Effect of the <i>Ing Oun</i> pillow for supporting baby's back in a side-lying position to promote breastfeeding: A proof-of-concept randomized controlled trial in Thailand.

Abstract

Despite the World Health Organization's recommendation for exclusive breastfeeding, Thailand's rate was only 14% in 2019. Many new mothers experience discomfort and lack confidence during breastfeeding. The novel <i>Ing Oun</i> breastfeeding pillow was developed to support breastfeeding in the side-lying position. This study compared breastfeeding effectiveness between the <i>Ing Oun</i> pillow and the normal side-lying position and evaluated maternal satisfaction. A proof-of-concept randomized controlled trial was conducted in a postpartum unit in Thailand. Ninety-two first-time mothers with vaginal births were randomly assigned to either the <i>Ing Oun</i> breastfeeding pillow in the side-lying position (intervention) or the normal side-lying position (control). Breastfeeding effectiveness was assessed by nurse-midwives and mothers based on infant positioning and attachment. Maternal satisfaction with the pillow was measured using a self-report questionnaire. Compared with the control group, mothers using the <i>Ing Oun</i> breastfeeding pillow demonstrated significant improvements in breastfeeding effectiveness, including reduced nipple pain during suckling [median=3 (IQR: 2-4) vs 3 (IQR: 1-4), p&lt;0.001], observing more areola above the infant's top lip [median=4 (IQR: 3-4) vs 3 (IQR:1-4), p&lt;0.001], and improved support for continued suckling [median=4 (IQR: 2-4) vs 3 (IQR: 1-4), p&lt;0.05]. Mothers in the intervention group reported high levels of satisfaction with the pillow, with 65.2% expressing confidence in breastfeeding. The <i>Ing Oun</i> breastfeeding pillow shows potential as a breastfeeding support aid; however, further research is needed to refine its design and evaluate broader applicability.<b>CLINICAL TRIAL REGISTRATION:</b> The study is registered on the official website of Thai Clinical Trials Registry.<b>IDENTIFIER:</b> TCTR20241016002.