Food is Medicine (FIM) interventions, which connect health-supporting food programs with healthcare systems, demonstrate substantial clinical and economic benefits. However, few FIM studies have focused on the health of postpartum mothers, a population facing unique vulnerabilities during a critical period. Food is the Best Medicine (FBM) is an 8-week, home-delivery-based FIM intervention targeting postpartum mothers experiencing food insecurity. Developed through partnerships between healthcare providers and community-based organizations, the FBM intervention integrates food delivery with supportive services. Here, we describe the research design and present baseline findings of a study evaluating the impacts of supplementing the FBM intervention with different sustainability-enhancing modalities. The Food is the Best Medicine (FBM) study was a three-arm randomized controlled trial conducted in Central Texas. Food-insecure postpartum mothers (n = 150) were randomized to receive: (1) FBM-Standard (8-week food delivery), (2) FBM-CHW (standard delivery plus Community Health Worker (CHW) support), or (3) FBM-Virtual (standard delivery plus online educational platform). Primary planned outcome measures included food security and fruit, vegetables, and whole grain intake. Secondary planned outcome measures included nutrition security, breastfeeding rates, mental health, financial stress, and cooking behaviors. Baseline data were collected via telephone or online surveys prior to randomization. Participants were predominantly Hispanic (71%) and Spanish-speaking (79%), with a mean household income of $20,620 (SD = $18,190). Most lived in households with multiple children (74%), in which the number of children and adults ranged from 1 to 15 and 1 to 9, respectively, and had limited formal education (38% without a high school diploma). Marital status was not collected. At baseline, 89% were food insecure. Depression screening indicated mental health concerns in 13% of participants. The 10-item Dietary Screener Questionnaire was used to assess fruit and vegetable intake. Mean fruit and vegetable consumption was 3.9 cups daily, but consumption of whole-grain bread and cooked whole grains was low, at about once a week. The FBM study uses a multi-component, randomized design to evaluate variations of a FIM intervention among food-insecure postpartum mothers. The intervention incorporates food delivery, CHW support, and virtual education components. Ongoing analyses will assess the potential of these approaches to improve food security and related maternal health outcomes in the postpartum period. ClinicalTrials.gov NCT06428578 (registered May 20, 2024).

Maternal nutrition during the postpartum period is a critical time for mothers as they recover from pregnancy and delivery and continue to support their infant through breastfeeding. As Mexico goes through a nutrition transition away from traditional, home-prepared meals to more processed foods, it is unknown what the current dietary choices of women are after pregnancy. This study aimed to explore the nutritional practices of women in Southern Mexico during the postpartum period. A qualitative study, guided by the Ecological Systems Theory and the Intersectionality Framework, was conducted involving 25 low-income women with children under the age of five in the cities of Oaxaca and Puerto Escondido, Oaxaca, Mexico. Data were collected through in-depth interviews between June and December 2023. Interviews were audio-recorded, transcribed verbatim in Spanish, coded, and analyzed using NVivo R1 following a grounded theory approach. Three main themes emerged: (i) maternal diet after a C-section, (ii) food practices during the breastfeeding period, and (iii) nutrition supplements after the delivery. These findings reveal that compared to women who deliver vaginally and are not advised on a specific diet during the postnatal recovery, women who deliver via C-section usually have a selective diet, based on recommendations from health providers and family members. Their diet consists mainly of fruit, vegetables, and broths with a restriction from consuming seafood and pork. A common traditional hot beverage, Atole, was frequently consumed by postnatal women to increase their milk supply. Iron and folic acid were nutritional supplements mostly consumed during the postnatal period by women with a greater need to replenish nutrients lost during childbirth or the postnatal period. This study highlighted the significance of understanding the nutritional habits that postnatal women in Puerto Escondido and Oaxaca City practice, as they are driven by customs and focus on the recovery of the mother and the development of the baby. These findings could be used to inform culturally relevant policies. Still, as postnatal care continues to be understudied in Mexico, future research is needed to identify any gaps in the nutrition of the mothers during puerperium.

