The Effect of Transcutaneous Electrical Acupoint Stimulation on Uterine Contraction Pain Induced by Breastfeeding in Women Undergoing Vaginal Delivery: A Randomized Controlled Study
Background: Postpartum uterine contraction pain (afterpains) is common after vaginal delivery and often worsens during breastfeeding, which may adversely affect rest, mood, and breastfeeding experience. Safe and breastfeeding-friendly nonpharmacological analgesic options are needed. This study evaluated the analgesic effect of transcutaneous electrical acupoint stimulation (TEAS) on breastfeeding-evoked uterine contraction pain after vaginal delivery. Patients and Methods: In this parallel-group clinical trial, women after vaginal delivery were assigned to a TEAS group (T, n = 92) or a control group (C, n = 97). Pain intensity was assessed using a 0–100 mm numerical rating scale (NRS) at the first breastfeeding session within 24 hours postpartum (pre-feeding baseline, and 5 and 10 minutes after latch). Secondary outcomes included the number of days with breastfeeding-related pain > 40 mm (NRS > 40), 24-hour postpartum blood loss, analgesia satisfaction (1–5), and adverse events. Between-group comparisons were performed using non-parametric tests for continuous variables and Fisher’s exact test for categorical variables. Results: Baseline and peripartum characteristics were largely comparable; however, the third stage of labor and breastfeeding frequency within 24 hours differed statistically between groups (P = 0.001 and P = 0.031, respectively). Pre-feeding pain did not differ significantly between groups (43.0 [41.0–45.0] vs 42.0 [40.0–43.0], P = 0.153). At 5 minutes after latch, pain was lower in the TEAS group than in controls (65.0 [59.0–68.0] vs 68.0 [59.0–68.0], P < 0.001), while no difference was observed at 10 minutes after latch (52.5 [46.0–55.0] vs 55.0 [46.0–55.0], P = 0.365). The number of days with NRS > 40 was similar between groups (3.0 [3.0–4.0] vs 4.0 [3.0–5.0], P = 0.516). There were no significant differences in 24-hour blood loss (P = 0.365) or analgesia satisfaction (P = 0.516). Adverse events were rare (2.2% vs 0%, P = 0.236). Conclusion: TEAS significantly reduced breastfeeding-evoked uterine contraction pain at 5 minutes after latch during the first breastfeeding session within 24 hours postpartum, but the effect was not sustained at 10 minutes and did not reduce the overall burden of moderate-to-severe breastfeeding-related pain days. Further studies with adjustment for breastfeeding frequency and other potential confounders are warranted.
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