Postpartum Yoga Reduces Maternal Stress and Improves Breast Milk Expression in Mothers of Preterm Infants: A Randomized Control Trial.

Authors

Ms. Bandita Patra

PhD Scholar, LNCT University, Bhopal, M.P. (India)

Dr. T Jayakumar

Professor cum Principal, LN Nursing College, Bhopal, M.P. (India)

Article Information

DOI: 10.51244/IJRSI.2026.1305000240

Subject Category: Health Science

Volume/Issue: 13/5 | Page No: 2696-2720

Publication Timeline

Submitted: 2026-05-20

Accepted: 2026-05-27

Published: 2026-06-12

Abstract

Background: The postpartum period is associated with elevated stress levels that may adversely affect maternal well-being and lactation. Yoga, as a mind-body intervention, has shown promise in stress reduction; however, evidence regarding its effect on lactation outcomes remains limited.
Aim: This study aimed to evaluate the effectiveness of a structured postpartum yoga intervention on perceived stress and milk volume among postpartum mothers.
Methods: A randomized controlled trial with a pre-test and post-test parallel group design was conducted in the postnatal ward and outpatient department of [Hospital/Community Health Center],. Sixty-four postpartum mothers 6–8 weeks after delivery were selected through consecutive sampling and randomized into an experimental group (n=32) and a control group (n=32). The experimental group received standard postpartum care plus structured postpartum yoga for 45–60 minutes per session, five days per week for six weeks. The control group received standard postpartum care alone. Data were collected using a demographic proforma, the Perceived Stress Scale-10, and milk volume measurement by the test-weighing method. Data were analyzed using SPSS version 27.0 with paired and independent t-tests. Significance was set at p < 0.05.[City]Results: Both groups were comparable at baseline. The experimental group showed a significant reduction in perceived stress scores from 24.6 ± 3.8 to 15.2 ± 3.1 (p < 0.001), while the control group showed no significant change. Milk volume increased significantly in the experimental group from 412.5 ± 68.4 mL/day to 587.3 ± 74.2 mL/day (p < 0.001). Between-group comparisons revealed significantly greater improvement in both perceived stress (p < 0.001, d = 1.42) and milk volume (p < 0.001, d = 1.28) in the experimental group. Compliance with the intervention was 92.4%, with no adverse events reported.
Conclusion: A six-week structured postpartum yoga intervention is effective in reducing perceived stress and improving milk volume among postpartum mothers. The intervention is safe, feasible, and clinically relevant. Integration of postpartum yoga into routine postnatal care is recommended to enhance maternal psychological well-being and lactation outcomes.

Keywords

Postpartum yoga, Perceived stress, Milk volume, Lactation, Randomized controlled trial

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References

1. Chawanpaiboon S, et al. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. [Google Scholar] [Crossref]

2. Lancet Glob Health. 2019;7(1): e37-e46. National Neonatology Forum India. National Neonatal-Perinatal Database Report 2019. NNF; 2020. [Google Scholar] [Crossref]

3. Ionio C, et al. Mothers and fathers in NICU: the impact of preterm birth on parental distress. J Reprod Infant Psychol. 2016;34(1):103-114. [Google Scholar] [Crossref]

4. Vigod SN, et al. Prevalence of psychiatric disorders among pregnant and postpartum women in Ontario. J Clin Psychiatry. 2016;77(1):e104-e111. [Google Scholar] [Crossref]

5. Padovani FH, et al. Anxiety and depression symptoms in mothers of preterm infants: a study in a public maternity hospital. [Google Scholar] [Crossref]

6. Arch Womens Ment Health. 2009;12(2):125-130. [Google Scholar] [Crossref]

7. Ueda T, et al. Psychological stress affects milk ejection reflex in lactating women. [Google Scholar] [Crossref]

8. Psychoneuroendocrinology. 1994;19(3):245-250. [Google Scholar] [Crossref]

9. WHO. Guideline: Protecting, Promoting and Supporting Breastfeeding in Facilities Providing Maternity and Newborn Services. Geneva: WHO; 2017. World Health Organization. Improving Early Childhood Development: WHO Guideline. Geneva: WHO; 2020. [Google Scholar] [Crossref]

10. Dennis CL, Dowswell T. Psychosocial and psychological interventions for preventing postpartum depression. Cochrane Database Syst Rev. 2013;2:CD001134. [Google Scholar] [Crossref]

