Trial reportInternational breastfeeding journal2020
Effectiveness of biological nurturing on early breastfeeding problems: a randomized controlled trial.
Trial report in International breastfeeding journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 22 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effectiveness of a Laid-back Breastfeeding Approach on Breastfeeding Initiation in Hospital Setting. A Randomized Controlled Trial
The Effect of Biological Nutrition Technique Which is Used in Initiation of Breastfeeding in Primiparas on Breastfeeding Success and on Self-Efficacy: A Randomized Controlled Study
The Effect of Different Breastfeeding Position Education With Lactation Simulation Model on Breastfeeding
Effect of Biological Nurturing Education to Pregnant Women on Breastfeeding Status
The Effect of Applying Kinesio Tape on Back Pain, Breastfeeding Success and Breastfeeding Self-Efficacy Levels in Mothers: Randomized Controlled Trial
Who cites it
22 citing papers in PubMed, 5 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- Effective Interventions to Prevent Breastfeeding-Related Nipple-Areolar Lesions: A Systematic Review.International journal of environmental research and public health · 2026Pooled it
- Pooled it
- Interventions for breastfeeding-related nipple pain or injury: a meta-analysis.Frontiers in global women's health · 2025Pooled it
- Support for healthy breastfeeding mothers with healthy term babies.The Cochrane database of systematic reviews · 2022Pooled it
- The effectiveness of the laid-back position on lactation-related nipple problems and comfort: a meta-analysis.BMC pregnancy and childbirth · 2021Pooled it
- Trial
- Nipple shield use does not impact sucking dynamics in breastfeeding infants of mothers with nipple pain.European journal of pediatrics · 2021Trial
- Interventions for the Prevention and Management of Nipple Trauma in Breastfeeding Women: A Systematic Review.Healthcare (Basel, Switzerland) · 2026Review
- Recent Advancements and Best Practices in Supporting Newborn Feeding: A Narrative Review.Pediatric clinics of North America · 2025Review
- Breastfeeding and workplace support in Nepal.PLOS global public health · 2025Article
- Laid-back breastfeeding: knowledge, attitudes and practices of midwives and student midwives in Ireland.International breastfeeding journal · 2024Article
- The economic value of human milk from three cohort studies in Friuli Venezia Giulia, Italy.International breastfeeding journal · 2024Article
- Effectiveness of a community-based support programme to reduce social inequality in exclusive breastfeeding: study protocol for a cluster-randomised trial.BMC public health · 2023Article
- A brief gestalt intervention changes ultrasound measures of tongue movement during breastfeeding: case series.BMC pregnancy and childbirth · 2022Article
- Newborn Weight Loss as a Predictor of Persistence of Exclusive Breastfeeding up to 6 Months.Frontiers in pediatrics · 2022Article
- Prevalence of breastfeeding in a baby-friendly pediatric practice in Trieste, Italy: follow up to 36 months of age.International breastfeeding journal · 2021Article
- Effects of a theory of planned behavior-based intervention on breastfeeding behaviors after cesarean section: A randomized controlled trial.International journal of nursing sciences · 2021Article
- An exploration of the breastfeeding behaviors of women after cesarean section: A qualitative study.International journal of nursing sciences · 2020Article
- Re-thinking benign inflammation of the lactating breast: Classification, prevention, and management.Women's health (London, England)Article
- A Scoping Review of Interventions and Outcomes for Postpartum Mothers.Iranian journal of nursing and midwifery researchReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBiological nurturing is a neurobehavioral approach to breastfeeding support that encourages women to breastfed in a relaxed, laidback position. This approach has the potential to reduce breast problems (e.g., sore nipples), making good latch easier and thus facilitating the initiation of exclusive breastfeeding. However, its effects have not been adequately investigated in a real-life situation. The aim of this randomized controlled trial was to assess the effectiveness of biological nurturing, compared to usual hospital practices, on the frequency of breast problems and on the prevalence of exclusive breastfeeding at discharge from the maternity ward, after 1 week, and at one and 4 months.
methodsOpen randomized parallel controlled trial carried out in a third level maternity ward (IRCCS Burlo Garofolo, Trieste, Italy) between March and December 2018. Two-hundred eight women who planned to give birth at the hospital and who expressed the intention to breastfeed were enrolled during pregnancy and randomized to receive breastfeeding support following either the biological nurturing approach or the usual care protocol based on the WHO/UNICEF 20-h course, in use at the hospital. The primary study outcome was the incidence of breast problems during hospital stay, defined as the presence of one or more of the following outcomes, collected separately: sore nipples, cracked nipples, engorgement and mastitis. The primary analysis was performed by intention to treat. The follow up lasted 4 months.
resultsOne hundred eighty eight out of 208 women (90.3%) were included in the analysis, 90 allocated to the biological nurturing group and 98 to the usual care group. At discharge from the maternity ward, biological nurturing significantly reduced the risk of breast problems (Relative risk [RR] 0.56, 95% Confidence Interval [CI] 0.40, 0.79), including cracked (RR 0.42, 95% CI 0.24, 0.74) and sore nipples (RR 0.59, 95% CI 0.40, 0.88). No statistically significant difference was observed for exclusive breastfeeding at discharge and up to 4 months. No adverse events occurred.
conclusionsThe biological nurturing approach applied in the real-life situation of a third level hospital was effective in preventing breast problems.
trial registrationClinicaltrials.gov NCT03503500. Date of First Submission: 28 March 2018.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.