DOI Number:

Indian Journal of Forensic Medicine & Toxicology, 10.5958/0973-9130.2019.00550.4

October-December 2019, Vol. 13, No. 4  1687

Effectiveness of Oxytocin Massage and Breast Care

Treatment on Breast Milk Production

Feftin Hendriyani1, Suryaningsih1, Agung Suharto1

1Lecturer, Health Polytechnic of Surabaya

Abstract
Breast care treatment is an important part that must be considered as a preparation for breastfeeding. The
smoothness factor of breast milk apart from giving breast care treatment that develops one of them in
triggering the release of oxytocin hormone is through oxytocin massage which is done on the postpartum
and breastfeeding mothers. This study aims to determine the effectiveness of oxytocin massage and breast
care treatment for more breast milk production, using static group comparison design. Dependent variables
for postpartum maternal breast milk production, the independent variables were oxytocin massage and breast
care treatment. The subjects were 28 postpartum mothers at BPS Rtn, Mlajah, Bangkalan Indonesia, selected
using simple random sampling. Data were collected using observation sheets, then analyzed by Krusskal
Wallis test. Based on the results, it was proved that the average rank in the oxytocin massage and breast
care treatment combination group was higher than the average rank in the breast care treatment group. The
average rating in the breast care treatment group was higher than the average oxytocin massage group and
the average oxytocin massage group was higher than the control group. However, there was no difference in
breast milk expenditure in each group (p-value >0.05).

Keywords: breast milk production, oxytocin massage, breast care treatment

Introduction Based on the results of the Basic Health Research

2014, breastfeeding in infants born for 6 months has not
In the first day postpartum mothers often
been satisfactory. Breastfeeding at 0-1 month is 45.4%,
experience psychological disorders. The occurrence of
2-3 months 38.3%, and 4-5 months 31%. Overall, the
psychological disturbances can reduce milk production.
coverage of exclusive breastfeeding in Indonesia is only
Another study conducted by Roesli(1) identified that with
20% far from the target set of 80%. Ministry of Health has
breast milk, babies are eight times saver likely to develop
set a target coverage of exclusive breastfeeding per 2014
blood cancer, spleen cancer, nerve cancer, and diarrhea,
by 80%. In fact, only 27.5 percent of mothers in Indonesia
because the ability of the baby’s intestine to absorb
have succeeded in giving exclusive breastfeeding.
food has been adjusted by respective compositions
Responding to these findings, World Vision Indonesia
each mother. Children without breastfeeding by breast
(WVI) and the Indonesian Breastfeeding Mothers
milk are more likely to develop chronic diseases such
Association (AIMI) collaborated to conduct research to
as cancer, heart disease, hypertension, and diabetes after
find solutions for breastfeeding(3).
adulthood, the likelihood of children suffering from
malnutrition and obesity is also higher(2). There are several factors that affect the mother in
giving breast milk to her baby. Huang et al.(4) reported that
To reducing mortality and preventing disease and
the behavior of breastfeeding mothers was influenced by
increase intelligence, breast milk also affects the family
maternal education, the status of parity and the closeness
economy, where the amount of money parents spend
of the mother’s relationship with her baby. Based on
in Indonesia for the need for formula milk for their
Nuraini(5), there was significant relationship between
babies in a year can spend around Rp. 3.96 trillion and
maternal knowledge and behavior on breastfeeding,
calculations in a year there are 4.5 million newborns and
but there was no relationship with family support with
each baby needs 44 cans of milk at a price of Rp. 20,000/
breastfeeding. This shows that better the mother’s
cans.
1688  Indian Journal of Forensic Medicine & Toxicology, October-December 2019, Vol. 13, No. 4

