The effect of using topical breast milk on the healing of the episiotomy site in primiparous women: A randomized controlled clinical trial

Introduction: Women are at risk of perineal infection after episiotomy. The topical use of breast milk has been recommended to repair the perineum, but its effectiveness is not known in women at high risk of perineal infection. Objective: This study aimed to determine the effect of using topical breast milk on the healing of the episiotomy site in primiparous women at risk of episiotomy site infection. Methods: This clinical randomized trial was conducted from 2020 to 2021 on 78 primiparous women prone to episiotomy site infection referred to two teaching hospitals affiliated with Mashhad University of Medical Sciences in Mashhad, Iran. They were randomly allocated into two groups: control (n=39) and intervention (n=39). The intervention group received topical use of 2 mL of their expressed milk over their perineal wound twice daily for ten days (0.25 mL from the first to the third day), rinsing with normal saline twice a day. Only rinsing the perineum with normal saline was performed in the control group for 10 days. The REEDA scale (Redness, Edema, Ecchymosis, Discharge, and Approximation) was completed in the first 24 hours and on the fifth and tenth days after delivery. Data analysis was performed using the Mann-Whitney U test, independent t-test, and Friedman’s test. P<0.05 was considered statistically significant. Results: Four mothers were excluded from the study (3 from the intervention group and one from the control group). The mean age of the participants was 25.6 ± 7 and 23.9 ± 5.7 years in the intervention and control groups, respectively. The mean total score of REEDA scale in the first 24 hours (12.9 ± 0.6 for the intervention group and 13.0 ± 0.6 for the control group) and on the fifth day after delivery (7.3±1.5 vs. 7.5 ± 1.3) was not significantly different between the two groups, but the difference was significant on the 10th day (2.7 ±1.5 for the intervention group and 3.2 ± 1.4 for the control group; P=0.017). Conclusion: The topical use of breast milk is effective in healing episiotomy wounds in primiparous women, although more clinical trials are needed to confirm its efficacy.