Cherry Seed Massage Lactation and Milk Perception

Breast milk is the ideal food source, containing all the nutrients that meet all the needs of the newborn and supporting immunity with its bioactive content . The World Health Organization (WHO), the United Nations Children's Fund (UNICEF), the American Academy of Pediatrics (APA), and the Ministry of Health (MoH) recommend that babies should be exclusively breastfed for the first six months, and that breastfeeding should continue with complementary foods until the age of two. Breast milk meets all of the energy and nutritional needs of the baby in the first six months, more than half after the sixth month, and one-third until the second year.

Data from the Turkey Demographic Health Survey (TDHS) show that breastfeeding is very common in Turkey, with 98% of infants breastfed in the two years prior to the survey. However, 41% of infants under 6 months of age in Turkey are exclusively breastfed, and the median duration of exclusive breastfeeding is 1.8 months . Many women, despite being able to produce enough milk to meet their baby's milk needs, worry that it's not enough. This is cited as one of the most common reasons for prematurely ending breastfeeding or supplementing with formula . The perception of insufficient milk stems from mothers' concerns that the quality and quantity of milk are insufficient for their babies, and their belief that their babies are not getting enough. The "perception of insufficient milk supply," which cannot be expressed with objective data and is simply assumed to be "there," is one of the leading reasons for not continuing breastfeeding . Furthermore, while more than 50% of breastfeeding mothers perceive their milk supply as insufficient, it is reported that only 5% actually experience physiological milk insufficiency . Therefore, midwives are expected to provide breastfeeding counseling in the postpartum period and contribute to the continuation of breastfeeding by reducing mothers' perception of insufficient milk supply through accurate information and psychosocial support. Harting et al. (2025) state that midwives reinforce mothers' confidence in the breastfeeding process and play an important role in encouraging breastfeeding through practices such as breastfeeding initiation, skin-to-skin contact, and breastfeeding counseling. Breast massage applied within this scope has been reported to support the early onset of lactation and is effective in reducing mothers' perception of insufficient milk supply. The literature reports that oketani massage increases breastfeeding success and reduces the time to breastfeeding initiation and breast massage combined with acupuncture stimulation increases breast milk production . It has also been reported that breast massage combined with milk expression increases breast milk production by 92% and the average daily milk supply by 48%, while reducing pumping duration and frequency .

There are also various scientific studies on the materials used in breast massage treatments in the delivery room. A therapy device called BERES, designed to massage and heat the breasts, has been reported to increase breast milk production from 20 ml before use to 27.3 ml after use . The Lactamo breast massage device, which combines heating/cooling and compression, has been reported to be beneficial for pain, congestion, and milk production problems . The Gua Sha massage technique, commonly used in traditional Chinese medicine by scraping the skin with smooth stones like jade, has been reported to help increase lymphatic drainage and relieve breast congestion . Products like Lansinoh Therapearl and Mumasil Reusable Warm and Cool Breast Packs are disc-shaped gel packs designed for this purpose. These packs are warmed before breastfeeding to encourage milk flow and cooled after breastfeeding to reduce pain and swelling . Similarly, cherry pit sachets, used as natural heat traps and massage tools, are thought to stimulate milk ducts when applied to breast tissue, facilitating the onset of lactation.

This study aims to evaluate the effects of massage with cherry pit sac applied to primiparous pregnant women during labor on physiological signs of postpartum lactation and mothers' perception of insufficient milk supply. While the literature indicates the positive contributions of breast massage and hot and cold applications to the lactation process, studies directly examining the effect of massage applied during labor on postpartum milk production are limited. Furthermore, the potential benefits of using cherry pit sac, a natural, accessible, and noninvasive method, in this process have not been adequately documented in the literature. Cherry pit sacs, with their natural structure that allows them to retain heat for extended periods and distribute evenly across the body when applied, have the potential to be an ideal material for massage applications. Furthermore, it is anticipated that this method may reduce the perception of insufficient milk supply, a common complaint among mothers, and support the continuity of breastfeeding. In this respect, the study has the potential to make an ecological and cost-effective contribution to postpartum care practices. The lack of scientific data in the literature on the use of cherry pit as a breastfeeding support material constitutes both the innovative aspect and the scientifically original value of this study.

Hypotheses

H1. Massage with cherry pits in primiparous pregnant women during labor accelerates the onset of postpartum lactation symptoms.

H2. Massage with cherry pits in primiparous pregnant women during labor reduces the perception of insufficient postpartum milk supply.