The aim of this study was to assess the presence of pyrethroid metabolites in the urine of mothers and their full-term newborns during the first days of life and to investigate the correlation between maternal and neonatal urinary concentrations. It also explores potential clinical and environmental factors influencing these levels. Creatinine-adjusted urinary concentrations of 5 pyrethroid metabolites, 3-phenoxybenzoic acid, 4-fluoro-3-phenoxybenzyl acid (FPBA), cis-3-(2,2-dibromovinyl)-2,2-dimethylcyclopropane-carboxylic acid, and cis and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid (Cis-dimethylcyclopropane-1-carboxylic acid), and (Trans-dimethylcyclopropane-1-carboxylic acid), were measured within the first 3 days postpartum in mothers and their children. The study included 88 mothers and 91 full-term newborns. At least 1 pyrethroid metabolite was detected in 99% of mothers and 77% of newborns. A significant (P < 0.05) correlation was observed between maternal and neonatal urinary concentrations of dimethylcyclopropane-carboxylic acid, a metabolite specific to deltamethrin, supporting the hypothesis of placental transfer. Newborns born during winter had considerably lower urinary metabolite concentrations compared with those born in other seasons. No significant correlations were found for the other metabolites, likely due to the diversity of their parent compounds. This study provides evidence of transplacental transfer of deltamethrin, while the lack of 3-phenoxybenzoic acid correlation suggests differential metabolic or exposure pathways for nonspecific metabolites. The seasonal variation in metabolite levels suggests environmental or behavioral factors influencing exposure. These findings emphasize the need to investigate dietary and domestic pesticide exposure as key contributors to perinatal pyrethroid exposure, as well as longitudinal studies to assess the evolution of metabolite concentrations and their potential health effects on mothers and infants.

In the United States, Black women are three to four times more likely to die from pregnancy-related complications than White women and experience disproportionately higher rates of maternal mental health issues across pregnancy, childbirth, and the postpartum period. Structural racism, healthcare bias, and inequitable access to culturally responsive care position Black women among the most underserved and undertreated populations in the nation and contribute to intergenerational impacts on Black families and communities. This study aimed to understand how Black communities conceptualize perinatal mental health and wellbeing and identify barriers and facilitators to care, with the goal of informing culturally responsive, community-centered, and family-focused interventions that promote safety, confidence, and agency. Semi-structured virtual interviews were conducted with Black pregnant and postpartum mothers, fathers, and community members (N = 17) using a qualitative, descriptive approach while noting recurring themes. Participants were English-speaking, residents of the United States, aged 18 years or older, and recruited through purposive sampling via community networks and social media. We analyzed data using reflexive thematic analysis to examine multilevel influences on perinatal mental health. The Social-Ecological Model (SEM) was used as a guiding framework to understand how individual, interpersonal, community, and structural factors shape perinatal mental health and wellbeing as well as access to care. Among the four levels of the Socioecological model, including individual, interpersonal, organizational, and community/policy, ten subthemes emerged, including perinatal health literacy, supportive networks, collective resilience, healthcare harm and advocacy, medical institutional environments, parenting while Black, and perinatal health climate. Findings highlight the need for multilevel, culturally responsive, and community-centered strategies to advance Black perinatal mental health and wellbeing.

