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JOURNAL OF Applied Science and Technology
Research of Applied Science and Education V9.i4 (282-293)

THE EFFECT OF OXYTOSIN MASSAGE AGAINST INCREASE IN ASI PRODUCTION

MOMS Breastfeeding at MANDIANGIN PLUS HEALTH CENTER

Mera Pomegranate 1 *, Gina Zulfia Arni 2, Ernalinda Rosya 3

Nursing Study Program STIKes Perintis Padang, Jl. Kusuma Bakti
* Email: meradelima@rocketmail.com

Submitted: 26-26-2016, Rewiewed: 11-16-2016, Accepted: 11-22-2016

http://dx.doi.org/10.22216/jit.2015.v9i4.571

Abstract
This study is based on interviews conducted to 3 breastfeeding mothers who amount of mother's milk is little caused baby
crying and blister on mother's nipple. Meanwhile, the other two women were told that her milk production.is normal. The mother
said lack of information about treatments to improve the production of breast milk (ASI) and they don't know about oxytocin
massage to help increase milk production. This study is aimed at observing the effect of oxytocin massage to increase milk
production of breastfeeding mother in Bukittinggi Public Health Center Plus Mandiangin 2016. The study design uses a quasi
experimental method, with the approach of one group for pretest and posttest. Retrieving data using a questionnaire about milk
production. The sample were 21 people at Mandiangin Public Health Center Bukittinggi. This study showed that there is an
effect of oxytocin message to increase milk production in with a p-value of 0,000. Can be concluded that there is a massage
effect of oxytocin to increase milk production on breastfeeding mother in Bukittinggi Public Health Center plus Mandiittin 2016.
It is expected that this study can be used as a therapy to increase milk production of breastfeeding mothers.

Keywords: oxytocin, massage, breastfeeding, breast milk

Abstract

This research is based on interviews conducted on 3 breastfeeding mothers whose breast milk is small, causing
babies to cry often and nip the mother's milk. Meanwhile, two other women said milk production was normal. The
mother said lack of information about treatments to increase milk production (ASI) and they did not know about
oxytocin massage to help increase milk production. This study aims to look at the effect of oxytocin massage to
increase milk production of breastfeeding mothers at Puskesmas Plus Mandiangin Bukittinggi 2016. The research
design uses quasi experimental methods, with one group pretest and posttest approaches. Retrieval of data using a
questionnaire containing questions about the production of breast milk. The study sample was 21 people who were at
the Mandiangin Plus Puskesmas Bukittinggi 2016. In this study showed that there was an effect of oxytocin massage
to increase breastfeeding production of breastfeeding mothers at Puskesmas Plus Mandiangin Bukittinggi 2016, with
a p-value of 0,000. It was concluded that there is an effect of oxytocin massage to increase milk production for
breastfeeding mothers at Puskesmas Plus Mandiangin Bukittinggi 2016. It is hoped that this study can be used as a
therapy to increase breast milk production of nursing mothers.

Keywords: oxytocin, massage, breastfeeding, production, breast milk

PRELIMINARY basic education, supporting gender equality and

Program Millennium Development Goals empowering women, reducing child mortality,
(MDG΄s) which consists of eight subjects namely reducing maternal and child mortality, fighting HIV
eradicating extreme poverty and hunger, / AIDS,
equal distribution

