Development And Evaluation Of A Scheme For Improving Lactation In Postpartum Women By Combining Breast Acupressure Massage With Ear Acupoint Pressure

Objectives1.To develop a program that combines breast acupoint massage and ear acupressure to improve lactation volume in women who have undergone spontaneous labor;2.To assess the effectiveness of the program that combines breast acupoint massage and ear acupressure to improve lactation volume in women who have undergone spontaneous labor.MethodsSearching databases including CNKI,VIP,Wanfang,CBM,Pub Med,Web of Science to collect literature about offering breast acupoint massage and(or)ear acupressure to intervene lactation volume,the time was since the establish of databases up to Wednesday,2022.The quality of the included studies was evaluated according to the JBI Critical Appraisal Tool in Australia(2016),and the basic characteristics were analyzed.Through literature reviews and group discussions,the program was constructed.There were 124 parturients selected from the Department of Obstetrics in the affiliated hospital.By using computer to generate a random number sequence,The numbered parturients were randomly divided into four groups:breast acupoint massage combined with ear acupressure group(hereinafter referred to as“combined group”),breast acupoint massage group(massage group),ear acupressure group(acupressure group)and the control group,with 31 cases in each group.The control group was given routine post-natal care,which included offering adequate nutrition,guiding and assisting breastfeeding.On the basis of the routine nursing care,the parturients in the combined group were given breast acupoint massage combined with ear acupressure according to the program.On the basis of the routine nursing care,the parturients in the massage group were given breast acupoint massage according to the program.On the basis of the routine nursing care,the parturients in the acupressure group were given ear acupressure according to the program.The first intervention was began in the first 2hours,continuous intervention for 3 day.Breast acupoint massage was given once a day.Ear acupressure was given three times a day.According to the outline of the interview,The semi-structured interviews were carried out in 42 days.The onset time of lactation and the eligibility rate of lactation volume in the first 3 days,the weight of newborn in the first 3 days,the rate of pure breast-feeding in 42 days,and the qualitative interviews were recorded.Results1.General data between the four groups before intervention were comparable and the differences were not statistically significant(P>0.05).2.After intervention,the onset time of lactation,the eligible rate of lactation volume in the first 3 days,the weight of newborn in the first 3 days and the rate of pure breast-feeding in 42 days were compared.After intervention,the onset time of lactation was:the combined group(15.94±0.77)h,the massage group(22.04±1.64)h,the acupressure group(22.35±1.12)h,the control group(32.47±0.96)h,the difference was statistically significant(F=956.798,P<0.05).After intervention,the eligible rate of lactation volume in the first 3 days was 82.14%in the combined group,48.28%in the massage group,41.38%in the acupressure group and 25.00%in the control group,there was a significant difference(~2=67.613,P<0.05).After intervention,the body weight of newborn in the first 3 days was:the combined group(3187.68±204.52)g,the massage group(3237.76±288.35)g,the acupressure group(3183.28±310.82)g and the control group(3240.71±342.59)g,with no significant difference(F=0.325,P>0.05).After intervention,the rate of pure breast-feeding in 42 days was 53.57%in the combined group,55.17%in the massage group,44.83%in the acupressure group and 50.00%in the control group,with no significant difference(~2=2.685,P>0.05).3.Results of semi-structured interviews.Three themes emerged from this study:parturients were concerned about the program,but willing to try it;parturients suffered from pain,but confirmed the program;parturients got health knowledge.ConclusionsThere is some uniformity and viability to the evidence-based program of breast point massage and ear acupressure to enhance postpartum lactation.It can hasten the start of lactation,enhance the volume of lactation,improve breastfeeding knowledge,and offer direction and references for enhancing nursing programs to encourage lactation.