Introduction: Comprehensive midwifery care is care that is provided continuously from pregnancy, childbirth, postpartum and newborns. According to the Aceh Health Service report, in 2023 the number of maternal deaths was 3 people, 1 person was caused by heart disease, and 2 people were caused by bleeding. The number of live births in West Aceh district was 2,643 people and infant deaths were 16 people. Objective: This study aims to provide comprehensive midwifery care from pregnancy, childbirth, newborns and the postpartum period (including family planning counseling for postpartum mothers). Research Method: This study is a case study, carried out with midwifery care documented with SOAP. The subjects of this study were mothers K G1P0A0 aged 30 years starting from 37 weeks 3 days of pregnancy to 9 days postpartum. Data collection techniques were primary data and secondary data. Research results: Based on the results of the research conducted, the results obtained were that the pregnancy process of mother K was normal and no complications were found during the assessment starting from the gestational age of 37 weeks 3 days and the mother was able to adapt to her pregnancy. The labor process took place normally without complications. At the gestational age of 38 weeks 6 days there were no complications or problems in Mother K until 6 hours postpartum. During newborn care, it was found that Mother K's baby was a full-term male and postpartum care was carried out 2 times (including family planning counseling for Mother K) the mother planned to use a 3-month injection of birth control. Conclusion: Comprehensive midwifery care for mother K at TPMB Dewi Sandra Lubis, Meureubo District, West Aceh Regency took place normally. Suggestion: It is expected to improve knowledge and skills by studying cases during practice in the form of SOAP management and implementing care according to the established midwifery service standards in accordance with the authority of midwives that have been given to the midwife profession.

The postpartum period is marked by significant biological, social, and emotional changes that may affect maternal self-care, including oral health maintenance. This study explores the impact of periodontal inflammatory status on mental health status in postpartum women. In this cross-sectional study, postpartum mothers were recruited within 6 weeks to 6 months after delivery. Clinical periodontal parameters and sociodemographic variables were measured and mental health was assessed using standard 38 items Mental Health Inventory. Multiple linear regression analysis was performed to examine the relationship between periodontal parameters and Mental Health Index(MHI) scores. Mediation analysis explored potential mediators affecting the association. 128 mothers were recruited in the study. The study population was stratified into three categories according to the quartiles of the mean MHI scores. A statistically significant difference was seen in the periodontal parameters among the three groups(p<0.05). After adjusting for sociodemographic variables, Bleeding on probing (BOP) (β = -0.437) and Clinical Attachment Loss (CAL) (β = -0.470) remain the only statistically significant predictors of MHI. Both are negatively associated with MHI, indicating poorer mental health with worsening periodontal condition. Bleeding on probing significantly mediated the relationships between education, occupation, socioeconomic status, family characteristics, and mental health, accounting for approximately 70-90% of the total effect. Periodontal inflammation has been identified as a mediating factor in the relationship between sociodemographic factors and mental health status during the postpartum period.

BackgroundThe breastfeeding coverage rate (that is, the number of mothers reached by breastfeeding programs) in several regions in Indonesia, including Banten and West Java, is still below the actual rate of breastfeeding nationwide. The breastfeeding coverage rate is influenced by mothers’ condition after childbirth, particularly among mothers who have had a caesarean section. Support from partners, family, and close friends also has a large influence on the continuation of exclusive breastfeeding.ObjectiveThis study aims to identify the effectiveness of a culturally based intervention and its effect on mothers’ perceptions of breast milk adequacy and the weight of newborns after caesarean section.MethodsThis study used a quasi-experimental design involving 116 respondents who were grouped into control and intervention groups. Pre- and postintervention measurements were taken using the Perceived Insufficient Milk scale (r=0.976) and calibrated baby weight scales. Paired t tests were used for the analysis.ResultsThere was a significant increase in perception of breast milk adequacy and newborn weight in the intervention group compared to the control group. The intervention also increased the odds of perceiving breastfeeding as “very sufficient” by 2.53 times (odds ratio 2.53, 95% CI 1.36-4.73) after controlling for culturally held myths regarding breast milk insufficiency and family support.ConclusionsThis model could be applied as an alternative intervention by health care personnel, especially nurses, to support postpartum mothers who have undergone a cesarean section.

