HTechJ Health and Technology Journal (HTechJ) HTechJ 2986-5662 2985-959X KHD Production 755 10.53713/htechj.v4i5.755 Original Research Woolwich Massage as a Non-Pharmacological Intervention to Enhance Breast Milk Production Among Postpartum Mothers: A Quasi-Experimental Study Woli Kristiani Anjelica 1 Ilmiah Widia Shofa 1 * Undergraduate Midwifery Study Program Institute of Science and Health Technology (ITSK) Dr. Soepraoen Hospital Malang Indonesia Correspondence should be addressed to Widia Shofa Ilmiah, widiashofailmiah@itsk-soepraoen.ac.id 02 10 2026 4 5 606 617 19 06 2026 14 09 2026 18 09 2026 © 2026 The Authors 2026 This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Insufficient breast milk production remains a major challenge during the postpartum period and may contribute to early discontinuation of exclusive breastfeeding. Non-pharmacological interventions that are safe, accessible, and applicable in maternal healthcare settings are needed to support improvements in lactation. Woolwich massage has been proposed as a supportive technique to stimulate physiological mechanisms associated with breast milk production; however, evidence regarding its effectiveness in specific postpartum care settings remains limited. This study aimed to evaluate the effectiveness of Woolwich massage in increasing breast milk production among postpartum mothers at KRI Madinah Pujon. A quasi-experimental study with a two-group pre-test and post-test design was conducted among 30 postpartum mothers. Participants were selected using quota sampling and divided into an intervention group that received Woolwich massage and a control group that received standard postpartum care. Breast milk production was assessed before and after the intervention. Data were analyzed using the Wilcoxon Signed-Rank Test at a significance level of p < 0.05. The findings showed an improvement in breast milk production following the Woolwich massage intervention. The mean production score increased from 9.377 before intervention to 11.310 after intervention. The Wilcoxon analysis demonstrated a significant difference between pre-test and post-test measurements (Z = −4.787; p < 0.001), indicating that Woolwich massage was associated with increased breast milk production among postpartum mothers. Woolwich massage represents an effective complementary intervention to support breast milk production during the postpartum period. The findings highlight its potential for integration into postpartum breastfeeding support programs as a practical, non-pharmacological approach to improving lactation outcomes. Further studies with larger sample sizes and rigorous experimental designs are recommended to strengthen the evidence for its clinical effectiveness.

 breast milk production breastfeeding support lactation intervention postpartum mothers woolwich massage INTRODUCTION

Breastfeeding remains a fundamental component of maternal and infant health because optimal breast milk intake provides essential nutrients, immune protection, and developmental benefits during early life. Exclusive breastfeeding during the first six months is globally recognized as an important strategy for reducing infant morbidity and mortality while supporting long-term health outcomes (Pérez-Escamilla et al., 2023). Breast milk production is influenced by complex physiological processes, including hormonal regulation, maternal psychological factors, breastfeeding practices, and adequate stimulation of the mammary glands (Hannan et al., 2023). Successful breastfeeding requires effective lactation support, particularly during the early postpartum period, when mothers often face challenges in establishing adequate milk production (Pados & Camp, 2024).

Insufficient breast milk production represents a persistent challenge among postpartum mothers and contributes to premature discontinuation of exclusive breastfeeding. Delayed onset of lactogenesis and inadequate milk production during the early postpartum period have been identified as important factors affecting breastfeeding continuation and maternal confidence (Peng et al., 2024). Mothers experiencing inadequate milk supply often report concerns about infant hunger, breastfeeding failure, and reduced confidence in their ability to breastfeed, which may negatively affect breastfeeding outcomes (Nagel et al., 2022). These problems may be associated with delayed lactogenesis, maternal stress, fatigue, anxiety, inadequate breastfeeding techniques, and limited access to professional lactation assistance (Mullen et al., 2022). The condition becomes particularly important in healthcare settings where postpartum mothers require immediate support to overcome breastfeeding barriers and maintain breastfeeding continuity.

The problem of inadequate breast milk production is also observed among postpartum mothers receiving care at KRI Madinah Pujon, where breastfeeding difficulties remain a concern during the early postpartum period. Mothers experiencing reduced milk production require appropriate interventions to stimulate lactation and improve breastfeeding outcomes. Evidence indicates that structured postpartum breastfeeding counseling and continuous professional support can improve breastfeeding initiation, exclusive breastfeeding practices, and maternal confidence (Beyene et al., 2025). Conventional breastfeeding support often focuses on education regarding positioning, attachment, and feeding frequency, while complementary approaches that directly stimulate physiological mechanisms of milk production remain an important area of interest (Knutson & Butler, 2022). The availability of safe, affordable, and easily implemented interventions is essential for strengthening postpartum maternal care, particularly through approaches that support maternal relaxation and the continuation of breastfeeding (Levene et al., 2024).

Current approaches to improving breast milk production include pharmacological and non-pharmacological strategies. Pharmacological interventions may provide benefits in certain conditions but are often limited by considerations of safety, accessibility, and clinical indication. Non-pharmacological interventions, including breast massage, oxytocin massage, relaxation techniques, and lactation counseling, have gained attention because they are relatively safe and can be integrated into routine maternal healthcare services (Khatib et al., 2023). Woolwich massage is one such approach, focusing on stimulating breast tissue to support milk secretion through physiological mechanisms involving prolactin and oxytocin. Breast stimulation techniques, including massage and warm-compress application, have demonstrated potential benefits in improving milk production and reducing maternal anxiety during lactation (Mollaahmetoglu & Guvenc, 2025). Similar supportive massage-based interventions have also been reported to enhance lactation outcomes by promoting oxytocin release and improving maternal comfort during breastfeeding (Kartilah & Februanti, 2024).

Previous studies have demonstrated that breast stimulation techniques can improve breast milk production and breastfeeding effectiveness among postpartum mothers. Research on various massage-based interventions has shown positive effects on milk volume, maternal comfort, and breastfeeding confidence. A randomized controlled study reported that back and breast massage could increase milk production while reducing maternal anxiety, suggesting that physical stimulation may support lactation outcomes through both physiological and psychological mechanisms (Kılcı Erciyas & Kavlak, 2024). Existing evidence indicates that the physical stimulation and relaxation effects of massage may support lactation. Furthermore, oxytocin massage and other breast stimulation techniques have been reported as supportive non-pharmacological approaches for improving lactation problems and facilitating breastfeeding continuation among postpartum mothers (Lestari et al., 2022). Most previous studies, however, have examined general breast massage or oxytocin massage interventions. In contrast, specific evidence regarding the effectiveness of Woolwich massage remains limited, particularly among postpartum mothers experiencing breastfeeding difficulties in specific clinical settings.

