Impact of Press Needle Combining Breast Massage on Onset of Lactogenesis II in Post-Cesarean Mothers: A Randomized...

To assess the effectiveness of press needle acupoint stimulation and breast massage on lactation outcomes.

This two-arm randomized controlled trial enrolled 132 first-time mothers undergoing cesarean section between December 2023 to June 2024. Participants were randomly assigned in a 1:1 ratio to an experimental group or a control group (66 cases in each) using a computer-generated block randomization sequence. Both groups received routine post-cesarean care, early skin-to-skin contact, and breastfeeding guidance. In addition, the experimental group received press needle acupoint stimulation initiated within 4-6 h after cesarean delivery and breast massage combined with low-frequency electronic pulse stimulation 3 times daily for 3 days. The primary outcome was the onset time of lactogenesis II. Secondary and mechanistic outcomes included breastfeeding frequency, formula supplementation, exclusive breastfeeding rate, infant weight change within 72 h, serum prolactin and oxytocin levels, and breast milk composition at 72 h postpartum. Safety was monitored by recording any maternal or neonatal adverse events during the intervention period.

The experimental group showed earlier lactogenesis II onset, higher breastfeeding frequency at 24-48 h and 48-72 h, and higher exclusive breastfeeding rates at 72 h (P<0.01, P=0.013, 0.034, respectively). Mothers in the experimental group used less formula at 72 h postpartum (P=0.022). In addition, breast milk from the experimental group contained higher levels of protein, fat, and minerals (P=0.021, 0.027, P<0.01, respectively), as well as a slightly higher water content [P=0.022]. Maternal serum prolactin and oxytocin levels were also significantly higher in the experimental group (both P<0.01). Infants in the experimental group also had less weight loss at 72 h (P<0.01). No serious adverse events were observed.

Press needle acupoint stimulation and breast massage effectively enhance early lactation outcomes. Further studies are needed to evaluate their long-term impacts on breastfeeding duration and maternal health. (Registration No. NCT06498882).