11. Jiang Q, et al. The effect of yoga-based interventions on anxiety and depression in pregnant and postpartum women: a systematic review and meta-analysis. Complement Ther Med. 2021;56:102607. [Google Scholar] [Crossref]

12. Field T. Yoga research review. Complement Ther Clin Pract. 2016;24:145-161. Curtis K, et al. The effects of yoga on maternal psychological outcomes: a systematic review. [Google Scholar] [Crossref]

13. J Obstet Gynecol Neonatal Nurs. 2012;41(5):618-628. Beddoe AE, et al. Mind-body interventions during pregnancy: a systematic review of the impact on birth outcomes. J Midwifery Womens Health. 2009;54(2):130-140. [Google Scholar] [Crossref]

14. Felice E, et al. Psychological interventions for preventing postpartum depression in high-risk women: early evidence from a randomized controlled trial. Arch Womens Ment Health. 2004;7(2):127-133. [Google Scholar] [Crossref]

15. Ueda T, et al. Psychological stress affects milk ejection reflex in lactating women. Psychoneuroendocrinology. 1994;19(3):245-250. WHO. Guideline: Protecting, Promoting and Supporting Breastfeeding in Facilities Providing Maternity and Newborn Services. Geneva: WHO; 2017. [Google Scholar] [Crossref]

16. Jiang Q, et al. The effect of yoga-based interventions on anxiety and depression in pregnant and postpartum women: a systematic review and meta-analysis. Complement Ther Med. 2021;56:102607. [Google Scholar] [Crossref]

17. Felice E, et al. Psychological interventions for preventing postpartum depression in high-risk women: early evidence from a randomized controlled trial. Arch Womens Ment Health. 2004;7(2):127-133. Ministry of AYUSH, Government of India. National Guidelines for Yoga Therapy for Mental Health and Lifestyle Disorders. New Delhi: AYUSH; 2019. [Google Scholar] [Crossref]

18. Ueda T, et al. Psychoneuroendocrinology. 1994;19(3):245-250. Field T. Complement Ther Clin Pract. 2016;24:145-161. [Google Scholar] [Crossref]

19. WHO. Breastfeeding and Maternal Medication. Geneva: WHO; 2020. Ministry of AYUSH. National Guidelines for Yoga Therapy. 2019. American Academy of Pediatrics. Family-Centered Care in NICU. Pediatrics. 2012;129(2). [Google Scholar] [Crossref]

20. Dutta A, et al. Indian J Public Health. 2014;58(4):219-222. NNF India. Neonatal Care Protocols. 3rd ed. 2020. Jiang Q, et al. Complement Ther Med. 2021;56:102607. [Google Scholar] [Crossref]

21. Jiang Q, et al. The effect of yoga-based interventions on anxiety and depression in pregnant and postpartum women: a systematic review and meta-analysis. Complement Ther Med. 2021;56:102607. [Google Scholar] [Crossref]

22. Ueda T, et al. Psychological stress affects milk ejection reflex in lactating women. Psychoneuroendocrinology. 1994;19(3):245-250. [Google Scholar] [Crossref]

23. Field T. Yoga research review. Complement Ther Clin Pract. 2016;24:145-161. [Google Scholar] [Crossref]

24. Ministry of AYUSH, Government of India. National Guidelines for Yoga Therapy for Mental Health and Lifestyle Disorders. New Delhi: AYUSH; 2019. [Google Scholar] [Crossref]

25. WHO. Guideline: Protecting, Promoting and Supporting Breastfeeding in Facilities Providing Maternity and Newborn Services. Geneva: WHO; 2017. [Google Scholar] [Crossref]

26. Shah et al., “Stress, postpartum depression, and anxiety in mothers of neonates admitted in the NICU,” PMC, 2022. [Google Scholar] [Crossref]

27. Buccini et al., “Postpartum Health in Mothers of Preterm Infants in the NICU,” PubMed, 2025. [Google Scholar] [Crossref]

28. Owusu-Addo et al., “Prevalence and risk factors for postpartum depression and stress,” PubMed, 2025. [Google Scholar] [Crossref]

29. Spencer et al., “Parenting Stress Following a NICU Hospitalization,” PubMed, 2024. [Google Scholar] [Crossref]

30. Lassri et al., “Maternal mental health following preterm birth,” PMC, 2025. [Google Scholar] [Crossref]

31. Garfield et al., “Parental stress and depression in NICU mothers,” PubMed, 2021. [Google Scholar] [Crossref]

32. Adhikari et al., “Stress among mothers of preterm infants in NICU,” PubMed, 2025. [Google Scholar] [Crossref]

33. Holditch-Davis et al., “Development of the PSAS-NICU,” PubMed, 2024. [Google Scholar] [Crossref]

34. Aparicio et al., “Effects of Maternal Stress on Breast Milk Production and the Microbiota of Very Premature Infants,” PMC, 2023 [Google Scholar] [Crossref]

