<![CDATA[Aim: Breastfeeding effectiveness is influenced by various factors, including medical conditions, gestational age, maternal health, and environmental influences, all of which affect a baby's ability to breastfeed effectively. A breastfeeding pillow may improve breastfeeding positioning, attachment, sucking ability, and suckling duration, thereby enhancing feeding performance and reducing maternal discomfort. Methods: A quasi-experimental pretest-posttest control group study with repeated outcome measurements was conducted involving 70 hospitalized preterm infants recruited using consecutive sampling. Mothers in the intervention group used a customized U-shaped breastfeeding pillow, while the control group received routine breastfeeding care. Breastfeeding performance, including positioning, attachment, sucking ability, and suckling duration, was assessed using an 11-item observational checklist at four predetermined time points over four-day intervention period. Data were analyzed using a general linear model repeated measures analysis. Results: Significant group-by-time interaction effects were observed for breastfeeding position, attachment, sucking ability, and suckling duration (all p<0.001). Compared with the control group, preterm infants in the intervention group demonstrated greater improvements in breastfeeding positioning (mean final score: 1.09 vs.2.11; 95% CI: -1.276 to 19.787), attachment (1.09 vs. 2.57; 95% CI: -1.712 to -1.259), and sucking ability (1.29 vs. 2.51; 95% CI: -1.487 to 3.123). Suckling duration also increased significantly in the intervention group from baseline to the final assessment (21.34 vs. 15.43 min; 95% CI: 1.163-3.577; p<0.001). Conclusion: The use of a breastfeeding pillow significantly improved breastfeeding effectiveness in preterm infants by enhancing positioning, attachment, sucking ability, and suckling duration. ]]>
