The Effect of Breast Crawl on Breastfeeding Success and Maternal Feeding Attitudes: A Randomized Controlled Trial.
Çimen Coşkun Kevser K, İlçioğlu Kevser K
Breastfeeding difficulties often begin with the first feeding after birth. Although infant-led approaches that support newborns' instinctive feeding behaviors are considered beneficial, experimental evidence on their effectiveness and mechanisms is limited. This study aimed to evaluate the effect of the breast crawl intervention on breastfeeding success and maternal feeding attitudes, and to examine whether maternal attitudes and duration of the first breastfeeding episode mediate this relationship. This study used a randomized controlled trial design with 63 mother and infant dyads. Newborns in the intervention group initiated breastfeeding through breast crawl, while routine breastfeeding care was provided in the control group, and outcomes were analyzed using adjusted and mediation models. After adjusting for breastfeeding experience, the intervention group demonstrated significantly longer duration of the first breastfeeding episode (F = 83.89, p < .001), higher LATCH scores (F = 8.99, p = .004), and more positive IIFAS scores (F = 4.34, p = .041) compared to the control group. Parallel mediation analysis indicated that the intervention had a significant direct effect on breastfeeding success (LATCH), but this relationship was not mediated by maternal attitudes or breastfeeding duration (p > .05). Breast crawl is an effective, low-cost, and non-invasive intervention that supports early breastfeeding success through primarily direct mechanisms and can be integrated into routine postpartum care.