The limited evidence on the effectiveness of Woolwich massage creates a research gap that warrants further investigation. Previous studies have not fully addressed how Woolwich massage influences changes in breast milk production among postpartum mothers through structured pre-intervention and post-intervention assessments. Evidence from different healthcare contexts is needed to determine whether Woolwich massage can be applied as a reliable supportive intervention for mothers with insufficient milk production. Recent breastfeeding intervention studies have emphasized that structured support programs using measurable pre- and post-intervention evaluations are important for determining the effectiveness of breastfeeding-related interventions (Rodríguez-Gallego et al., 2024). This study is novel in that it specifically evaluates the effectiveness of Woolwich massage in improving breast milk production among postpartum mothers at KRI Madinah Pujon, using a quasi-experimental approach. Previous research also highlights the importance of developing accessible, evidence-based lactation interventions to reduce breastfeeding difficulties and improve maternal breastfeeding outcomes (Koca & Yurdakul, 2026).

This study aims to analyze the effectiveness of Woolwich massage in increasing breast milk production among postpartum mothers at KRI Madinah Pujon. The urgency of this research stems from the need to develop practical, evidence-based interventions to support breastfeeding success during the critical postpartum period. Evidence from recent systematic reviews indicates that breastfeeding support interventions can improve breastfeeding outcomes and increase the likelihood of maintaining exclusive breastfeeding (Patnode et al., 2025). The findings are expected to contribute to maternal healthcare practice by providing additional evidence on implementing Woolwich massage as a complementary strategy to improve lactation outcomes and strengthen breastfeeding support services. Recent observational research has also demonstrated that early access to appropriate breastfeeding support is associated with better breastfeeding continuation and reduced breastfeeding difficulties during the postpartum period (Lojander et al., 2024).

 METHOD Design

This study employed a quasi-experimental two-group pre-test-post-test design to evaluate the effectiveness of Woolwich massage in improving breast milk production among postpartum mothers. The study involved an intervention group that received Woolwich massage and a control group that received standard postpartum care. Measurements of breast milk production were conducted before and after the intervention to assess changes between and within groups.

 Setting and Time

The study was conducted at the inpatient clinic Madinah Pujon, Malang, Indonesia. Data collection was carried out over a three-day intervention period. The research period included participant recruitment, baseline assessment, intervention implementation, post-intervention measurement, and data recording.

 Population, Sample, and Sampling

The target population consisted of all postpartum mothers at the inpatient clinic Madinah Pujon who experienced breastfeeding difficulties, particularly related to insufficient breast milk production. The study sample consisted of 30 postpartum mothers, allocated to two groups: 15 in the intervention group and 15 in the control group. Participants were selected using a non-probability sampling method with a quota sampling technique. The recruitment process continued until the predetermined sample size was achieved based on the established eligibility criteria. The inclusion criteria were postpartum mothers who were breastfeeding, experiencing breastfeeding problems related to milk production, and willing to participate in the study. The exclusion criteria included postpartum mothers with breastfeeding disorders associated with medical complications, such as breast tumors or nipple injuries, and mothers who declined participation during the study period.

 Intervention

The intervention group received Woolwich massage as a non-pharmacological breastfeeding support intervention. The massage technique was applied to stimulate breast tissue and support physiological mechanisms associated with lactation, particularly by promoting the release of prolactin and oxytocin. The intervention was conducted for three consecutive days. The control group received standard postpartum care without Woolwich massage intervention. The implementation of the intervention followed a standardized procedure to maintain consistency throughout the study period.

 Instrument and Measurement Properties

Breast milk production was measured using a structured assessment instrument designed to evaluate changes in production among postpartum mothers. The measurement was conducted during the pre-test and post-test periods. The instrument assessed breast milk production indicators before and after the intervention. The recorded scores were used to assess changes in milk production and to determine statistical differences between measurement periods.

 Data Collection Procedure

Data collection began with participant screening based on the inclusion and exclusion criteria. Eligible participants received information regarding the research objectives, procedures, potential benefits, and their rights as research participants before providing informed consent. Baseline measurements of breast milk production were collected before the intervention. Participants in the intervention group subsequently received Woolwich massage according to the research protocol, while participants in the control group continued receiving routine postpartum care. Post-test measurements were performed after completion of the intervention period. All collected data were documented and prepared for statistical analysis.

 Data Analysis

Data analysis was performed using statistical software. Descriptive analysis was conducted to summarize participant characteristics and the distribution of breast milk production before and after the intervention. The normality of data distribution was assessed before selecting the appropriate statistical test. The Wilcoxon Signed-Rank Test was used to analyze differences in breast milk production before and after Woolwich massage, as the data distribution did not meet the parametric assumptions. The significance level was established at p < 0.05. A statistically significant result indicated an association between Woolwich massage intervention and changes in breast milk production among postpartum mothers.

 Ethical Declaration

This study received ethical approval from the Institute of Science and Health Technology, Dr. Soepraoen Hospital, Malang, Indonesia. All participants provided informed consent before participating in the study. Participant confidentiality and anonymity were maintained throughout the research process. The study was conducted in accordance with ethical principles for research involving human participants, including respect for autonomy, protection of privacy, and voluntary participation.

 RESULT Distribution of Breast Milk Production Before and After Woolwich Massage Intervention

The distribution of breast milk production among participants before and after the Woolwich massage intervention is presented in Table 1. Before the intervention, most participants experienced low breast milk production (9 participants; 60.0%), followed by moderate production (6 participants; 40.0%). No participants were categorized as having high breast milk production before receiving the intervention. After the Woolwich massage intervention, breast milk production improved, with 12 participants (80.0%) classified as having high production and 3 participants (20.0%) classified as having moderate production. No participants remained in the low production category after the intervention.

Distribution of Breast Milk Production Before and After Woolwich Massage Intervention (N=15)
Breast Milk Production Level Before Woolwich Massage n (%) After Woolwich Massage n (%)
Low 9 (60.0%) 0 (0.0%)
Moderate 6 (40.0%) 3 (20.0%)
High 0 (0.0%) 12 (80.0%)

As shown in Table 1, breast milk production shifted from predominantly low before the intervention to predominantly high after the intervention.

 Comparison of Breast Milk Production Scores Before and After Woolwich Massage Intervention

Table 2 presents the comparison of breast milk production scores before and after the Woolwich massage intervention. The mean breast milk production score increased from 9.377 ± 0.5157 during the pre-test assessment to 11.310 ± 0.4992 after the intervention. The minimum and maximum scores also increased from 8.6–10.5 before the intervention to 10.7–12.5 after the intervention. These findings indicate an improvement in breast milk production following the implementation of Woolwich massage among postpartum mothers.