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malaria and other diseases, guaranteeing the
carrying capacity of the environment and
developing global partnerships for development.
The 4th MDG's target is to reduce infant and
under-five mortality rates to 2/3 in terms of
knowledge in the 1990-
2015. The main causes of infant and toddler deaths
are diarrhea and pneumonia, more than 50% of
infant and toddler deaths are caused
by lack of nutrition.
Exclusive breastfeeding for 6 months and
continued for 2 years in addition
giving food
ASI companion (MP ASI) is adequately proven as
one of the effective interventions that can reduce
infant mortality (Sitaresmi, 2010).
Infant Mortality Rate (IMR) in Indonesia,
still enough high
compared to countries in Southeast Asia that is
34/1000 live births, still quite high compared to
countries in Southeast Asia which are 34/1000
live births, still quite high compared to Malaysia
(16/1000)
and Singapore (2/1000)
live birth (SDKI, 2007). This figure is also far from
the MDG target of 24 per 1000 live births in 2015
(BPS, 2008). Cause
Most infant deaths are diarrhea and drinking
problems (31.4%) and pneumonia (23.8%)
(Riskesdas, 2007). Then in 2009
Millennium Development Goals ( MDG΄s)
Indonesia is targeting a decrease of 23 in infant
and under-five mortality rates in the 2009-2015
period. Therefore, Indonesia has a commitment to
reduce infant mortality from 68 / 1,000 live births
to 23 / 1,000 live births and under-five mortality
from 97 / 1,000 live births to 32 / 1,000 live births.
To reach the target Millennium Development
Goals
(MDG΄s) 2015 in order
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reducing IMR can be done one of them by giving
exclusive breastfeeding (MOH, 2002).
Based on the 2010 Susenas data, only
33.6% or about a third of infants who received
exclusive breastfeeding from birth until the age of
six months, coverage is still considered very low
and in 2011 exclusive breastfeeding in Indonesia
increased, the percentage of infants who
exclusively breastfeeded 0 to 6 month by 61.5%.
This is still far from the MDG's target of 80% of
infants for exclusive breastfeeding (Kemenkes,
2012).
Final development breast
being an organ that secretes milk requires
progesterone and works synergistically with the
hormone estrogen as well as other hormones to
grow and develop breast lobules and the
secretive properties of alveoli. Instead the
hormone prolactin has
the opposite effect viz
increase milk production, this hormone is secreted
by the anterior pituitary gland, and its
concentration is increased in the mother's blood
steadily increasing from the fifth week of
pregnancy until the birth of the baby, at which
time this
increased 10-20 times of normal levels at the time
not pregnant. Concentration
high prolactin at the end of pregnancy (Gyton,
2007)
Breast milk is a type of food that is
sufficient for all elements of the baby's needs
whether physical, psychological, social or spiritual,
breast milk contains nutrients, hormones, immune
growth elements, anti-allergic, and
anti-inflammatory. Nutrition in breast milk includes
nearly 200 elements of food substances
(Hubertin, 2007). The Government has stipulated
Government Regulation No. 33 of 2012 Regarding
Exclusive Breastfeeding, the Government
Regulation states that every baby must get
exclusive breast milk which is given to babies
from birth
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During 6 (six) month, without the hormone oxytocin after childbirth (Biancuzzo,
add and / or replace with other food or drinks 2003; Indiyani, 2006; Yohmi & Roesli, 2009 in
(Ministry of Health, Mardiyaningsih,
2012). 2010). Hormone oxytocin will come out through
Breast milk is useful for maintaining stimulation to the nipple through baby's mouth
endurance baby because it contains substances suction or through massage on the baby's spine,
anti namely infection of substances immune by doing massage on the spine the mother will
unique modulators and nutrients such as feel calm, relaxed, increase the pain threshold
carbohydrates in the form of lactose, lots of fat and love her baby, so that the hormone oxytocin
(polyunsaturated fatty acids), main proteins in the comes out and breast milk too get out quickly
form lactabumin which is easily digested, contains (WBW,
a lot of vitamins and minerals (Venter et al, 2008).
The benefits of breastfeeding for mothers not only
can establish love, 2007).
but Oxytocin massage is done to stimulate
What's more can reduce bleeding after the oxytocin reflex or reflex
give birth, speed up let down. By doing this massage the mother will feel
health recovery mother, delay relaxed, fatigue after childbirth will disappear, so
pregnancy, reduce risk of being exposed that the hormone oxytocin will come out and breast
cancer breast, and is milk comes out quickly (Mardiyaningsih, 2010). In
happiness for mother (Piliteri, addition to stimulating reflexes let down
2003).
Data from the West Sumatra health the benefits of oxytocin massage is to provide
service profile 2010-2012 shows that the comfort mother, reduce
coverage of exclusive breastfeeding in 2010 was swollen ( engorgement), reduce milk
43.7% and in 2011 it rose to 54.8% while in 2012 blockage, stimulate hormone release
it was 61.1% (Riskesdas, 2013). Exclusive oxytocin, maintain
breastfeeding can be influenced by several milk production when mother and baby are sick
factors including breastfeeding (MOH RI, 2007). Research conducted by Endang
(2015) at
on day first post Surakarta about the effect of oxytocin massage on
give birth, promotion effect milk postpartum mothers on breast milk production
substitute for breast milk, baby's difficulty in sucking, the the results obtained that there is
condition of the mother's nipples and the mother feels that increased milk production in the intervention group
the milk is released a little (Siregar, 2004). implemented with a Pvulue result of 0.0005

ASI expenditure can be influenced by two Research conducted by Rusdiati (2013)

factors, namely production and expenditure. ASI who examined the effect of oxytocin massage on
production is affected by postpartum mothers on breast milk expenditure in
hormone prolactin while Jember District found that there was an effect of
expenditure is influenced by hormones oxytocin massage on breast milk expenditure on
oxytocin. Oxytocin massage is one
the solution to resolve puerperal mother. Results research
lack of milk production. Massage shows the average milk expenditure for postpartum
oxytocin is massage along the bone mothers who did not do oxytocin massage by 4.61
back ( vertebrae) and minutes and the average breast milk expenditure for
is an attempt to stimulate postpartum mothers who