ObjectiveTo evaluate the effectiveness of an innovative “Safe Breastfeeding Pillow” on postpartum maternal self‐efficacy, awareness, and comfort during breastfeeding.MethodsA participant‐ and outcome assessor–blinded, parallel randomized controlled trial was conducted. Postpartum mothers were randomized into intervention and control groups. The intervention group used the innovative Safe Breastfeeding Pillow, which includes a main pillow and an additional pillow that can be wrapped around the baby to maintain a stable feeding posture and reduce the risk of accidents due to maternal fatigue during breastfeeding. The control group used a U‐shaped breastfeeding pillow as usual. Outcome measures included the Breastfeeding Self‐Efficacy Scale–Short Form (BSES‐SF), Breastfeeding Awareness Scale (BAS), Body Part Discomfort Scale (BPDS), and B‐R‐E‐A‐S‐T‐Feed Observation Form. Statistical analyses included Chi‐squared tests, independent t-tests, and linear regression.ResultsIn total, 128 mothers (64 each in the intervention and control groups) were enrolled. No differences were found between the two groups in demographic characteristics. The BSES‐SF did not significantly differ between the groups. The intervention group reported significantly higher scores for the BAS (3.58 ± 0.04 vs. 1.60 ± 0.15, p < 0.0001). In the BPDS, the intervention group showed significantly higher comfort levels in all body parts during breastfeeding compared to the control group (3.52 ± 0.13 vs. 1.70 ± 0.33, p < 0.0001). Both groups exhibited increased emotional bonding at the initial assessment and at discharge according to the B‐R‐E‐A‐S‐T‐Feed Observation Form.ConclusionsThe innovative Safe Breastfeeding Pillow effectively improved maternal comfort, safety, and breastfeeding awareness compared to a traditional pillow. It provides essential support and warmth, enhancing the overall breastfeeding experience and maternal well‐being.Implications for Nursing ManagementNursing leaders should incorporate the “Safe Breastfeeding Pillow” into routine care as a key strategy to ensure feeding safety, enhance maternal comfort, and improve breastfeeding rates.Trial Registration: ClinicalTrials.gov_identifier: NCT05687383

IntroductionExclusive breastfeeding during the first six months postpartum is essential for preventing unintended pregnancy. Lactational amenorrhea method (LAM) is a safe and effective natural family planning method that provides up to 98% protection when its three criteria are met. Inadequate knowledge of LAM and poor exclusive breastfeeding practices increase the risk of unintended pregnancy. This study assessed the association between exclusive breastfeeding practice and maternal knowledge of LAM and its associated factors among postpartum mothers in Northeast Ethiopia, 2023/24.MethodAn institution-based cross-sectional study design was employed. The study was conducted in four hospitals in Northeast Ethiopia. A total of 607 participants were included, and the study period was from March 2023 to June 30, 2023. Data were collected using standardized, interviewer-administered questionnaires. Multivariable logistic regression model was employed using SPSS version 26. Multicollinearity, sensitivity analysis and Hosmer–Lemeshow goodness-of-fit test were assessed. Variables with p-values less than 0.25 in the bivariable analysis were entered into multivariable logistic regression model to control for potential confounders. Finally, variables with p-values less than 0.05 at 95% CI were considered statistically significant.ResultThe prevalence of good exclusive breastfeeding practice was 68.4% (95% CI: 64.0–72.8%), while good maternal knowledge of the lactational amenorrhea method was 56.0% (95% CI: 50.7–61.2%). Maternal knowledge of LAM was significantly associated with exclusive breastfeeding practice (χ² = 5.378, p = 0.02). Factors significantly associated with exclusive breastfeeding practice included marital status (AOR: 0.5; 95% CI: 0.2–0.9), educational level (AOR: 2.0; 95% CI: 1.3–3.0), and reason for hospital visit (AOR: 0.45; 95% CI: 0.28–0.73). Factors associated with maternal knowledge of LAM were marital status (AOR: 4.0; 95% CI: 1.83–9.0), educational status (AOR: 1.8; 95% CI: 1.16–2.76), age (AOR: 0.42; 95% CI: 0.28–0.63), and hospital level (AOR: 1.5; 95% CI: 1.02–2.17).ConclusionTwo-thirds of participants had good exclusive breastfeeding practices, and 56% were knowledgeable about LAM. Marital status, educational level, and reason for hospital visit were significantly associated with exclusive breastfeeding practice. Structured postnatal education should be provided across all hospitals to improve exclusive breastfeeding practice.Clinical trial numberNot applicable.