Comparison of Breast Milk Production Scores Before and After Woolwich Massage Intervention
Measurement Period Mean ± SD Minimum Maximum
Before Woolwich Massage (Pre-test) 9.377 ± 0.5157 8.6 10.5
After Woolwich Massage (Post-test) 11.310 ± 0.4992 10.7 12.5

See Table 2 for the pre-test and post-test mean, standard deviation, minimum, and maximum scores.

 Effectiveness of Woolwich Massage on Increasing Breast Milk Production Among Postpartum Mothers

Table 3 presents the results of the Wilcoxon Signed Ranks Test evaluating changes in breast milk production before and after the Woolwich massage intervention. The analysis showed that all participants experienced an increase in breast milk production, as indicated by 30 positive ranks, with no negative ranks or ties. The Z-value was −4.787 with p < 0.001, indicating a statistically significant difference between pre-test and post-test scores. These findings indicate that Woolwich massage was effective in increasing breast milk production among postpartum mothers.

Effectiveness of Woolwich Massage on Increasing Breast Milk Production Among Postpartum Mothers
Comparison Negative Ranks Positive Ranks Ties Z-value p-value
Pre-test vs post-test 0 30 0 -4.787 <0.001

See Table 3 for the Wilcoxon Signed Ranks Test results.

 DISCUSSION

This study demonstrated that Woolwich massage was associated with a significant improvement in breast milk production among postpartum mothers. The findings showed an increase in the mean breast milk production score from pre- to post-intervention, accompanied by a shift in the distribution of milk production categories from predominantly low to predominantly high. The statistical analysis confirmed a significant difference between pre-test and post-test measurements, indicating that mothers who received Woolwich massage experienced measurable improvements in breast milk production. Previous research has reported that breast massage and other non-pharmacological lactation stimulation techniques may improve milk production by enhancing maternal comfort, stimulating physiological lactation responses, and supporting breastfeeding effectiveness among postpartum mothers (Mollaahmetoglu & Guvenc, 2025). These findings support the potential role of Woolwich massage as a complementary non-pharmacological intervention to assist postpartum mothers experiencing breastfeeding difficulties.

The improvement in breast milk production observed in this study is consistent with previous studies reporting that breast stimulation techniques can enhance lactation outcomes among postpartum mothers. Woolwich massage is designed to stimulate breast tissue, particularly the areas surrounding the lactiferous ducts and milk sinuses, which may facilitate milk flow and improve breastfeeding comfort. Mechanical stimulation through breast massage may contribute to neuroendocrine regulation by promoting oxytocin release and supporting effective milk ejection. At the same time, adequate breast stimulation also helps maintain lactation physiology (Munsittikul et al., 2022). Increased oxytocin activity promotes contraction of myoepithelial cells surrounding the alveoli, thereby allowing milk to be transported more efficiently through the ductal system and improving breastfeeding effectiveness (Sweet & Vasilevski, 2022).

The findings also correspond with previous research examining various breast massage interventions for improving lactation performance. Studies involving lactation massage and oxytocin massage have demonstrated improvements in breast milk production and breastfeeding outcomes, suggesting that these interventions may support lactation through hormonal stimulation and improved milk transfer (Agustia & Camelia, 2025). Furthermore, recent evidence indicates that combining massage-based interventions with supportive approaches can enhance oxytocin and prolactin responses, which are key physiological mechanisms underlying milk synthesis and ejection in mothers with insufficient milk production (Astuti et al., 2024). The present findings extend prior evidence by demonstrating the beneficial effect of Woolwich massage in postpartum mothers with limited breast milk production.

The effectiveness of Woolwich massage may also be explained through the interaction between physiological and psychological factors affecting breastfeeding. Postpartum mothers frequently experience anxiety, fatigue, discomfort, and concerns regarding insufficient milk supply, which may negatively influence oxytocin secretion and breastfeeding success (Hoberg et al., 2024). Massage-based interventions provide physical stimulation and create a relaxing experience that may reduce maternal stress responses. A reduction in stress-related hormonal activity can support optimal oxytocin release, thereby improving milk ejection and breastfeeding performance (Moriyama et al., 2024).

The present study highlights the importance of early postpartum support in improving breastfeeding outcomes. The postpartum period is a critical stage for establishing successful breastfeeding practices because inadequate milk production in the early days after delivery is a major reason mothers introduce formula supplementation or discontinue exclusive breastfeeding (Karthigesu et al., 2023). Providing simple, safe, and accessible interventions, such as Woolwich massage, may strengthen existing maternal care programs by offering healthcare providers an additional strategy to support mothers facing breastfeeding challenges (Allen et al., 2023).

The findings have important implications for midwifery and maternal healthcare practice. Woolwich massage can be integrated into postpartum education and breastfeeding support programs as an intervention that requires no medication, specialized equipment, or extensive healthcare resources. Midwives and maternal health professionals may consider incorporating standardized Woolwich massage techniques into postpartum counseling to improve maternal knowledge and confidence in managing early breastfeeding problems (Wang et al., 2023). Implementation of this intervention requires appropriate training to ensure that healthcare providers apply consistent procedures and provide accurate guidance to mothers and families (Şimşek-Çetinkaya et al., 2024).

The results also contribute to the broader understanding of non-pharmacological approaches in maternal and neonatal health. Breastfeeding success depends on multiple factors, including maternal health status, infant feeding behavior, breastfeeding technique, emotional condition, and social support (Chambers et al., 2023). Woolwich massage should not be considered an independent solution for all breastfeeding problems, but rather a supportive intervention within comprehensive lactation management. Integration with proper breastfeeding positioning, infant attachment assessment, nutritional support, and professional counseling may provide more optimal outcomes (Bilgiç & Bozkurt, 2024).

The methodological findings of this study indicate that Woolwich massage produced consistent improvements among participants. The absence of negative changes and the presence of positive changes among participants suggest that the intervention had a favorable effect on breast milk production. The magnitude of improvement observed after the intervention provides preliminary evidence supporting further investigation of Woolwich massage using stronger experimental designs. Previous breastfeeding intervention studies have demonstrated that initial positive findings from quasi-experimental approaches should be followed by controlled trials with larger samples and longer observation periods to confirm the effectiveness and sustainability of breastfeeding-related outcomes (Saehoong et al., 2024). Future studies may explore whether repeated administration over longer periods produces sustained improvements in milk production and exclusive breastfeeding rates.

