Relationship Between the Severity of Sleep Deprivation in the First 48 Hours Postpartum, Breastfeeding Motivation, and Breastfeeding Success

The postpartum period is a critical time marked by significant physiological and psychosocial changes that can affect sleep, emotional well-being, and breastfeeding behaviors. Previous studies indicate that mode of delivery and sleep quality are closely associated with breastfeeding outcomes, with cesarean birth often linked to poorer sleep and lower breastfeeding success. Evidence also suggests that postpartum sleep disturbances are related to reduced breastfeeding self-efficacy, lower motivation, fatigue, depressive symptoms, and shorter breastfeeding duration.

However, the literature lacks studies that evaluate insomnia severity, breastfeeding motivation, and breastfeeding success simultaneously-particularly during the first 48 hours after birth. This analytical study aims to assess insomnia severity, breastfeeding motivation, and breastfeeding success (LATCH) within the first 48 postpartum hours and to examine the relationships among these variables. Findings are expected to support early postpartum clinical interventions to improve maternal and infant health outcomes.

Study Overview

• Status: Recruiting
• Conditions: Sleep; Cesarean Section; Motivation; Lactation; Breastfeeding; Postpartum Period

• Study Type: Observational
• Enrollment (Estimated): 167

Contacts and Locations

• Study Contact: Name: Güzin Ünlü Suvari, M.Sc.; Phone Number: +902165004429; Email: guzin.unlu@acibadem.edu.tr

Study Locations

• Turkey (Türkiye)
  • Altunizade
    • Istanbul, Altunizade, Turkey (Türkiye)
      • Recruiting
      • Acibadem Health Group
      • Principal Investigator: Merve Coşkun, Ph.D.
      • Contact: Güzin Ünlü Suvari, M.Sc.; Phone Number: 2165004429 +90; Email: guzinnunlu@gmail.com
      • Principal Investigator: Şevval Çilekci, B.Sc.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

The study population will consist of primiparous and multiparous women aged ≥18 years who have delivered a healthy term infant, whose newborn is not admitted to the NICU, and who initiated breastfeeding within the first 48 hours postpartum.

Description

Inclusion Criteria:

• Primiparous or multiparous women aged 18 years and older
• Having a healthy term delivery
• Infant not admitted to the neonatal intensive care unit (NICU)
• Initiated breastfeeding within the first 48 hours postpartum

Exclusion Criteria:

• Complications requiring sedation
• Severe postpartum hemorrhage
• Severe postoperative pain or need for narcotic analgesics

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Breastfeeding Success (LATCH Score)	Breastfeeding success will be assessed using the LATCH Breastfeeding Assessment Tool, which evaluates five domains: latch, audible swallowing, type of nipple, maternal comfort (breast/nipple), and holding/positioning. Each item is scored from 0 to 2, with a total score ranging from 0 to 10. Higher scores indicate greater breastfeeding success.	Within the first 48 hours postpartum (one-time assessment at enrollment)
Insomnia Severity (Insomnia Severity Index, ISI)	Insomnia severity will be measured using the Insomnia Severity Index (ISI), a 7-item self-report questionnaire assessing difficulty initiating sleep, difficulty maintaining sleep, early morning awakening, satisfaction with sleep, interference with daytime functioning, noticeability of impairment, and distress caused by sleep problems. Each item is scored from 0 to 4, yielding a total score of 0-28. Higher scores indicate more severe insomnia.	Within the first 48 hours postpartum (one-time assessment at enrollment)
Breastfeeding Motivation (Breastfeeding Motivation Scale Subscale Scores)	Breastfeeding motivation will be evaluated using the Breastfeeding Motivation Scale based on Self-Determination Theory. The scale includes 24 items rated on a 4-point Likert scale and provides scores for five subdomains: integrated regulation, intrinsic motivation/identified regulation, introjected regulation (social approval), introjected regulation (social pressure), and external regulation (secondary benefits). Subscale scores are calculated as the mean of items within each subdomain; higher scores indicate stronger motivation of that type.	Within the first 48 hours postpartum (one-time assessment at enrollment)
Maternal and Neonatal Characteristics (Descriptive Data Form)	Participant demographic, obstetric, delivery-related, neonatal, breastfeeding history, breastfeeding-related characteristics, and sleep habit information will be collected using a structured descriptive information form developed by the researchers based on the literature.	Within the first 48 hours postpartum (one-time assessment at enrollment)

Collaborators and Investigators

• Sponsor: Acibadem University

Publications and helpful links

General Publications

• Altıparmak, S., & Yılmaz, A. N. (2021). The effect of birth type on breastfeeding success and insomnia severity in puerperant women. Samsun Sağlık Bilimleri Dergisi, 6(1), 119-127.
• Witkowska-Zimny, M., Zhyvotovska, A., Isakov, R., Boiko, D. I., & Nieradko-Iwanicka, B. (2024). Maternal sleeping problems before and after childbirth-A systematic review. International journal of women's health, 345-371.
• Khadka, R., Hong, S. A., & Chang, Y. S. (2020). Prevalence and determinants of poor sleep quality and depression among postpartum women: a community-based study in Ramechhap district, Nepal. International health, 12(2), 125-131. https://doi.org/10.1093/inthealth/ihz032
• Jensen, D., Wallace, S., & Kelsay, P. (1994). LATCH: a breastfeeding charting system and documentation tool. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 23(1), 27-32.
• Boysan, M., Güleç, M., Besiroglu, L., & Kalafat, T. (2010). Uykusuzluk Siddeti Indeksi'nin Türk örneklemindeki psikometrik özellikleri. Anadolu Psikiyatri Dergisi, 11(3), 248.
• Kestler-Peleg, M., Shamir-Dardikman, M., Hermoni, D., & Ginzburg, K. (2015). Breastfeeding motivation and Self-Determination Theory. Social Science & Medicine, 144, 19-27. doi:10.1016/j.socscimed.2015.09.006
• Ruan, H., Zhang, Y., Tang, Q., Zhao, X., Zhao, X., Xiang, Y., Geng, W., Feng, Y., & Cai, W. (2022). Sleep duration of lactating mothers and its relationship with feeding pattern, milk macronutrients and related serum factors: A combined longitudinal cohort and cross-sectional study. Frontiers in nutrition, 9, 973291. https://doi.org/10.3389/fnut.2022.973291
• Kayahan, C., & Ozturk, C. S. (2025). Antenatal and postnatal breastfeeding motivation and self-efficacy in primiparous women: a prospective observational study. European Journal of Pediatrics, 184(10), 631.

Study record dates

Study Major Dates

• Study Start (Actual): March 12, 2026
• Primary Completion (Estimated): February 23, 2027
• Study Completion (Estimated): February 23, 2027

Study Registration Dates

• First Submitted: February 10, 2026
• First Submitted That Met QC Criteria: February 10, 2026
• First Posted (Actual): February 17, 2026

Study Record Updates

• Last Update Posted (Actual): March 24, 2026
• Last Update Submitted That Met QC Criteria: March 23, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavior; Feeding Behavior; Breast Feeding
• Other Study ID Numbers: 2025-20-750

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data (IPD) will not be publicly shared due to privacy concerns and the sensitive nature of maternal and infant health information. However, anonymized data may be made available upon reasonable request to the corresponding author after publication of the study results.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No