The transition to motherhood has been shown to result in significant changes in the structure and function of the brain, with particular emphasis on the enhancement of cognitive abilities that are essential for survival. Specifically, in murine models, spatial learning and cognitive flexibility have been identified as critical components of mothering. While cognitive enhancements during the postpartum period have been observed in various experimental setups, research using long-term data collection with automated monitoring in a home cage setup is lacking despite its reliability compared to other experimental procedures. This study aims to address this knowledge gap by systematically examining spatial learning and cognitive flexibility in female mice during the reproductive stages using the IntelliCage system. The results showed that female mice in the postpartum phase outperformed pregnant and nulliparous females in place learning, reversal learning, and fixed schedule drinking tasks, demonstrating faster adaptation and superior retention of information. Postpartum mothers showed elevated cognitive ability in spatial learning, and also showed increased flexibility compared to the control/pregnant group suggesting a greater ability to update previously learned associations. The identification of these improvements in maternal behavior may provide novel insights into how reproductive experiences impact brain function, with implications for maternal health and broader cognitive research.

Postpartum depression is a common complication in mothers that leads to adverse outcomes for mothers, children, and families. Some studies have investigated the role of supplement use in reducing and preventing depression; therefore, the present study aimed to determine the effect of folic acid supplement use on the rate of postpartum depression. This study was conducted as a single-blind clinical trial on 60 postpartum mothers who had referred to service centers in Mashhad and Gonabad for 3-5days of postpartum care in 2023. Sampling was carried out using a convenient method and using block random allocation of participants in two groups. Data collection tools included a demographic and obstetric characteristics checklist and the Edinburgh Standard Questionnaire. In this study, the control group used one placebo tablet daily and the intervention group used half a 1mg folic acid vitamin tablet daily for two months. The depression score was measured at the beginning and one month and two months after the intervention. After completing the sampling, the three-day food intake record was examined at the beginning and end of the study in both groups. The collected data were analyzed using SPSS version 21 software and the level of significance was set at p < 0.05. The mean postpartum depression score in the intervention group was 5.07(2.77) lower than the control group 5.70(3.63), but there was no significant difference. The present study showed that although folic acid consumption in the postpartum period had reduced the mean depression score, there was no statistically significant relationship between folic acid supplement consumption and reducing the score on maternal depression. It is recommended to recommend further studies with larger sample sizes and longer folic acid consumption.

The neonatal period, defined as the first 28 days of life, remains a critical phase for child survival. According to the 2019 Ethiopian Demographic and Health Survey, the neonatal mortality rate was 33 deaths per 1,000 live births. Despite various interventions, neonatal mortality and morbidities related to neonatal danger signs persist. Previous studies on maternal knowledge of neonatal danger signs have reported inconsistent findings. This study replicates established associations between maternal characteristics and neonatal danger sign knowledge in a previously unstudied urban site within Oromia, Ethiopia, and also examines how prompted recognition affects the measured prevalence of knowledge compared with spontaneous-recall approaches. A facility-based cross-sectional study was conducted from April 1-30, 2022. A total of 426 postpartum women were selected using systematic random sampling. Data were collected through face-to-face exit interviews using a structured questionnaire. Data entry was done with EPI Info, and analysis was performed using SPSS version 26. Knowledge assessed via 9 World Health Organization (WHO) neonatal danger signs (NDS) items (prompted yes/no, mean cutoff ≥ 5 = good). Multivariable logistic regression identified factors (p < 0.05). 75.5% (95% CI 71.6-79.7%) had good knowledge. Factors significantly associated with good maternal knowledge include educational level of college or above [AOR: 4.83; 95% CI: 1.49, 15.64], secondary educational level [AOR: 3.10; 95% CI: 1.09, 8.78], delivery by caesarean section [AOR: 2.47; 95% CI: 1.28, 4.80], multigravida [AOR: 2.11; 95% CI: 1.26, 3.52], and grand multigravida [AOR: 3.68; 95% CI: 1.08, 12.62]. Maternal knowledge of neonatal danger signs was relatively high in this urban postnatal sample, but the estimate is influenced by the recognition-based measurement approach. The findings reinforce previously reported associations and provide context-specific evidence from Adama town to inform newborn health education.