Several limitations should be considered when interpreting the findings of this study. The relatively small sample size may limit the generalizability of the results to broader postpartum populations. The study was conducted within a single healthcare setting, which may reduce the applicability of the findings to mothers with different demographic characteristics, healthcare access conditions, or cultural backgrounds. Research evaluating breastfeeding interventions has emphasized the need for studies conducted in broader populations and across multiple healthcare settings to improve external validity and determine whether intervention effects can be generalized across maternal groups (Titaley et al., 2022). Larger multicenter studies are required to confirm the effectiveness of Woolwich massage across diverse postpartum populations.

The study design also presents limitations related to causal interpretation. Although the quasi-experimental approach provides evidence of changes following the intervention, the design may not fully control for potential confounding variables that influence breast milk production. Factors such as maternal nutritional status, breastfeeding frequency, infant sucking ability, psychological condition, and previous breastfeeding experience may affect lactation outcomes. Future research should include more comprehensive assessments of these variables to strengthen the understanding of how Woolwich massage contributes to improvements in breastfeeding. Breastfeeding intervention research has emphasized that stronger causal conclusions require rigorous study designs, adequate control of confounding factors, and careful consideration of maternal and infant characteristics that may influence breastfeeding outcomes (Patnode et al., 2025).

Measurement-related limitations should also be considered. Complex biological processes influence breast milk production and may require objective measurement methods to provide a more accurate evaluation. Future studies should consider incorporating direct measurements of milk volume, breastfeeding frequency records, infant weight gain, or validated lactation assessment tools. The use of standardized measurement approaches would improve the reliability and comparability of findings across studies. The current findings provide valuable evidence regarding the potential application of Woolwich massage as a supportive intervention for postpartum breastfeeding problems. Further research with larger samples, rigorous randomized controlled trials, longer follow-up periods, and objective outcome measures is needed to establish stronger evidence of its effectiveness and long-term contribution to breastfeeding success. Recent evidence indicates that estimates of breast milk intake vary across measurement techniques, highlighting the importance of selecting objective, standardized approaches when evaluating lactation outcomes (Rios-Leyvraz & Yao, 2023).

 CONCLUSION

This study demonstrates that Woolwich massage is an effective non-pharmacological intervention to improve breast milk production in postpartum mothers. The intervention was associated with a significant increase in breast milk production scores and a positive shift in milk production categories after implementation. The findings support the integration of Woolwich massage into postpartum breastfeeding support services as a practical, safe, and accessible approach to addressing early lactation difficulties. The application of this intervention may strengthen maternal breastfeeding management and improve breastfeeding outcomes. Further research using larger sample sizes, randomized controlled designs, and objective lactation measurements is recommended to confirm the effectiveness and long-term benefits of Woolwich massage across diverse postpartum populations.