knowledge, more breastfeeding behavior will increase. with experiment group that receive oxytocin massage
and breast care treatment, and control that no receive
The Ministry of Health has issued decree concerning treatment. A score determined to measure differences
exclusive breastfeeding. But not all postpartum mothers among two groups. Dependent variable was breast milk
immediately excrete breast milk because breast milk was production and the independent variables were oxytocin
complicated interaction between mechanical stimuli, massage and breast care treatment. Subjects were 28
nerves and various hormones that affect oxytocin postpartum mothers at BPS Rtn, Mlajah, Bangkalan
release(6). Indonesia, selected using simple random sampling. Data
Based on preliminary study on February 1, 2018 were collected using observation sheets, then analyzed
at the BPS Rtn Mlajah, Bangkalan, Indonesia, 4 of 10 by Krusskal-Wallis test.
breastfeeding mothers that did not give breast milk
through the first, second, and third days, this was because
Findings and Discussion
breast milk had not come out and breast milk production The results showed that postpartum mothers who
was low(7). The 4 respondent had never done oxytocin were given oxytocin massage released enough milk
massage and breast care treatment. as much as 75% more than those who lacked it. The
p-value was >0.05, it means there was no effect of
Many factors influence breastfeeding and breast breastfeeding production on postpartum mothers given
milk production, including maternal physical factors, oxytocin massage.
such as breast anatomical abnormalities, health
problems, hormonal contraceptives (estrogen), lack of There are many factors that must be controlled so
nutritious food, working mothers, smokers, and alcohol that breast milk production was high. Oxytocin massage
consumption. Breastfeeding factors such as not giving is one of the factors that can affect the smooth release
IMD (Early Breastfeeding Initiation), breastfeeding of breast milk so that breast milk production increases.
technique errors, not breastfeeding on demand, and The accuracy in applying oxytocin massage techniques
prelactal supplementation of breast milk complementary determines the effect given in facilitating the production
foods. Infant factors such as health, low birth weight, of breast milk, but does not rule out the possibility when
and congenital abnormalities. Psychological factors such oxytocin massage techniques are applied correctly but
as stress, lack of confidence, anxiety, and sadness(8),(9). other factors not controlled by breast milk production
In addition to the above factors, other factors that also will decrease. It is also possible that the mother did not
affect breast milk production were breast care treatment apply oxytocin massage techniques but can control the
and oxytocin massage. Physical treatment of the breast factors that affect adequate breastfeeding. Some factors
nearing the lactation period and during lactation needs that influence the production of breast milk include
to be done because it can flex the nipples and avoid breast care treatment during pregnancy, breastfeeding
blockage of the lactation lactus so that when the baby techniques, frequency of breastfeeding, formula milk,
becomes more susceptible to suckling and breast milk food consumed by mothers, and maternal psychology.
will come out smoothly.
According to IDAI(8) increased milk production is
Other factors that also affect breast milk production influenced by maternal physical factors, such as breast
and breast milk production are breast care treatment and anatomic abnormalities, health problems, hormonal
oxytocin massage. Oxytocin massage is expected and contraceptives (estrogen), nutrition, working mothers,
breast treatment provides benefits. Increases comfort, smokers, and alcohol consumption. Breastfeeding
increases breast milk movement to the breast, adds breast factors such as doing Early Breastfeeding Initiation
milk to the breast, and expedites breastmilk production. (IMD), breastfeeding technique errors, breastfeeding
are not on demand, and prelactal administration of
This study aims to determine the effectiveness of breast milk supplementary food. Infant factors such as
oxytocin massage and breast care treatment for more health, prematurity, low birth weight and congenital
breast milk production abnormalities. Psychological factors such as stress,
lack of confidence, anxiety, and sadness. Other factors
Method
are breast care treatment and oxytocin massage.
The design of this study was static-group comparison, Breastfeeding mothers that can control these factors,
 Indian Journal of Forensic Medicine & Toxicology, October-December 2019, Vol. 13, No. 4  1689

more breast milk production and early breastfeeding and been practiced how to do breast care treatment, but
exclusive breastfeeding can be applied. the absorption and perception of individuals varies
according to the level of education.
Besides the above factors that affect the increase
in breast milk production is the time period and sample 2. Psychological factors
size. While the time observed by the researchers is only
3 days, the possibility of an increase in breast milk Breast milk from the breast is affected by oxytocin
production can be assessed. There was potential to and prolactin in the blood, these hormones can improve
increase, although the sample size is too little. by making the mother feel comfortable and happy.

The results showed that post partum mothers who This oxytocin reflex can be increased by: increase
were given breast care treatment issued enough milk feelings of happiness for example by seeing the baby,
as much as 71.4%. The phenomenon found in the field improve your sense of relaxation and comfort, increase
showed that breast milk expenditure and breast milk confidence that breast milk was the best for baby.
ejection were small on the first day after giving birth Based on the results of the study showed that
to become an obstacle in early breastfeeding. This there was an effect of breastmilk expenditure in the
obstacle is caused by the lack of stimulation of prolactin combination group of oxytocin massage and breast care
and oxytocin hormones which are very instrumental in treatment on breastmilk expenditure, 100% of breastmilk
smoothing out Breast milk production. According to expenditure was sufficient.
IDAI(8), breast care treatment is beneficial to stimulate
the breast to affect the pituitary to release prolactin The results of this study are reinforced by research
and oxytocin. Prolactin affects the amount of milk conducted by Mardiyaningsih(11) on the effectiveness
production, while oxytocin influences the process of of the combination of marmet and oxytocin massage
breast milk. techniques on post section mother’s milk production in
the Central Java Regional Hospital. There is a difference
Breast care treatment is very important during in the proportion of smooth breast milk production.
pregnancy until breastfeeding. This is because the breast
is the only producer of breast milk which is the staple According to IDAI(8), breast care treatment is
food of a newborn baby so it must be done as early as beneficial to stimulate the breast to affect the pituitary
possible. Breast and nipple treatment will help flex and to release the hormone prolactin and oxytocin. It has
strengthen the nipples, making it ebreast milker for the been mentioned above that the production and release
baby to suckle, as well as stimulating the milk glands of breast milk are affected by two hormones, namely
so that milk production is transmitted and increased. prolactin and oxytocin. Prolactin affects the amount of
Breast care treatment is a way of treating the breast that milk production, while oxytocin influences the process
is done during pregnancy or the puerperium for breast of breast milk. Breast care treatment is very important
milk production, in addition to the cleanliness of the during pregnancy until breastfeeding. Because the breast
breast and the shape of the nipple that goes in or flat. was the only producer of breast milk which is the staple
Such nipples are actually not an obstacle for the mother food of a newborn baby so it must be done as early as
to breastfeed properly by knowing from the start, the possible. Breast and nipple treatment will help flex and
mother has time to make the nipples ebreast milker when strengthen the nipples, making it ebreast milker for the
breastfeeding. Besides that it is also very important to baby to suckle, as well as stimulating the milk glands so
pay attention to personal hygiene(10). that milk production was transmitted and increased.

