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N/A N=250 Randomized Double-blind Treatment

Promoting Self-Management of Breast and Nipple Pain With Technology (PROMPT) for Breastfeeding Women Study

Breastfeeding, Exclusive · Pain, Acute · Maternal Distress · Parent-Child Relations · Self Efficacy

Enrolled (actual)
250
Serious AEs
30.0%
Results posted
Jan 2026
Primary outcome: Primary: Visual Analogue Scale for Breast and Nipple Pain Severity — 39.43; 36.55; 44.31; 36.93 units on a scale — p=<0.0045

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
The BSM Intervention (Behavioral); Attention Control (Behavioral)
Age
Adult · 18+ yrs
Sex
Female
Sponsor
University of Connecticut
Primary completion
Dec 2023

Outcome Measures

OutcomeResultp-value
PRIMARY
Visual Analogue Scale for Breast and Nipple Pain Severity
39.43; 36.55; 44.31; 36.93; 33.8; 25.68 <0.0045 sig
PRIMARY
Brief Pain Inventory Pain Intensity Scale
3.88; 3.79; 3.56; 3.72; 2.89; 3.24 0.65
PRIMARY
Brief Pain Inventory Interference Scale
3.38; 3.55; 2.27; 2.46; 1.92; 2.00 0.681
PRIMARY
Cumulative Breast and Nipple Pain Scores
36.55; 39.43; 72.47; 84.36; 98.57; 117.64 <0.011 sig
SECONDARY
Breastfeeding Exclusivity Participation Rate
119; 118; 67; 74; 56; 70 0.135
SECONDARY
Breastfeeding Self-Efficacy Scale
45.28; 45.49; 51.44; 51.26; 53.24; 51.62 0.571
SECONDARY
Anxiety Patient-Reported Outcomes Measurement Information System (PROMIS) Short Form 6a
51.56; 51.27; 48.35; 49.81; 47.02; 48.36 0.186
SECONDARY
Edinburgh Postnatal Depression Scale
5.56; 6.03; 4.56; 5.76; 4.05; 4.50 0.191
SECONDARY
Fatigue Patient-Reported Outcomes Measurement Information System (PROMIS) Short Form 6a
53.99; 54.95; 51.72; 54.48; 50.98; 52.26 0.09
SECONDARY
Perceived Stress Scale10 Form V.09/16/13
12.94; 12.93; 11.52; 12.68; 10.71; 11.44 0.672
SECONDARY
Sleep Patient-Reported Outcomes Measurement Information System (PROMIS) Short Form v1.0 - Sleep Disturbance 6a
52.35; 54.13; 49.32; 50.69; 48.10; 48.91 0.221

Summary

Every year, 1 million women cease breastfeeding (BF) before 6 months, the minimum time required for optimal maternal and infant health, development, and well-being. The highest rate of BF cessation occurs within 3 weeks after birth, with 30% of women ceasing BF due to acute breast and nipple pain (BNP). BNP is a complex and understudied biobehavioral phenomenon involving nociceptive signaling that stimulates multiple pain pathways. Women who experience BNP beyond BF initiation report lower BF self-efficacy, a key predictor of BF at 6 months and increased maternal distress symptoms contributing to differences in early BF cessation rates. The investigators developed and tested their 6-week nurse-led and participant-informed, Breastfeeding and Breast and Nipple Pain Self-Management (BSM) intervention guided by the Individual and Family Self-Management Theory. Aligned with the needs and preferences elicited from BF participants, the investigators used a cloud-based platform to deliver BF knowledge and skills and provided support through nurse-led text-based communication to decrease BNP, increase BF self-efficacy, decrease burdensome face-to-face visits, and increase adaptive coping behaviors. Participants in the BSM intervention group reported significantly reduced BNP intensity at 1 and 2 weeks which predicted increased BF self-efficacy and decreased anxiety at 6 weeks. Based on these promising results, the investigators propose to examine the efficacy of the BSM intervention in an R56NR020041 Randomized Control Trial (RCT), Promoting Self-Management of Breast and Nipple Pain Using Technology (PROMPT) for Breastfeeding Women to decrease BNP intensity and interference and increase BF exclusivity. The study will reproduce and extend the pilot findings by exploring in a diverse population of BF participants how participants' pain sensitivity affects BNP. The study will explore the moderating role of BNP, and maternal well-being symptoms of fatigue, depressive symptoms, anxiety, and sleep, pain, pain coping, and maternal self-efficacy, on BF exclusivity. Participants (N = 222) intending to breastfeed will be randomized to the BSM intervention or the attention control group with assessments performed at baseline, 1, 2, 3, 6, 9, 12, 18, and 24 weeks. Study results will advance knowledge on the BSM intervention, with direct implications for nurse-designed and lead self-management interventions in clinical settings or health care systems.

Eligibility Criteria

Please reformat the Eligibility Criteria. The preferred format includes lists of inclusion and exclusion criteria as shown below.

Inclusion Criteria

  • women
  • 18 - 45 years of age
  • Gave birth 37 weeks gestational age
  • Intend to BF
  • Received standardized BF basics during their antenatal care
  • Access to the internet via own smartphone or study provided smartphone
  • Able to read and write English
  • Assessed by lactation consultant during BF

Exclusion Criteria

  • 45 years of age
  • History of significant mental health disorder (e.g., major depression, schizophrenia, or bipolar disorder) due to additional challenges in the capacity for self-management
  • Skin conditions on nondominant forearm which could interfere with quantitative sensory testing
  • Birth of an infant with medical complications or congenital anomalies
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT05262920). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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