 REFERENCES Agustia N. Camelia R. Effect of lactation massage and oxytocin massage on milk production in postpartum women: A quasi-experimental study Lentera Perawat 2025 6 2 355 361 10.52235/lp.v6i2.475 https://doi.org/10.52235/lp.v6i2.475 Agustia, N., & Camelia, R. (2025). Effect of lactation massage and oxytocin massage on milk production in postpartum women: A quasi-experimental study. Lentera Perawat, 6(2), 355–361. https://doi.org/10.52235/lp.v6i2.475 Agustia, N., & Camelia, R. (2025). Effect of lactation massage and oxytocin massage on milk production in postpartum women: A quasi-experimental study. Lentera Perawat, 6(2), 355–361. https://doi.org/10.52235/lp.v6i2.475 Allen J. Gao Y. Germain J. O’Connor M. Hurst C. Kildea S. Impact of the Thompson method on breastfeeding exclusivity and duration: Multi-method design International Journal of Nursing Studies 2023 141 104474 10.1016/j.ijnurstu.2023.104474 https://doi.org/10.1016/j.ijnurstu.2023.104474 Allen, J., Gao, Y., Germain, J., O’Connor, M., Hurst, C., & Kildea, S. (2023). Impact of the Thompson method on breastfeeding exclusivity and duration: Multi-method design. International Journal of Nursing Studies, 141, Article 104474. https://doi.org/10.1016/j.ijnurstu.2023.104474 Allen, J., Gao, Y., Germain, J., O’Connor, M., Hurst, C., & Kildea, S. (2023). Impact of the Thompson method on breastfeeding exclusivity and duration: Multi-method design. International Journal of Nursing Studies, 141, Article 104474. https://doi.org/10.1016/j.ijnurstu.2023.104474 Astuti D. Rahfiludin M. Z. Dwidiyanti M. Denny H. M. Enhancing oxytocin and prolactin levels to address oligogalactia through emotional management and massage in working mothers Narra Journal 2024 4 3 e963 10.52225/narra.v4i3.963 https://doi.org/10.52225/narra.v4i3.963 Astuti, D., Rahfiludin, M. Z., Dwidiyanti, M., & Denny, H. M. (2024). Enhancing oxytocin and prolactin levels to address oligogalactia through emotional management and massage in working mothers. Narra Journal, 4(3), e963. https://doi.org/10.52225/narra.v4i3.963 Astuti, D., Rahfiludin, M. Z., Dwidiyanti, M., & Denny, H. M. (2024). Enhancing oxytocin and prolactin levels to address oligogalactia through emotional management and massage in working mothers. Narra Journal, 4(3), e963. https://doi.org/10.52225/narra.v4i3.963 Beyene B. N. Wako W. G. Moti D. Edin A. Debela D. E. Postnatal counseling promotes early initiation and exclusive breastfeeding: A randomized controlled trial Frontiers in Nutrition 2025 12 1473086 10.3389/fnut.2025.1473086 https://doi.org/10.3389/fnut.2025.1473086 Beyene, B. N., Wako, W. G., Moti, D., Edin, A., & Debela, D. E. (2025). Postnatal counseling promotes early initiation and exclusive breastfeeding: A randomized controlled trial. Frontiers in Nutrition, 12, 1473086. https://doi.org/10.3389/fnut.2025.1473086 Beyene, B. N., Wako, W. G., Moti, D., Edin, A., & Debela, D. E. (2025). Postnatal counseling promotes early initiation and exclusive breastfeeding: A randomized controlled trial. Frontiers in Nutrition, 12, 1473086. https://doi.org/10.3389/fnut.2025.1473086 Bilgiç F. Ş. Bozkurt G. Effect of online infant care training and postpartum counseling based on Meleis' transition theory on mothers' readiness for care and breastfeeding: A randomized controlled trial Clinical and Experimental Pediatrics 2024 67 10 521 530 10.3345/cep.2024.00423 https://doi.org/10.3345/cep.2024.00423 Bilgiç, F. Ş., & Bozkurt, G. (2024). Effect of online infant care training and postpartum counseling based on Meleis' transition theory on mothers' readiness for care and breastfeeding: A randomized controlled trial. Clinical and Experimental Pediatrics, 67(10), 521–530. https://doi.org/10.3345/cep.2024.00423 Bilgiç, F. Ş., & Bozkurt, G. (2024). Effect of online infant care training and postpartum counseling based on Meleis' transition theory on mothers' readiness for care and breastfeeding: A randomized controlled trial. Clinical and Experimental Pediatrics, 67(10), 521–530. https://doi.org/10.3345/cep.2024.00423 Chambers A. Emmott E. Myers S. Page A. E. Emotional and informational social support from health visitors and breastfeeding outcomes in the UK International Breastfeeding Journal 2023 18 14 10.1186/s13006-023-00551-7 https://doi.org/10.1186/s13006-023-00551-7 Chambers, A., Emmott, E., Myers, S., & Page, A. E. (2023). Emotional and informational social support from health visitors and breastfeeding outcomes in the UK. International Breastfeeding Journal, 18, Article 14. https://doi.org/10.1186/s13006-023-00551-7 Chambers, A., Emmott, E., Myers, S., & Page, A. E. (2023). Emotional and informational social support from health visitors and breastfeeding outcomes in the UK. International Breastfeeding Journal, 18, Article 14. https://doi.org/10.1186/s13006-023-00551-7 Hannan F. M. Elajnaf T. Vandenberg L. N. Kennedy S. H. Thakker R. V. Hormonal regulation of mammary gland development and lactation Nature Reviews Endocrinology 2023 19 46 61 10.1038/s41574-022-00742-y https://doi.org/10.1038/s41574-022-00742-y Hannan, F. M., Elajnaf, T., Vandenberg, L. N., Kennedy, S. H., & Thakker, R. V. (2023). Hormonal regulation of mammary gland development and lactation. Nature Reviews Endocrinology, 19, 46–61. https://doi.org/10.1038/s41574-022-00742-y Hannan, F. M., Elajnaf, T., Vandenberg, L. N., Kennedy, S. H., & Thakker, R. V. (2023). Hormonal regulation of mammary gland development and lactation. Nature Reviews Endocrinology, 19, 46–61. https://doi.org/10.1038/s41574-022-00742-y Hoberg M. G. Demirci J. R. Sereika S. M. Levine M. D. DeVito Dabbs A. Mixed-methods assessment of maternal anxiety during the first 8 weeks after birth Journal of Obstetric, Gynecologic & Neonatal Nursing 2024 53 4 368 382 10.1016/j.jogn.2024.01.003 https://doi.org/10.1016/j.jogn.2024.01.003 Hoberg, M. G., Demirci, J. R., Sereika, S. M., Levine, M. D., & DeVito Dabbs, A. (2024). Mixed-methods assessment of maternal anxiety during the first 8 weeks after birth. Journal of Obstetric, Gynecologic & Neonatal Nursing, 53(4), 368–382. https://doi.org/10.1016/j.jogn.2024.01.003 Hoberg, M. G., Demirci, J. R., Sereika, S. M., Levine, M. D., & DeVito Dabbs, A. (2024). Mixed-methods assessment of maternal anxiety during the first 8 weeks after birth. Journal of Obstetric, Gynecologic & Neonatal Nursing, 53(4), 368–382. https://doi.org/10.1016/j.jogn.2024.01.003 Karthigesu K. Balakumar S. Arasaratnam V. Determinants of early cessation of exclusive breastfeeding practices among rural mothers from Jaffna District of Sri Lanka International Breastfeeding Journal 2023 18 42 10.1186/s13006-023-00575-z https://doi.org/10.1186/s13006-023-00575-z