Background <p>This study was conducted to determine the effect of the patient rotation and movement system (PRMS) on breastfeeding success, pain, and comfort in puerperants who gave birth by caesarean delivery.</p> Methods <p>This is a randomised controlled trial. Data were collected in the caesarean unit of Kars Harakani State Hospital between 01.12.2020 and 30.06.2021. The study was completed with 146 puerperants (experimental group <i>n</i> = 74; control group <i>n</i> = 72). Data were collected using the LATCH Breastfeeding Diagnosis and Evaluation Scale, Visual Analogue Scale (VAS), Postpartum Comfort Scale (PCS), and Lactogenesis Symptoms Follow-up Form. The trial was retrospectively registered at ClinicalTrials.gov.</p> Results <p>LATCH scores were significantly higher in the experimental group at all breastfeeding assessments (<i>p</i> &lt; 0.001). VAS pain scores were significantly lower in the experimental group during the first three breastfeeding sessions and the first breastfeeding before discharge (<i>p</i> &lt; 0.05). Physical comfort and total PCS scores were significantly higher in the experimental group (<i>p</i> &lt; 0.05). Most lactogenesis breast symptoms were more prevalent in the experimental group from postpartum day 2 onward. No adverse events related to PRMS use were observed during the study period.</p> Conclusions <p>The PRMS improved breastfeeding success, reduced early postpartum pain, and enhanced physical comfort after caesarean delivery. No significant effect was observed on psychospiritual or sociocultural comfort. These findings suggest the PRMS may be a promising non-pharmacological supportive strategy in post-caesarean care. Future studies with formal safety endpoints and standardised protocols are warranted.</p>