Effect of a competency-based nurse-led exclusive breastfeeding training program on nurses' counseling competence and postpartum mothers' breastfeeding self-efficacy: A quasi-experimental study in Egypt.

To evaluate the effect of postpartum mothers' health literacy levels on their knowledge and attitudes toward newborn screening. This descriptive, cross-sectional, correlational study was conducted in the postpartum ward of a university hospital in Ankara, Türkiye. The sample consisted of 160 postpartum mothers. Data were collected using a parent identification form, a health literacy scale, and a researcher-developed scale assessing maternal knowledge and attitudes toward newborn screening. Spearman correlation analysis, regression analysis, and path analysis were used to evaluate relationships among variables. Mothers' health literacy levels were at a moderate-to-high level (94.55 ± 13.4), while their knowledge and attitudes toward newborn screening were at a moderate level (37.23 ± 3.7). Maternal health literacy had a significant effect on overall knowledge and attitudes regarding newborn screening (β = 0.17, P = .032). Health literacy demonstrated a stronger effect on attitudes toward newborn screening (β = 0.23, P = .003) and a substantial effect on knowledge level (β = 0.30, P < .001). Postpartum mothers' health literacy levels significantly influence their knowledge and attitudes toward newborn screening. Enhancing maternal health literacy may improve awareness, engagement, and the overall effectiveness of newborn screening programs. Given that nurses are a primary source of information for parents, strengthening nurse-led education and counseling is essential. Ongoing training should support nurses' communication and educational competencies. Future multicenter studies with larger samples are needed to examine the long-term effects of health literacy-focused educational interventions on newborn screening outcomes.

1646-P: Prevalence of Cardiometabolic Risk Factors in Postpartum WIC Participants Screened for a Lifestyle Intervention Trial

Breastfeeding is essential for infant nutrition, survival, and development. Identifying factors associated with breastfeeding success is important for improving early postpartum care and breastfeeding support in hospital settings. This study aimed to identify determinants of successful breastfeeding among postpartum mothers in a private hospital in Yogyakarta, Indonesia. A cross-sectional study was conducted among 124 postpartum mothers who had delivered vaginally and had healthy infants. Participants were recruited using convenience sampling. Data were collected using a structured questionnaire during the postpartum hospital stay. Variables included maternal education, occupation, knowledge, early initiation of breastfeeding (EIBF), supplementary feeding, rooming-in, breastfeeding frequency, breastfeeding experience, health worker support, and family support. Data were analyzed using univariate analysis, Pearson's chi-square test for bivariate analysis, and binary logistic regression for multivariable analysis. Multivariable analysis results were presented as adjusted odds ratios (AORs) with 95% confidence intervals (CIs), with p < 0.05 considered statistically significant. Bivariate analysis showed that maternal occupation (p = 0.040), EIBF (p = 0.024), supplementary feeding (p = 0.017), and breastfeeding experience (p = 0.002) were significantly associated with breastfeeding success. In multivariable analysis, only breastfeeding experience remained significantly associated with breastfeeding success. Mothers with previous breastfeeding experience were 3.66 times more likely to achieve breastfeeding success than those without prior experience (AOR = 3.66; 95% CI [1.47, 9.12]; p = 0.005). Breastfeeding experience emerged as the most consistent factor associated with breastfeeding success. Early postpartum breastfeeding support, especially for first-time mothers, should be strengthened to improve breastfeeding success.