Karthigesu, K., Balakumar, S., & Arasaratnam, V. (2023). Determinants of early cessation of exclusive breastfeeding practices among rural mothers from Jaffna District of Sri Lanka. International Breastfeeding Journal, 18, Article 42. https://doi.org/10.1186/s13006-023-00575-z Karthigesu, K., Balakumar, S., & Arasaratnam, V. (2023). Determinants of early cessation of exclusive breastfeeding practices among rural mothers from Jaffna District of Sri Lanka. International Breastfeeding Journal, 18, Article 42. https://doi.org/10.1186/s13006-023-00575-z Kartilah T. Februanti S. Emotional Freedom Techniques and oxytocin stimulation massages that effectively reduce anxiety and increase smooth breast milk production of nursing mothers The Malaysian Journal of Nursing 2024 16 2 46 53 10.31674/mjn.2024.v16i02.005 https://doi.org/10.31674/mjn.2024.v16i02.005 Kartilah, T., & Februanti, S. (2024). Emotional Freedom Techniques and oxytocin stimulation massages that effectively reduce anxiety and increase smooth breast milk production of nursing mothers. The Malaysian Journal of Nursing, 16(2), 46–53. https://doi.org/10.31674/mjn.2024.v16i02.005 Kartilah, T., & Februanti, S. (2024). Emotional Freedom Techniques and oxytocin stimulation massages that effectively reduce anxiety and increase smooth breast milk production of nursing mothers. The Malaysian Journal of Nursing, 16(2), 46–53. https://doi.org/10.31674/mjn.2024.v16i02.005 Khatib M. N. Gaidhane A. Upadhyay S. Telrandhe S. Saxena D. Simkhada P. P. Sawleshwarkar S. Quazi S. Z. Interventions for promoting and optimizing breastfeeding practices: An overview of systematic review Frontiers in Public Health 2023 11 984876 10.3389/fpubh.2023.984876 https://doi.org/10.3389/fpubh.2023.984876 Khatib, M. N., Gaidhane, A., Upadhyay, S., Telrandhe, S., Saxena, D., Simkhada, P. P., Sawleshwarkar, S., & Quazi, S. Z. (2023). Interventions for promoting and optimizing breastfeeding practices: An overview of systematic review. Frontiers in Public Health, 11, 984876. https://doi.org/10.3389/fpubh.2023.984876 Khatib, M. N., Gaidhane, A., Upadhyay, S., Telrandhe, S., Saxena, D., Simkhada, P. P., Sawleshwarkar, S., & Quazi, S. Z. (2023). Interventions for promoting and optimizing breastfeeding practices: An overview of systematic review. Frontiers in Public Health, 11, 984876. https://doi.org/10.3389/fpubh.2023.984876 Kılcı Erciyas Ş. Kavlak O. The effect of back and breast massage on the amount of milk and anxiety level of mothers with preterm birth: A randomized controlled study Journal of Neonatal Nursing 2024 30 3 251 257 10.1016/j.jnn.2023.10.003 https://doi.org/10.1016/j.jnn.2023.10.003 Kılcı Erciyas, Ş., & Kavlak, O. (2024). The effect of back and breast massage on the amount of milk and anxiety level of mothers with preterm birth: A randomized controlled study. Journal of Neonatal Nursing, 30(3), 251–257. https://doi.org/10.1016/j.jnn.2023.10.003 Kılcı Erciyas, Ş., & Kavlak, O. (2024). The effect of back and breast massage on the amount of milk and anxiety level of mothers with preterm birth: A randomized controlled study. Journal of Neonatal Nursing, 30(3), 251–257. https://doi.org/10.1016/j.jnn.2023.10.003 Knutson J. Butler J. Providing equitable postpartum breastfeeding support at an urban academic hospital Nursing for Women’s Health 2022 26 3 184 193 10.1016/j.nwh.2022.03.002 https://doi.org/10.1016/j.nwh.2022.03.002 Knutson, J., & Butler, J. (2022). Providing equitable postpartum breastfeeding support at an urban academic hospital. Nursing for Women’s Health, 26(3), 184–193. https://doi.org/10.1016/j.nwh.2022.03.002 Knutson, J., & Butler, J. (2022). Providing equitable postpartum breastfeeding support at an urban academic hospital. Nursing for Women’s Health, 26(3), 184–193. https://doi.org/10.1016/j.nwh.2022.03.002 Koca A. G. Yurdakul M. Impact of web-based lactation support on exclusive breastfeeding, maternal motivation and breastfeeding challenges: A randomized controlled trial BMC Pregnancy and Childbirth 2026 26 269 10.1186/s12884-026-08662-9 https://doi.org/10.1186/s12884-026-08662-9 Koca, A. G., & Yurdakul, M. (2026). Impact of web-based lactation support on exclusive breastfeeding, maternal motivation and breastfeeding challenges: A randomized controlled trial. BMC Pregnancy and Childbirth, 26, 269. https://doi.org/10.1186/s12884-026-08662-9 Koca, A. G., & Yurdakul, M. (2026). Impact of web-based lactation support on exclusive breastfeeding, maternal motivation and breastfeeding challenges: A randomized controlled trial. BMC Pregnancy and Childbirth, 26, 269. https://doi.org/10.1186/s12884-026-08662-9 Lestari P. Fatimah F. Ayuningrum L. Herawati H. D. Afifaturrohmah N. Effect of oxytocin massage in reducing lactation problems and supporting infant growth Open Access Macedonian Journal of Medical Sciences 2022 10 T8 81 85 10.3889/oamjms.2022.9487 https://doi.org/10.3889/oamjms.2022.9487 Lestari, P., Fatimah, F., Ayuningrum, L., Herawati, H. D., & Afifaturrohmah, N. (2022). Effect of oxytocin massage in reducing lactation problems and supporting infant growth. Open Access Macedonian Journal of Medical Sciences, 10(T8), 81–85. https://doi.org/10.3889/oamjms.2022.9487 Lestari, P., Fatimah, F., Ayuningrum, L., Herawati, H. D., & Afifaturrohmah, N. (2022). Effect of oxytocin massage in reducing lactation problems and supporting infant growth. Open Access Macedonian Journal of Medical Sciences, 10(T8), 81–85. https://doi.org/10.3889/oamjms.2022.9487 Levene I. Gardner H. Spiby H. Relaxation therapy and human milk feeding outcomes: A systematic review and meta-analysis Frontiers in Global Women’s Health 2024 5 110749 10.3389/fgwh.2024.110749 https://doi.org/10.3389/fgwh.2024.110749 Levene, I., Gardner, H., & Spiby, H. (2024). Relaxation therapy and human milk feeding outcomes: A systematic review and meta-analysis. Frontiers in Global Women’s Health, 5, 110749. https://doi.org/10.3389/fgwh.2024.110749 Levene, I., Gardner, H., & Spiby, H. (2024). Relaxation therapy and human milk feeding outcomes: A systematic review and meta-analysis. Frontiers in Global Women’s Health, 5, 110749. https://doi.org/10.3389/fgwh.2024.110749 Lojander J. Axelin A. Niela-Vilén H. Breastfeeding exclusivity, difficulties, and support in the first days after hospital discharge: A correlational study European Journal of Obstetrics & Gynecology and Reproductive Biology 2024 296 76 82 10.1016/j.ejogrb.2024.02.029 https://doi.org/10.1016/j.ejogrb.2024.02.029 Lojander, J., Axelin, A., & Niela-Vilén, H. (2024). Breastfeeding exclusivity, difficulties, and support in the first days after hospital discharge: A correlational study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 296, 