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Completed

NCT Number: NCT07694856

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

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.

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Key information

Conditions

Maternal Burnout Behavior Breast Feeding Breastfeeding Feeding Behavior Postpartum Fatigue

Age range

18 year–35 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

KTO Karatay University

Konya, Karatay, Turkey (Türkiye)

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Having given birth between 37 and 42 weeks of gestation
  • Having had a cesarean delivery
  • Being a primipara
  • Being admitted to the postpartum ward within the first 6 hours
  • No physical or cognitive limitations preventing the ability to shower
  • Providing written informed consent

Exclusion criteria

  • Premature infant or infant in the neonatal intensive care unit
  • Maternal history of infection, complications, or psychiatric diagnosis
  • Physiological condition preventing breastfeeding

Treatment and study plan

Warm Shower

Behavioral

Participants receive routine postpartum care in addition to a standardized warm shower (37-39°C, 10-15 minutes) once daily during the first three postpartum days after cesarean birth.

Primary outcomes

  1. Maternal Burnout

    Time frame: Assessed at baseline (6-12 hours postpartum), immediately after the intervention, and at 24, 48, and 72 hours postpartum, as well as on postpartum days 7 and 14.

    Maternal Burnout Scale (MBS). The Maternal Burnout Scale was used to assess maternal burnout levels. The scale consists of 15 items rated on a 4-point Likert scale and includes the dimensions of physical and emotional exhaustion, emotional distancing from the child, and reduced maternal accomplishment. Higher scores indicate higher levels of maternal burnout.

  2. Lactation Onset Indicators

    Time frame: Assessed at baseline (6-12 hours postpartum), immediately after the intervention, and at 24, 48, and 72 hours postpartum, as well as on postpartum days 7 and 14.

    Lactation onset indicators will be assessed as a composite outcome using the Lactation Assessment Form, which includes breast fullness, milk secretion characteristics, and post-feeding breast status.

  3. Postpartum Fatigue

    Time frame: Assessed at baseline (6-12 hours postpartum), immediately after the intervention, and at 24, 48, and 72 hours postpartum, as well as on postpartum days 7 and 14.

    Postpartum fatigue will be assessed using the Visual Analogue Scale for Fatigue (VAS-F), an 18-item instrument designed to assess fatigue. Higher scores indicate greater postpartum fatigue.

  4. Infant breast milk intake score

    Time frame: Assessed at baseline (6-12 hours postpartum), immediately after the intervention, at 24, 48, and 72 hours postpartum, and on postpartum days 7 and 14.

    Infant breast milk intake will be assessed using the IMDAT Breast Milk Intake Scoring System. Higher scores indicate greater breast milk intake. Unit of

Sponsors and collaborators

Lead sponsor

KTO Karatay University

Other

Registry information

Official study title

The Effect Of Warm Showers On Exhaustıon, Fatigue, Lactation Onset Symptoms and Breast Milk Quantity In The First Three Postpartum Days: A Randomized Controlled Trial

Acronym: WARM-SHOWER

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Jul 10, 2026
Registry last updated
Jul 10, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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