Effect of Hot Pads Applied to the Breast During Episiotomy Repair on the Amount of Milk, Breastfeeding Motivation, and Perception of Insufficient Milk: A Randomized Controlled Study

Background: Supportive interventions during episiotomy repair in the immediate postpartum period are essential to help women sustain breastfeeding motivation. Objectives: This study determined the effects of hot pad (HP) application to the breast during episiotomy repair on milk volume, breastfeeding motivation, and perceived insufficient milk (PIM). Materials and Methods: The type of study is a randomized controlled intervention study. The study population consisted of primiparous women who had spontaneous vaginal deliveries with mediolateral episiotomy at term between October 2023 and June 2024 at the Maternity Unit of Selçuk University Medical Faculty Hospital ( n = 218). Data were collected using the Introductory Information Form, the Primipara Breastfeeding Motivation Scale, the Perceived Insufficient Milk Questionnaire (PIMQ), and a standardized manual breast milk expression procedure. Following birth, skin-to-skin contact and breastfeeding were initiated, with each newborn breastfeeding from one breast, while the contralateral breast was not used for breastfeeding. In the intervention group (IG), a HP was applied to the nonbreastfed breast during episiotomy repair. At the second hour postpartum, milk was expressed for 20 minutes from the nonbreastfed breast using a manual breast pump in both groups. Results: Mean episiotomy repair time was 21.32 ± 6.71 minutes in the IG and 26.06 ± 7.40 minutes in the control group (CG). Mean expressed milk volume was 4.09 ± 2.12 mL in the IG and 2.82 ± 1.73 mL in the CG. The IG had significantly higher value ascribed to breastfeeding (VAB), self-effectiveness (SE), and midwife support (MS) scores (all p < 0.001), whereas expectation of success (ES) was higher in the CG ( p < 0.001). Mean PIMQ score was higher in the IG than in the CG (32.55 ± 12.12 versus 28.61 ± 10.98), indicating lower PIM. Conclusions: HP application during episiotomy repair was associated with higher expressed milk volume, greater VAB, SE, and MS, and lower PIM. ES was lower in the IG than in the CG.