35. Fallon et al., “Maternal psychological distress and lactation and breastfeeding outcomes,” PMC, 2021 [Google Scholar] [Crossref]

36. Castro et al., “From Mind to Milk: The Influence of Psychological Factors on the Composition of Human Breast Milk,” PMC, 2024 [Google Scholar] [Crossref]

37. Papadopoulou et al., “Factors associated with delayed onset of lactogenesis,” PubMed, 2015 [Google Scholar] [Crossref]

38. Galazka et al., “Maternal stress and breast milk hormones,” PubMed, 2024 [Google Scholar] [Crossref]

39. Moradi et al., “Perceived stress and exclusive breastfeeding,” PubMed, 2024 [Google Scholar] [Crossref]

40. Moberg et al., “Relaxation intervention increases oxytocin and milk volume in breastfeeding mothers,” PubMed, 2022 [Google Scholar] [Crossref]

41. Slattery et al., “Factors associated with early lactation in preterm mothers,” PubMed, 2022 [Google Scholar] [Crossref]

42. Pandit et al., “Effect of postnatal yoga on stress and lactation in mothers of preterm infants,” PubMed, 2022 [Google Scholar] [Crossref]

43. Kaur et al., “Yoga on maternal stress and breastfeeding outcomes,” PubMed, 2021 [Google Scholar] [Crossref]

44. Uebel et al., “Mindfulness-based stress reduction and breastfeeding duration,” PubMed, 2020 [Google Scholar] [Crossref]

45. Suresh et al., “Pranayama and meditation on breast milk volume,” PubMed, 2023 [Google Scholar] [Crossref]

46. Field et al., “Yoga on postpartum depression and breastfeeding self-efficacy,” PubMed, 2019 [Google Scholar] [Crossref]

47. Li et al., “Progressive muscle relaxation on stress and milk cortisol,” PubMed, 2024 [Google Scholar] [Crossref]

48. Choudhary et al., “Guided imagery and relaxation on lactation in mothers of LBW infants,” PubMed, 2023 [Google Scholar] [Crossref]

49. Dhillon et al., “Feasibility of postnatal yoga on stress and lactation,” PubMed, 2021 [Google Scholar] [Crossref]

50. Buttle et al., “Effect of postnatal yoga on postpartum depression and anxiety,” PubMed, 2018 [Google Scholar] [Crossref]

51. Davis et al., “Prenatal yoga and postpartum stress and depression,” PubMed, 2020 [Google Scholar] [Crossref]

52. Gong et al., “Online yoga on postpartum anxiety during COVID-19,” PubMed, 2021 [Google Scholar] [Crossref]

53. Muzik et al., “Trauma-informed yoga for postpartum PTSD and depression,” PubMed, 2022 [Google Scholar] [Crossref]

54. Smith et al., “Mindfulness yoga on stress and mood in new mothers,” PubMed, 2019 [Google Scholar] [Crossref]

55. Sharma et al., “Hatha yoga on postpartum depression in Indian women,” PubMed, 2023 [Google Scholar] [Crossref]

56. Rakhshani et al., “Yoga on sleep quality and stress in postpartum women,” PubMed, 2018 [Google Scholar] [Crossref]

57. Bowen et al., “Yoga and mindfulness on postpartum anxiety and bonding,” PubMed, 2020 [Google Scholar] [Crossref]

58. Bershadsky, S., Trumpfheller, L., Kimble, H. B., Pipaloff, D., & Yim, I. S. (2014). The effect of prenatal Hatha yoga on affect, cortisol and depressive symptoms. Complementary Therapies in Clinical Practice, 20(2), 106–113. doi.org [Google Scholar] [Crossref]

59. Dalal, K., Kaur, R., & Tiwari, M. (2019). Effect of yoga and relaxation therapy on lactation among postnatal mothers. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 8(4), 1560–1565. doi.org [Google Scholar] [Crossref]

60. Timlin, D., & Simpson, E. E. A. (2017). A preliminary randomised control trial of the effects of Dru yoga on psychological well-being in Northern Irish nurses. Journal of Occupational Health Psychology, 22(4), 508–520. doi.org [Google Scholar] [Crossref]

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