Association between per- and polyfluoroalkyl exposures and postpartum psychological symptoms: Evidence from two population-based pregnancy cohorts.

Despite Indonesia's national breastfeeding promotion efforts, exclusive breastfeeding rates remain below the 80% target, with limited evidence on structured breastfeeding self-efficacy (BSE) interventions in low-resource Indonesian settings. To evaluate the effectiveness of a BSE intervention on BSES-SF scores and exclusive breastfeeding continuation during the first six months postpartum. A quasi-experimental pretest-posttest design with a control group was conducted on 104 postpartum mothers (52 intervention, 52 control). Measurements were conducted longitudinally at baseline, weeks 2, 6, 12, and 24 postpartum. Data were analyzed using independent t-test, Chi-square, Cox proportional hazard regression, and linear mixed model (LMM). The intervention group's BSES-SF score increased significantly from 42.35 to 59.73 compared to the control group (41.88 to 48.06, p &amp;lt; 0.001). Exclusive breastfeeding at 24 weeks was significantly higher in the intervention group (71.2% vs. 40.4%, RR = 1.76, p = 0.001). Cox analysis identified the intervention as the strongest protective factor (HR = 0.41, p = 0.001), followed by husband's support (HR = 0.54, p = 0.039), while employment was a risk factor (HR = 1.72, p = 0.034). The non-randomized design and single-site setting may limit generalizability. The BSE intervention effectively increased self-efficacy scores and exclusive breastfeeding rates, suggesting integration into routine postpartum care as a scalable public health strategy.

Suboptimal breast milk production remains a challenge for postpartum mothers. Complementary therapies such as endorphin massage and lactation massage have the potential to enhance the hormonal response to lactation. To analyze the effectiveness of endorphin massage and lactation massage in optimizing breast milk production in breastfeeding mothers through a community service program. This analytic study using a community approach involved 50 breastfeeding mothers. Data were analyzed descriptively, bivariately using the Chi-Square and Fisher’s Exact tests, and multivariately using logistic regression. A total of 82.0% of respondents received endorphin massage and lactation massage. Endorphin massage was significantly associated with increased breast milk production (p=0.025; OR=6.31). Lactation massage was also significant (p=0.035; OR=4.79). Parity and type of delivery did not show a significant association. Complementary therapies have been shown to be effective in increasing breast milk production and are suitable for integration into community-based midwifery services.

The postpartum period is a vulnerable phase often accompanied by lactation problems, particularly ineffective breastfeeding and discomfort due to breast engorgement. These conditions may reduce maternal comfort, inhibit the let-down reflex, and increase the risk of failure in exclusive breastfeeding. Therefore, safe, practical, and comprehensive non-pharmacological nursing interventions are needed. This Final Nursing Project aims to describe the implementation of cabbage leaf compresses combined with breastfeeding education to improve maternal comfort and enhance breast milk flow in postpartum mothers. This study employed a case study method using a nursing care approach involving two postpartum mothers who experienced ineffective breastfeeding and discomfort due to breast engorgement. The interventions were provided for three days and included cabbage leaf compresses and education on breastfeeding techniques. Evaluation focused on breastfeeding ability, pain level, breast condition, maternal comfort, and milk production. The results showed improvement in breastfeeding ability, indicated by the mothers’ ability to correctly demonstrate proper positioning and latch-on techniques. Infants appeared calmer during feeding, and the duration of breastfeeding increased to approximately 10 minutes per breast. Pain scores decreased from 5 to 0–3, breast tension was reduced, and maternal comfort improved. It can be concluded that the application of cabbage leaf compresses combined with breastfeeding education is effective in improving breast milk flow and maternal comfort in postpartum mothers and can be recommended as an independent nursing intervention in maternity practice.