same approach and strength. Another nurse help the participants to fill the engorgement symptoms rating scale. All data collected were analyzed with Microsoft Excel 2007 and SPSS Version 18. Paired-samples t-test, independent t-test and Chi-Square test were used to evaluate differences in basic characteristics and outcome indicators. Generalized estimating equation (GEE) models were used to determine relationships between breast engorgement and basic characteristics. Data were again collected one month after intervention, and were subjected to Fisher’s exact test analysis.
Results: The basic characteristics of subjects in the two groups were homogeneous. In both groups, there were significant statistical differences (P < 0.001) in the extent of breast engorgement, subjective breast pain, and subjective breast discomfort at 5 minutes and 30 minutes after intervention on the 1st, 2nd and 3rd day postpartum. Comparisons between the experimental group and the control group showed significant improvements (P < 0.001) in all outcome indicators. After including the basic characteristics of subjects into the analysis, no significant changes in the results were found. Furthermore, results obtained from the data collected one month after intervention showed that subjects in the experimental group experienced no breast pain. In contrast, 39.3% of subjects in the control group experienced intermittent breast pain. Moreover, 3.3% and 53.6% of subjects in the experimental group and control group, respectively, experienced localized breast engorgement.
Conclusion: Acupressure had significant effects in reducing breast engorgement. It should be promoted to help lactating women to breastfeed successfully. The results of the present study can be used as a reference for postpartum breast engorgement care.
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