Comparing the effects of breastfeeding in the laid-back and cradle position upon the experiences of primiparous women: a parallel randomized clinical trial

Abstract

Background and aim: Appropriate positioning is crucial to successful breastfeeding and its continuation. Positioning can create, prevent, or correct breastfeeding problems. This study aimed to determine and compare the effects of both the laid-back and cradle positions upon the breastfeeding experiences of primiparous (cisgender) women.

Methods: A parallel randomized clinical trial was conducted with a sample of primiparous women (n = 168) with a gestational age of between 31 and 34 weeks, referring to the perinatal clinic of Shahid Gharazi Hospital in Malayer (Hamadan Province, Iran). Participants were recruited via convenience sampling and allocated to one of two groups: intervention (laid-back position) (n = 85) and control (cradle position) (n = 83) using the random block method. Breastfeeding education was given to both groups during two sessions (weeks 31-34 and 35--37 of pregnancy) by "baby-friendly" accredited hospitals in Iran. The intervention group was instructed on how to breastfeed using the laid-back position. The control group was instructed on how to breastfeed using the cradle position. In the immediate postnatal period, breastfeeding positions were assessed in both groups. Breastfeeding experiences were measured once at the time of participants returning home and again at both 1 week and 2 weeks following birth, using the breastfeeding experience scale. Data analysis was undertaken using the SPSS software version 21. A value of P < 0.05 was considered significant.

Results: No statistically significant difference was observed between the two groups in terms of concerns relating to participants nor their breasts, milk insufficiency, neonate, process, or breastfeeding experience at any time point measured. The means (SDs) of breastfeeding experience at the time of discharge, 1 week, and 2 weeks after childbirth in intervention group were 26.07 (4.533), 26.85 (3.812), and 26.65 (4.632) respectively. The means (SDs) of breastfeeding experience at the time of discharge, 1 week, and 2 weeks after childbirth in control group were 25.42 (3.315), 26.68 (3.872), and 25.41 (4.05) respectively.

Conclusion: There is no difference in breastfeeding experiences whether the laid-back or cradle position is used. Thus, broader education on breastfeeding and the provision of comprehensive support may be more effective in optimizing one's experience of breastfeeding.

Trial registration: Registration date: 2021 July 21, Code: IRCT20180427039436N10, https://irct.ir/user/trial/57054/view.

Keywords: Breastfeeding experience; Breastfeeding positions; Cradle position; Laid-back position.

Fig. 1

Enrolment of participants into two groups: intervention and control

Fig. 2

Comparison the mean of breast-feeding experience scores between the two groups at the times of hospital discharge and 1 and 2 weeks after childbirth