Effects of Warm Shower on Lactation, Fatigue, and Maternal Burnout

Overview

Lactation is a physiological process in which various hormones, especially prolactin and oxytocin, play a role. Methods such as warm showers are preferred because they are easy to apply and have a quick effect, as well as being cost-effective. It increases the amount of milk by showing a direct effect on oxytocin and prolactin hormones in the breastfeeding process that strengthens the bond between mother and baby. It helps to make the breastfeeding process more enjoyable for mother and baby. Guidelines in the literature emphasize that the mother should be psychologically evaluated and that practices that can relax her according to her needs should be applied to increase breastfeeding success. In addition to hormonal regulation, a warm shower improves self-care. In this way, breastfeeding motivation increases. The aim of this study was to investigate the effect of warm showers in the morning and evening in the first 3 postpartum days on the amount of breast milk by shedding light on hormones and lactation process.

This study is a single-center, parallel-group randomized controlled trial designed to evaluate the effects of warm shower application during the first three postpartum days on maternal burnout, fatigue, lactation onset indicators, and breast milk intake among women who underwent cesarean birth. The intervention is based on the premise that warm water exposure may promote relaxation, improve physical comfort, reduce fatigue and stress, and support physiological mechanisms associated with lactation. The study aims to determine whether a structured warm shower intervention can improve maternal well-being and breastfeeding-related outcomes during the early postpartum period. Eligible participants for the study are first-time mothers who have had a cesarean delivery and meet the study's inclusion criteria. Following the baseline assessment, participants are randomly assigned in a 1:1 ratio to either the intervention group or the control group. Women in the intervention group receive routine postpartum care plus a standard warm shower (37-39°C, 10-15 minutes) once daily at 24, 48, and 72 hours after delivery, as well as on days 7 and 14 postpartum, while women in the control group receive only routine postpartum care. Outcome assessments are conducted at baseline, immediately following the intervention, at 24, 48, and 72 hours postpartum, and during follow-up visits on the 7th and 14th days postpartum. Maternal burnout is evaluated using the Maternal Burnout Scale, while fatigue is assessed using the Visual Analogue Scale for Fatigue. Lactation onset indicators are assessed through breast fullness and milk secretion characteristics, and infant breast milk intake is evaluated using the IMDAT Breast Milk Intake Scoring System. Data are analyzed using appropriate repeated-measures statistical methods to examine changes over time, between-group differences, and group-by-time interactions. The study aims to provide evidence regarding the effectiveness, safety, and clinical applicability of a low-cost, non-pharmacological postpartum care intervention that may support maternal recovery and breastfeeding outcomes.