The Effect Of Postpartum Therapeutıc Touch On Breastfeedıng Self-Effıcacy, Maternal Attachment, And Postpartum Depressıon In Prımıparous Women: A Randomızed Controlled Study

The postpartum period, also known as the fourth trimester, begins with the birth of the baby and lasts approximately 6-8 weeks, varying from person to person. This period is when the physiological changes caused by pregnancy return to the mother's pre-pregnancy state. However, this period has critical effects on the health of both the mother and the baby (Çevik and Avcıbay Vurgeç, 2022). The mother is burdened with many responsibilities in the postpartum period. Some of these include providing care, especially feeding the baby, communicating with the baby, and establishing a bond of trust (Taşkın, 2016). During this period, the mother's breastfeeding self-efficacy, maternal bonding, and psychological state have long-term consequences not only on individual health but also on public health (Irmak, 2016; Erdoğan and Hocaoğlu, 2020; Çimen and Varol, 2021). The mother's immediate initiation and continuation of breastfeeding after birth positively affects mother-baby bonding and reduces the risk of developing postpartum depression (Irmak, 2016). Breastfeeding success is directly linked to the mother's breastfeeding self-efficacy (Turfan et al., 2018).

Breastfeeding self-efficacy refers to the mother's self-confidence regarding the breastfeeding process, her ability to cope with the challenges she encounters in this process, and her willingness to breastfeed (Turan and Bozkurt, 2020). The literature indicates that mothers with high breastfeeding self-efficacy breastfeed for longer periods and more successfully (Lau et al., 2018). It is also known that mothers with high breastfeeding self-efficacy have more positive relationships with their babies. This is another important factor affecting maternal bonding (Gibbs et al., 2018).

Maternal bonding describes the warm, continuous, and close relationship that the mother establishes with her baby. This bonding is a process that begins during the mother's pregnancy and intensifies in the postpartum period (Hoca Nacar and Gökkaya, 2019). Maternal bonding is a critical element that supports the baby's physical, social, and psychological development (Kınık and Özcan, 2020). Early contact between mothers and their babies in the postpartum period and adaptation to the maternal role strengthens this bond. However, psychological problems such as postpartum blues or postpartum depression can negatively affect the maternal bonding process (Nakić Radoš, 2021).

Postpartum depression is a condition that emerges in the first weeks after birth and is usually characterized by a depressed mood, apathy, feelings of inadequacy, and hopelessness (Sharma and Mazmanian, 2014). Depression experienced by the mother during this period can disrupt the breastfeeding process, weaken maternal bonding, and therefore negatively affect the physical and emotional development of the baby (Oskay and Avcı, 2020).

Therapeutic touch is an evidence-based complementary treatment method aimed at restoring a person's energy balance (Therapeutic Touch International Association, 2020). The literature indicates that therapeutic touch has positive effects on postpartum pain and anxiety, providing psychological relief to the mother and supporting better adaptation to the breastfeeding process (Ertekin Pınar and Demirel, 2021). Furthermore, studies have shown that therapeutic touch applications increase breastfeeding self-efficacy in mothers and positively affect milk production (Fischer and Johnson, 1999).

This study will make significant contributions to the literature by examining the effects of therapeutic touch on breastfeeding self-efficacy, maternal bonding, and postpartum depression in the postpartum period. Demonstrating the effectiveness of therapeutic touch can encourage healthcare professionals to use this method more widely. The results may shed light on the development of supportive care models for mothers in the postpartum period. Additionally, this study will lead to a better understanding of the relationships between breastfeeding self-efficacy, maternal bonding, and postpartum depression.

Study Overview

• Status: Active, not recruiting
• Conditions: Breastfeeding Self-efficacy; Maternal Attachment
• Intervention / Treatment: Other: therapeutic touch; Behavioral: terapötik dokunma

Detailed Description

Pregnancy, childbirth, and the postpartum period are critical processes that shape the health of both mother and baby, marked by biological, psychological, and social changes. The postpartum period, in particular, is crucial for the mother's physiological return to pre-pregnancy state and for strengthening the mother-baby bond. During this period, the mother's breastfeeding self-efficacy, level of maternal bonding, and psychological health have long-term effects not only on individual health but also on public health (Erdoğan and Hocaoğlu, 2020; Çevik and Avcıbay Vurgeç, 2022).

Breastfeeding is the most suitable method of nutrition for all babies and is considered the gold standard (Oddy, 2017). The milk of every living creature is unique to its offspring and is an unparalleled source of nutrition. Breast milk meets all the needs of babies for the first six months. Breastfeeding affects the health of the mother and society as well as the baby. It is recommended that babies receive only breast milk for the first six months and that breastfeeding continue with complementary foods until the age of two (Irmak, 2016). Breastfeeding can be influenced by factors such as the mother's physiological characteristics, social conditions, the presence of social support systems received after birth, the desire to breastfeed, and the baby's characteristics (Mahmood et al., 2011). Another factor affecting breastfeeding is the mother's breastfeeding self-efficacy (Lau et al., 2018). Breastfeeding self-efficacy is the ability to anticipate the mother's desire to breastfeed, the positive or negative nature of her thoughts during the breastfeeding process, and how she can cope with problems she experiences during breastfeeding. Breastfeeding self-efficacy is also a concept that can be influenced by various factors. These factors include the mother's breastfeeding experiences, events she has observed in others, the support she receives from her social environment, and the mother's age, type of delivery, occupation, and psychological state (Aluş Tokat et al., 2010; Ngo et al., 2019).

