Lactation Clinical Trial
Official title:
The Effect of Auricular Therapy on Lactation: A Pilot Study
The aim of this study is to function as a pilot study in evaluating the effects of auricular therapy (AT) on lactation for women in the immediate post cesarean period while examining the feasibility of the three-parallel-arm, sham-controlled randomized design. The study hypothesizes that post cesarean women who receive AT with standard care for 96 hours postpartum have earlier onset of lactogenesis II and larger milk production when compared with women who receive sham AT with standard care or standard care alone.
Breastfeeding has been of major concern in maternal-child healthcare. Challenges posed by
cesarean delivery can have negative impacts on breastfeeding. Efforts to facilitate, support,
and sustain breastfeeding have been investigated to a great extent by researchers from a
variety of disciplines. In the field of Traditional Chinese Medicine (TCM), a number of
clinical studies have been carried out to study the effect of auricular therapy (AT) on
postpartum lactation over the years. Limitations in the evidence that currently exists
include the lack of randomization, sham-controlled treatment, blinding and/or no valid
outcome measures. Given that such information is important for maternal-child health and
clinical practice, the study has set out to conduct a pilot trial which employs randomized,
single-blinded, and sham group design that examines relevant outcomes using valid
measurement.
A total of 96 post cesarean participants have been randomly assigned to one of three
treatment conditions: (1) standard care (n=32); (2) standard care with Medulla Junci adhesive
on auricular acupoints (n=32); (3) standard care with magnetic pellets adhesive on auricular
acupoints (n=32). The standard care group participants only received the standard post
cesarean care of the study hospital without any additional therapies. The same set of six
pre-specified auricular points were adopted for both Medulla Junci and magnetic pellets
groups. The treatment was initiated within 4 to 8 hours post cesarean for 96 hours during
their hospital stay at a maternal hospital in Kaohsiung, Taiwan.
Milk production and onset of lactogenesis II have been used as primary outcome variables for
the evaluation of the effectiveness of AT. Milk production is determined by the summed value
of infant test weighing measurements and expressed breast milk. Maternal perceptions of
breast fullness, swelling, leakage, or tingling are the indicator of onset of lactogenesis
II. The secondary outcome measures are infant behaviors of observed swallowing and rooting
during breastfeeding, neonatal weight gain, and frequencies of urination and defecation of
the infant.
Numeric rating scales have been used to measure the effect of the possible mediating
variables, i.e., pain and stress. Potential confounding variables have been controlled by
either stratified randomization and exclusion criteria or monitored during the study period.
Treatment expectation and satisfaction toward AT have been assessed in order to examine their
relationship with therapy outcomes. Main components of study feasibility, i.e., recruitment,
retention, and acceptance, have been evaluated. Participants also have been contacted to
acquire their one and three-month breastfeeding practice status.
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