Effect of the Marmet Technique on Breastfeeding Problems and Breastfeeding Self-Efficacy in Postpartum Women (MARMET-BSE)

The Effect of Breast Massage Using the Marmet Technique on Breastfeeding Problems and Breastfeeding Self-Efficacy

This randomized controlled study aims to evaluate the effect of breast massage using the Marmet technique on breastfeeding problems and breastfeeding self-efficacy in postpartum women. Breastfeeding difficulties such as nipple pain, latch problems, and perceived insufficient milk are common in the early postpartum period and may lead to early cessation of breastfeeding. The Marmet technique is a manual breast massage method designed to stimulate milk flow and relieve mechanical difficulties during breastfeeding.

In this study, postpartum women were randomly assigned to either an intervention group receiving Marmet technique training and application or a control group receiving routine breastfeeding care. Outcomes were assessed at 24 hours and on the 15th postpartum day using validated scales. The findings are expected to contribute to improving breastfeeding support practices and maternal confidence in breastfeeding.

Study Overview

• Status: Completed
• Conditions: Breastfeeding Self-Efficacy; Breastfeeding Problems Assessment
• Intervention / Treatment: Behavioral: Marmet Breast Massage Technique

Detailed Description

Breastfeeding is essential for optimal infant growth and maternal health; however, many women experience physical and psychological challenges during the early postpartum period. Common breastfeeding problems include nipple pain, breast engorgement, latch difficulties, and concerns about insufficient milk supply. These challenges may negatively affect breastfeeding continuation and maternal confidence.

Breastfeeding self-efficacy, defined as a mother's confidence in her ability to breastfeed successfully, is a key determinant of breastfeeding duration and success. Interventions that address both physical and psychosocial aspects of breastfeeding are therefore critically important.

The Marmet technique is a manual breast massage and expression method that supports milk ejection reflex, improves milk flow, and helps relieve blocked ducts without requiring equipment. It may also enhance maternal autonomy and confidence in breastfeeding management.

This study was designed as a randomized controlled, longitudinal trial conducted in a hospital setting. A total of 104 postpartum women were randomly assigned to intervention and control groups. The intervention group received individualized training and application of the Marmet technique in the early postpartum period, while the control group received routine breastfeeding care.

Data were collected at postpartum 24 hours and day 15 using a Breastfeeding Self-Efficacy Scale and a Breastfeeding Problems Assessment Scale. The primary aim was to evaluate the effect of the Marmet technique on breastfeeding problems and self-efficacy levels over time. The study also explored factors influencing breastfeeding self-efficacy in the postpartum period.

• Study Type: Interventional
• Enrollment (Actual): 104
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Istanbul, Turkey (Türkiye)
    • Istanbul Medipol University Hospital

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Women aged 18 to 49 years
• Able to read and write in Turkish
• Voluntary agreement to participate in the study
• Delivered a healthy full-term infant
• Had a spontaneous vaginal birth
• Actively breastfeeding during the postpartum period

Exclusion Criteria:

• Presence of a clinically serious breastfeeding problem in the mother or infant during the early postpartum period
• Transfer of the mother or infant to another center before completion of the first data collection stage
• Inability to complete follow-up assessment on postpartum day 15 or refusal to participate in the follow-up interview
• For participants assigned to the intervention group, inability to complete the Marmet technique training at postpartum 6 hours or failure to respond to the follow-up call on postpartum day 7
• Meaningful missing or incomplete data in study forms or scales
• Withdrawal from the study at any point during the 15-day follow-up period
• Development of any unexpected maternal or neonatal health condition requiring discontinuation of breastfeeding, such as intensive care need, serious maternal infection, or infant pathology preventing sucking

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 1. Arm; Participants receive Marmet breast massage technique training and application in addition to routine breastfeeding care.	Behavioral: Marmet Breast Massage Technique; The Marmet Technique is a manual breast massage and milk expression method taught to postpartum women to support effective breastfeeding. The technique includes specific hand positioning (C-hold), rhythmic compression, rolling movements, and breast stimulation to facilitate the milk ejection reflex and improve milk flow. In this study, participants in the intervention group received individualized training on the Marmet Technique at approximately 6 hours postpartum. The application was demonstrated and practiced under supervision, and participants were instructed to perform the technique regularly for approximately 20-30 minutes on both breasts. Follow-up support was provided via telephone on postpartum day 7 to reinforce correct technique and adherence. The intervention aims to reduce mechanical breastfeeding difficulties, improve milk flow, and enhance maternal breastfeeding self-efficacy.
No Intervention: 2. Arm; Participants receive routine breastfeeding care and standard education without Marmet technique.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Breastfeeding Self-Efficacy	Assessed using the Breastfeeding Self-Efficacy Scale (short form).	24 hours postpartum and 15 days postpartum

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Breastfeeding Problems	Assessed using the Breastfeeding Problems Assessment Scale, including mechanical, process-related, milk insufficiency, breast-related, and social concerns.	24 hours postpartum and 15 days postpartum

Collaborators and Investigators

• Sponsor: Medipol University

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2024
• Primary Completion (Actual): October 1, 2024
• Study Completion (Actual): October 1, 2024

Study Registration Dates

• First Submitted: April 7, 2026
• First Submitted That Met QC Criteria: April 7, 2026
• First Posted (Actual): April 14, 2026

Study Record Updates

• Last Update Posted (Actual): April 14, 2026
• Last Update Submitted That Met QC Criteria: April 7, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Breastfeeding; Midwifery; Breastfeeding Self-Efficacy; Postpartum Women; Breastfeeding Problems; Marmet Technique
• Additional Relevant MeSH Terms: Behavior; Feeding Behavior; Breast Feeding
• Other Study ID Numbers: E-10840098-202.3.02-1630

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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