Some individuals may be negatively affected psychologically during the postpartum period. A mother's unpreparedness for the role of parenthood, certain difficulties experienced after the baby is born, lack of social support systems, insufficient spousal support, unwanted pregnancy, and problems experienced during the birthing process can all lead to mental health disorders. The most common psychological problems encountered in the postpartum period are postpartum depression, maternal sadness, and psychosis (Oskay and Avcı, 2020; Türkmen et al., 2021). Postpartum depression is generally described as a psychological distress in mothers during the postpartum period, characterized by a depressed mood, decreased interest, sadness, feelings of worthlessness, and hopelessness. According to the APA DSM-5, postpartum depression is defined as major depression that begins peripartum and occurs within 4 weeks postpartum, while the other diagnostic system, ICD-10, states that postpartum depression can occur within 6 weeks postpartum (Erdoğan and Hocaoğlu, 2020). Psychological disorders, especially postpartum depression, also affect maternal bonding (Nakić Radoš, 2021).

Maternal attachment describes the warm, continuous, and close relationship that develops between mother and baby. It is a unique process in which mother-baby love develops (Kınık and Özcan, 2020). Maternal attachment begins to form from the moment pregnancy is learned and is a long process. The mother's acceptance and adoption of the baby during pregnancy positively contributes to this attachment process. The postpartum period is a time when mother-baby bonding is experienced more intensely. Early contact between mother and baby during this period, and mothers' quick adaptation to their maternal role, improves the quality of parenting. Maternal attachment supports the baby's physical, social, and psychological development (Hoca Nacar and Gökkaya, 2019).

As can be seen, issues such as breastfeeding self-efficacy, maternal attachment, and postpartum depression in the postpartum period affect the health of both mother and baby, and consequently, the health of society. There are some practices that are effective in improving these processes. Education, social support, and some complementary alternative therapy methods are some of them (Pekcan and Yılmaz, 2021; Uçakcı and Sözbir, 2023).

Therapeutic touch is an evidence-based, non-pharmacological, complementary treatment method that uses universal energy to help individuals regain balance and health by regulating imbalanced energy fields or resolving blockages in energy transmission (TTIA, 2020). Therapeutic touch can be used at every stage of a woman's life. Many studies have shown beneficial results in its application during pregnancy, childbirth, and the postpartum period (Peters, 1999). For example, a study examining the effect of therapeutic touch on pain and anxiety during childbirth in women who had vaginal deliveries reported that women who received therapeutic touch experienced less pain and anxiety during labor, thus having a more positive effect on childbirth (Ertekin Pınar and Demirel, 2021). Another study...

• Study Type: Interventional
• Enrollment (Actual): 72
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Merkez
    • Karaman, Merkez, Turkey (Türkiye), 70100
      • Karaman Training and Research Hospital

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

Mothers who volunteer to participate in the study must meet the following criteria:

• Be 18 years of age or older,
• Reside in the city center,
• Have completed primary education or higher,
• Be able to speak, understand, and write Turkish,
• Have given birth for the first time,
• Have a healthy baby.

Exclusion Criteria:

• Mothers or babies with conditions that prevent breastfeeding (e.g., baby being in neonatal intensive care, mother taking medication that prevents breastfeeding, etc.),
• Mothers who have attended any prenatal childbirth preparation classes,
• Mothers with chronic and/or psychiatric health problems (based on self-report and clinical diagnosis)

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
No Intervention: kontrol grubu; No intervention was made on the control group.
Experimental: intervention; therapeutic touch	Other: therapeutic touch; Therapeutic touch (TT) is based on the existence of the bioenergy field in humans and is defined as energy healing. It is a practice that aims to improve the flow of human biofield energy by removing blockages in one's 'biofield'; Behavioral: terapötik dokunma; Terapötik dokunma, fiziksel ve ruhsal iyileşmeyi desteklemek amacıyla uygulanan enerji temelli bir tekniktir.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
breastfeeding self-efficacy	The concept of breastfeeding self-efficacy refers to a mother's belief in her ability to successfully initiate and maintain breastfeeding.	1-2 month

Collaborators and Investigators

• Sponsor: Necmettin Erbakan University

Study record dates

Study Major Dates

• Study Start (Actual): September 29, 2025
• Primary Completion (Estimated): July 15, 2026
• Study Completion (Estimated): July 20, 2026

Study Registration Dates

• First Submitted: June 13, 2026
• First Submitted That Met QC Criteria: July 3, 2026
• First Posted (Actual): July 9, 2026

Study Record Updates

• Last Update Posted (Actual): July 9, 2026
• Last Update Submitted That Met QC Criteria: July 3, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: postpartum depression; maternal attachment; breastfeeding self-efficacy; therapeutic touch
• Additional Relevant MeSH Terms: Urogenital Diseases; Mental Disorders; Female Urogenital Diseases and Pregnancy Complications; Pregnancy Complications; Mood Disorders; Puerperal Disorders; Depressive Disorder; Depression, Postpartum; Therapeutics; Mind-Body Therapies; Complementary Therapies; Spiritual Therapies; Therapeutic Touch
• Other Study ID Numbers: necmettin erbakan üniversitesi

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: We asked patients to keep their full names and other personal information confidential in the survey.

Drug and device information, study documents

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