Theoretically giving this treatment has a positive Breast care treatment was a way of treating the
impact on the mother. But in reality the provision of breast that is done during pregnancy or the puerperium
breast care treatment is also not optimal in the smoothness for breast milk production, in addition to the cleanliness
of breast milk production, this is due to several factors, of the breast and the shape of the nipple that goes in
which include: or flat. Such nipples are actually not an obstacle for the
mother to breastfeed properly by knowing from the start,
1. Educational factors the mother has time to make the nipples ebreast milker
This factor also determines, even though it has when breastfeeding. Besides that it is also very important
1690  Indian Journal of Forensic Medicine & Toxicology, October-December 2019, Vol. 13, No. 4

to pay attention to personal hygiene(10). The level of education is one of the social aspects
that can affect human behavior. The low level of maternal
Oxytocin massage is an act of spinal massage ranging education here tends to use exclusive breastfeeding than
from nerves to 5-6 to scapula which will accelerate the mothers with high education, generally they are open to
work of the parasympathetic nerve to convey commands accepting changes or new things to maintain their health.
to the back brain so that oxytocin exits(12),(13). Oxytocin Mothers who are more educated tend to prefer formula
massage is done to stimulate let down reflex or reflex feeding because they are busy with their career work, and
flow of breast milk. Effects of massage massage can be they do not want to repit and are also less painstaking.
seen after 6-12 hours of massage(14). The more often babies are given formula milk, the milk
Oxytocin massage is an action taken by the husband production decreases. According to Khasanah(7), the
on nursing mothers in the form of oxytocin massage on touch and lick of a baby on the mother’s nipples during
the mother’s back to increase the release of the hormone breastfeeding will help stimulate the release of oxytocin
oxytocin. Oxytocin massage carried out by the husband hormones in the brain which are important to stimulate
will provide comfort to the mother so that it will provide breast milk which has an impact on increbreast milkng
comfort for breastfed babies(15). breast milk.

The provision of oxytocin massage will accelerate There are many factors that can affect breast milk
the work of the parasympathetic nerve to stimulate the production, such as the frequency of breastfeeding,
peripheral sensory nerve endings in the back brain to breastfeeding techniques, maternal nutrition during
secrete the hormone endorphin, which can inhibit the breastfeeding and also formula feeding for control of all
release of adrenal hormones. Adrenaline hormone is factors is needed so that breast milk can still be produced
one of the hormones that can inhibit the release of the optimally, regardless of age, parity and breastfeeding
oxytocin(16). The release of the endorphin hormone can mother education.
provide comfort, help with relaxation, improve blood
circulation, and improve the work of the organ system.
Conclusion
This can stimulate the release of the hormone oxytocin Based on the results of the study it can be concluded
and prolactin so that it can increase milk production and that, Oxytocin massage is not effective in expediting
release milk. breast milk. Breast care treatment is not effective in
expediting breast milk. The combination of oxytocin
According to Marmi(16), the purpose of oxytocin massage and breast care treatment has proven to be
massage was maintain and facilitate breastfeeding and effective against breastfeeding. There is no difference
prevent infection. Benefits of oxytocin massage were between postpartum mothers who are given oxytocin
increase comfort, increase breast milk movement to the massage and breast care treatment for breastfeeding, but
breast, Add breast milk to the breast, increase breast there is the potential to expedite breast milk production.
milk production.
Conflict of Interest- No
Based on the results of the study, of the 7
postpartum mothers who had less breastmilk production, Source of Funding- Authors
4 postpartum mothers aged 20-35 years, postpartum
mothers educated from junior high school, 3 postpartum Ethical Clearance- Yes
mothers as housewives, 2 postpartum primiparous
mothers, and 2 multiparous postpartum mothers. Based
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