76–82. https://doi.org/10.1016/j.ejogrb.2024.02.029 Lojander, J., Axelin, A., & Niela-Vilén, H. (2024). Breastfeeding exclusivity, difficulties, and support in the first days after hospital discharge: A correlational study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 296, 76–82. https://doi.org/10.1016/j.ejogrb.2024.02.029 Mollaahmetoglu Ş. E. Guvenc G. The effect of breast massage and warm compress application on milk production and anxiety in mothers with premature newborn: A randomized controlled trial Breastfeeding Medicine 2025 20 6 416 423 10.1089/bfm.2024.0382 https://doi.org/10.1089/bfm.2024.0382 Mollaahmetoglu, Ş. E., & Guvenc, G. (2025). The effect of breast massage and warm compress application on milk production and anxiety in mothers with premature newborn: A randomized controlled trial. Breastfeeding Medicine, 20(6), 416–423. https://doi.org/10.1089/bfm.2024.0382 Mollaahmetoglu, Ş. E., & Guvenc, G. (2025). The effect of breast massage and warm compress application on milk production and anxiety in mothers with premature newborn: A randomized controlled trial. Breastfeeding Medicine, 20(6), 416–423. https://doi.org/10.1089/bfm.2024.0382 Moriyama Y. Nakao Y. Yamamoto N. Oki T. Dysphoric milk ejection reflex among Japanese mothers: A self-administered survey International Breastfeeding Journal 2024 19 21 10.1186/s13006-024-00625-0 https://doi.org/10.1186/s13006-024-00625-0 Moriyama, Y., Nakao, Y., Yamamoto, N., & Oki, T. (2024). Dysphoric milk ejection reflex among Japanese mothers: A self-administered survey. International Breastfeeding Journal, 19, Article 21. https://doi.org/10.1186/s13006-024-00625-0 Moriyama, Y., Nakao, Y., Yamamoto, N., & Oki, T. (2024). Dysphoric milk ejection reflex among Japanese mothers: A self-administered survey. International Breastfeeding Journal, 19, Article 21. https://doi.org/10.1186/s13006-024-00625-0 Mullen A. J. O’Connor D. L. Hanley A. J. Piedimonte G. Wallace M. Ley S. H. Associations of metabolic and obstetric risk parameters with timing of lactogenesis II Nutrients 2022 14 4 876 10.3390/nu14040876 https://doi.org/10.3390/nu14040876 Mullen, A. J., O’Connor, D. L., Hanley, A. J., Piedimonte, G., Wallace, M., & Ley, S. H. (2022). Associations of metabolic and obstetric risk parameters with timing of lactogenesis II. Nutrients, 14(4), 876. https://doi.org/10.3390/nu14040876 Mullen, A. J., O’Connor, D. L., Hanley, A. J., Piedimonte, G., Wallace, M., & Ley, S. H. (2022). Associations of metabolic and obstetric risk parameters with timing of lactogenesis II. Nutrients, 14(4), 876. https://doi.org/10.3390/nu14040876 Munsittikul N. Tantaobharse S. Siripattanapipong P. Wutthigate P. Ngerncham S. Yangthara B. Integrated breast massage versus traditional breast massage for treatment of plugged milk duct in lactating women: A randomized controlled trial International Breastfeeding Journal 2022 17 43 10.1186/s13006-022-00485-6 https://doi.org/10.1186/s13006-022-00485-6 Munsittikul, N., Tantaobharse, S., Siripattanapipong, P., Wutthigate, P., Ngerncham, S., & Yangthara, B. (2022). Integrated breast massage versus traditional breast massage for treatment of plugged milk duct in lactating women: A randomized controlled trial. International Breastfeeding Journal, 17, Article 43. https://doi.org/10.1186/s13006-022-00485-6 Munsittikul, N., Tantaobharse, S., Siripattanapipong, P., Wutthigate, P., Ngerncham, S., & Yangthara, B. (2022). Integrated breast massage versus traditional breast massage for treatment of plugged milk duct in lactating women: A randomized controlled trial. International Breastfeeding Journal, 17, Article 43. https://doi.org/10.1186/s13006-022-00485-6 Nagel E. M. Howland M. A. Pando C. Stang J. Mason S. M. Fields D. A. Demerath E. W. Maternal psychological distress and lactation and breastfeeding outcomes: A narrative review Clinical Therapeutics 2022 44 2 215 227 10.1016/j.clinthera.2021.11.007 https://doi.org/10.1016/j.clinthera.2021.11.007 Nagel, E. M., Howland, M. A., Pando, C., Stang, J., Mason, S. M., Fields, D. A., & Demerath, E. W. (2022). Maternal psychological distress and lactation and breastfeeding outcomes: A narrative review. Clinical Therapeutics, 44(2), 215–227. https://doi.org/10.1016/j.clinthera.2021.11.007 Nagel, E. M., Howland, M. A., Pando, C., Stang, J., Mason, S. M., Fields, D. A., & Demerath, E. W. (2022). Maternal psychological distress and lactation and breastfeeding outcomes: A narrative review. Clinical Therapeutics, 44(2), 215–227. https://doi.org/10.1016/j.clinthera.2021.11.007 Pados B. F. Camp L. Physiology of human lactation and strategies to support milk supply for breastfeeding Nursing for Women’s Health 2024 28 4 303 314 10.1016/j.nwh.2024.01.007 https://doi.org/10.1016/j.nwh.2024.01.007 Pados, B. F., & Camp, L. (2024). Physiology of human lactation and strategies to support milk supply for breastfeeding. Nursing for Women’s Health, 28(4), 303–314. https://doi.org/10.1016/j.nwh.2024.01.007 Pados, B. F., & Camp, L. (2024). Physiology of human lactation and strategies to support milk supply for breastfeeding. Nursing for Women’s Health, 28(4), 303–314. https://doi.org/10.1016/j.nwh.2024.01.007 Patnode C. D. Henninger M. L. Senger C. A. Perdue L. A. Whitlock E. P. Chou R. Interventions to support breastfeeding: Updated evidence report and systematic review for the U.S Preventive Services Task Force. JAMA 2025 333 13 1143 1154 10.1001/jama.2024.27267 https://doi.org/10.1001/jama.2024.27267 Patnode, C. D., Henninger, M. L., Senger, C. A., Perdue, L. A., Whitlock, E. P., & Chou, R. (2025). Interventions to support breastfeeding: Updated evidence report and systematic review for the U.S. Preventive Services Task Force. JAMA, 333(13), 1143–1154. https://doi.org/10.1001/jama.2024.27267 Patnode, C. D., Henninger, M. L., Senger, C. A., Perdue, L. A., Whitlock, E. P., & Chou, R. (2025). Interventions to support breastfeeding: Updated evidence report and systematic review for the U.S. Preventive Services Task Force. JAMA, 333(13), 1143–1154. https://doi.org/10.1001/jama.2024.27267 Peng Y. Zhuang K. Huang Y. Incidence and factors influencing delayed onset of lactation: A systematic review and meta-analysis International Breastfeeding Journal 2024 19 59 10.1186/s13006-024-00666-5 https://doi.org/10.1186/s13006-024-00666-5 Peng, Y., Zhuang, K., & Huang, Y. (2024). Incidence and factors influencing delayed onset of lactation: A systematic review and meta-analysis. International Breastfeeding Journal, 19, 59. https://doi.org/10.1186/s13006-024-00666-5 Peng, Y., Zhuang, K., & Huang, Y. (2024). Incidence and factors influencing delayed onset of lactation: A systematic review and meta-analysis. International Breastfeeding Journal, 19, 59. https://doi.org/10.1186/s13006-024-00666-5 Pérez-Escamilla R. Tomori C. Breastfeeding: Crucially important, but increasingly challenged in a market-driven world The Lancet 2023 401 10375 472 485 10.1016/S0140-6736(22)01932-8 https://doi.org/10.1016/S0140-6736(22)01932-8 Pérez-Escamilla, R., Tomori, C., Hernández-Cordero, S., et al. (2023). Breastfeeding: Crucially important, but increasingly challenged in a market-driven world. The Lancet, 401(10375), 472–485. https://doi.org/10.1016/S0140-6736(22)01932-8 Pérez-Escamilla, R., Tomori, C., Hernández-Cordero, S., et al. (2023). Breastfeeding: Crucially important, but increasingly challenged in a market-driven world. The Lancet, 401(10375), 472–485. https://doi.org/10.1016/S0140-6736(22)01932-8 Rios-Leyvraz M. Yao Q. The volume of breast milk intake in infants and young children: A systematic review and meta-analysis Breastfeeding Medicine 2023 18 3 188 197 10.1089/bfm.2022.0281 https://doi.org/10.1089/bfm.2022.0281 Rios-Leyvraz, M., & Yao, Q. (2023). The volume of breast milk intake in infants and young children: A systematic review and meta-analysis. Breastfeeding Medicine, 18(3), 188–197. https://doi.org/10.1089/bfm.2022.0281 Rios-Leyvraz, M., & Yao, Q. (2023). The volume of breast milk intake in infants and young children: A systematic review and meta-analysis. Breastfeeding Medicine, 18(3), 188–197. https://doi.org/10.1089/bfm.2022.0281 Rodríguez-Gallego I. Corrales-Gutierrez I. Gomez-Baya D. Leon-Larios F. Effectiveness of a postpartum breastfeeding support group intervention in promoting exclusive breastfeeding and perceived self-efficacy: A multicentre randomized clinical trial Nutrients 2024 16 7 988 10.3390/nu16070988 https://doi.org/10.3390/nu16070988 Rodríguez-Gallego, I., Corrales-Gutierrez, I., Gomez-Baya, D., & Leon-Larios, F. (2024). Effectiveness of a postpartum breastfeeding support group intervention in promoting exclusive breastfeeding and perceived self-efficacy: A multicentre randomized clinical trial. Nutrients, 16(7), 988. https://doi.org/10.3390/nu16070988 Rodríguez-Gallego, I., Corrales-Gutierrez, I., Gomez-Baya, D., & Leon-Larios, F. (2024). Effectiveness of a postpartum breastfeeding support group intervention in promoting exclusive breastfeeding and perceived self-efficacy: A multicentre randomized clinical trial. Nutrients, 16(7), 988. https://doi.org/10.3390/nu16070988 Saehoong S. Pookboonmee R. Daramas T. Chansatitporn N. Nuntnarumit P. Effects of an early breastfeeding education and proactive telephone support program for mothers of preterm infants: A quasi-experimental study Pacific Rim International Journal of Nursing Research 2024 28 3 548 562 10.60099/prijnr.2024.268608 https://doi.org/10.60099/prijnr.2024.268608 Saehoong, S., Pookboonmee, R., Daramas, T., Chansatitporn, N., & Nuntnarumit, P. (2024). Effects of an early breastfeeding education and proactive telephone support program for mothers of preterm infants: A quasi-experimental study. Pacific Rim International Journal of Nursing Research, 28(3), 548–562. https://doi.org/10.60099/prijnr.2024.268608 Saehoong, S., Pookboonmee, R., Daramas, T., Chansatitporn, N., & Nuntnarumit, P. (2024). Effects of an early breastfeeding education and proactive telephone support program for mothers of preterm infants: A quasi-experimental study. Pacific Rim International Journal of Nursing Research, 28(3), 548–562. https://doi.org/10.60099/prijnr.2024.268608 Şimşek-Çetinkaya Ş. Gümüş Çaliş G. Kibris Ş. Effect of breastfeeding education program and nurse-led breastfeeding online counseling system (BMUM) for mothers: A randomized controlled study Journal of Human Lactation 2024 40 1 101 112 10.1177/08903344231210813 https://doi.org/10.1177/08903344231210813 Şimşek-Çetinkaya, Ş., Gümüş Çaliş, G., & Kibris, Ş. (2024). Effect of breastfeeding education program and nurse-led breastfeeding online counseling system (BMUM) for mothers: A randomized controlled study. Journal of Human Lactation, 40(1), 101–112. https://doi.org/10.1177/08903344231210813 Şimşek-Çetinkaya, Ş., Gümüş Çaliş, G., & Kibris, Ş. (2024). Effect of breastfeeding education program and nurse-led breastfeeding online counseling system (BMUM) for mothers: A randomized controlled study. Journal of Human Lactation, 40(1), 101–112. https://doi.org/10.1177/08903344231210813 Sweet L. Vasilevski V. Evaluation of a new lactation device “Lactamo” designed to apply massage, heat or cold, and compression to the breast International Breastfeeding Journal 2022 17 23 10.1186/s13006-022-00466-9 https://doi.org/10.1186/s13006-022-00466-9 Sweet, L., & Vasilevski, V. (2022). Evaluation of a new lactation device “Lactamo” designed to apply massage, heat or cold, and compression to the breast. International Breastfeeding Journal, 17, Article 23. https://doi.org/10.1186/s13006-022-00466-9 Sweet, L., & Vasilevski, V. (2022). Evaluation of a new lactation device “Lactamo” designed to apply massage, heat or cold, and compression to the breast. International Breastfeeding Journal, 17, Article 23. https://doi.org/10.1186/s13006-022-00466-9 Titaley C. R. Dibley M. J. Ariawan I. Mu’asyaroh A. The impact of a package of behaviour change interventions on breastfeeding practices in East Java Province, Indonesia Maternal & Child Nutrition 2022 18 4 e13362 10.1111/mcn.13362 https://doi.org/10.1111/mcn.13362 Titaley, C. R., Dibley, M. J., Ariawan, I., Mu’asyaroh, A., & the BADUTA Study Team. (2022). The impact of a package of behaviour change interventions on breastfeeding practices in East Java Province, Indonesia. Maternal & Child Nutrition, 18(4), e13362. https://doi.org/10.1111/mcn.13362 Titaley, C. R., Dibley, M. J., Ariawan, I., Mu’asyaroh, A., & the BADUTA Study Team. (2022). The impact of a package of behaviour change interventions on breastfeeding practices in East Java Province, Indonesia. Maternal & Child Nutrition, 18(4), e13362. https://doi.org/10.1111/mcn.13362 Wang T. Shang M. Chow K. M. Effects of breastfeeding training programmes for midwives on breastfeeding outcomes: A systematic review and meta-analysis BMC Pregnancy and Childbirth 2023 23 262 10.1186/s12884-023-05540-6 https://doi.org/10.1186/s12884-023-05540-6 Wang, T., Shang, M., & Chow, K. M. (2023). Effects of breastfeeding training programmes for midwives on breastfeeding outcomes: A systematic review and meta-analysis. BMC Pregnancy and Childbirth, 23, Article 262. https://doi.org/10.1186/s12884-023-05540-6 Wang, T., Shang, M., & Chow, K. M. (2023). Effects of breastfeeding training programmes for midwives on breastfeeding outcomes: A systematic review and meta-analysis. BMC Pregnancy and Childbirth, 23, Article 262. https://doi.org/10.1186/s12884-023-05540-6