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oxytocin massage is 11.78 minutes. This was also
shown by the results of Siti Nur Endah's research
(2011) with the title of the influence of oxytocin
massage on colostrum expenditure in post partum
mothers in obstetrics room Muhammadiyah
Hospital Bandung showed the average colostrum
removal time of the treatment group was 5.8
hours while the length of the control group 5.89
hours.
The results of interviews conducted by
researchers on officers at the Public Health Center
Plus Mandiangin mother that
exclusive breastfeeding and breastfeeding for the
next 6 months in the last 3 months
64 person. Based on
Interviews conducted with 3 mothers who
breastfeeded breast milk was less smooth and the
amount of breast milk was small causing the baby
to cry frequently and prone to blisters. Whereas 2
other mothers said that her milk production was
normal. The nursing mother said the lack of
information obtained by the mother about care to
increase the smooth production of breast milk
(ASI), and food
which improves
breast milk production (ASI) and they do not know
that oxytocin massage is available to help
increase milk production.
Based on the background of the problem
above, it can be formulated the problem in this
study are: Is There an Effect of Oxytocin Massage
on Increasing Breast Milk Production in
Breastfeeding Mothers
in Puskesmas Plus
Mandiangin Bukittinggi in 2016 ".
Breast milk is a type of food that meets
all the elements of baby's needs
physical, psychologically as well
spiritual. Breast milk contains nutrients, hormones,
immune growth elements, anti-allergic, and
anti-inflammatory. Nutrition in breast milk includes
nearly 200 elements of food substances (Hubertin,
2003, p. 81).
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Breast milk is produced in „ alveolli ', at the
beginning of a small channel of milk. The tissue
around the milk and alveoli ducts is composed of
fatty tissue, the binding tissue determines the size
of the breast. During pregnancy, the breasts
enlarge two to three times their normal size, and
milk and alveoli ducts are prepared for lactation.
In the lactation process there are two reflexes that
play a role, namely prolactin reflexes and flow
reflexes that arise due to nipple stimulation due to
baby sucking, namely:
Reflex prolactin
Late pregnancy hormone prolactin
plays a role to make colostrum limited due to
activity
prolactin inhibited by estrogen and
progesterone which is still high.
Reflex flow ( reflex let down)
Together with formation
prolactin by hypophise anterior,
stimulation originating from the baby's sucking is
continued to the posterior pituitary which is then
released oxytocin. Through the bloodstream, this
hormone goes to the uterus so
give rise to contraction.
The contraception of the cell will squeeze the milk
that has been made out of the alveoli and into the
duct system and then flow through the baby's
mouth.
The smooth production of breast milk is a
process of release of breast milk from the mother's breast
with or without suctioning by the baby
(Wheeler, 2004). Mother's milk should be
given immediately after the baby is born. The first
milk that lasts around 4-5 days, is still in the form
of collustrum. The amount of collustrum that is
secreted every day ranges from 10-100 cc, with
an average of 30 cc. Water
milk
actually only came out after the fifth day.
mother must stick out
her breasts to the baby's mouth until all over
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the nipple and areola are "grasped" by the baby's mouth.
The amount of ASI secreted in the first 6
months is 750 cc a day. Secretion
on the day first only
accumulated as much as 50 cc which then
increased to 500, 650 and 750 cc, respectively on
day V, month I and
III. The volume of breast milk in the next 6 months
shrank to 600 cc. Many assumptions that mothers with
poor nutritional status will still be able to breastfeed
their babies the same as mothers with normal
nutritional status, even though the composition of
breast milk remains the same, the volume of milk
issued by mothers of poor nutritional status with normal
nutritional status is different. Categories for the division
of total milk production according to (Jellife & Jellife,
1997 in
Soetijiningsih, 2004) states that the average
volume of breast milk for women with good
nutritional status is around 700-800 cc / day, while
those who are undernourished are only around
500-600 cc / day so this is what can cause the
duration of exclusive exclusive breastfeeding.
How to find out the production of ASI
enough / not as follows: A lot of Asi can seep out
through putting,
before breastfeeding the breast feels
tense, the baby's weight rises according to age, If
enough milk, after breastfeeding the baby will fall
asleep / calm for 3-4 hours, the baby urinates more
often, about 8 times a day.
ASI expenditure can be influenced by two
factors, namely production and expenditure. ASI
production is affected by
hormone prolactin while
expenditure is influenced by hormones
oxytocin. Hormone oxytocin will come out through
stimulation to the nipple through baby's mouth
suction or through massage on the baby's spine,
by doing massage on the spine the mother will
feel calm, relaxed, increase the pain threshold
and love her baby, so that the hormone oxytocin
comes out and breast milk too get out quickly
(WBW,
2007).
Massage or the spine, neurotransmitters
will stimulate medulla oblongata immediately sent
a message to
hypothalamus in posterior hypofise to issue
oxytocin so that
causes the breasts to secrete milk. Oxytocin
massage can be done whenever the mother wants
with a duration of 3-5 minutes, more advisable to
do before breastfeeding
or blush ASI
(Kaltimpos.co.id). So to
get the optimal amount of milk and good,
preferably massage oxytocin
done every day with a duration of 3-5 minutes .
RESEARCH METHODS
The research design used is quasi experiment without
a control group using the approach

Oxytocin massage is one one group pretest-postest design.

the solution to resolve The population in this research is all
lack of milk production. Massage breastfeeding mothers in the Territory
oxytocin is massage along the spine ( vertebrae) until Puskesmas Plus Mandiangin for the past 3 months
the bones numbered 64 patients. The sample in this study
costae fifth-sixth and is an attempt to stimulate the amounted to 21 people with a technique that is total
hormones prolactin and oxytocin after childbirth sampling.
This massage serves to increase the hormone
oxytocin which can calm the mother, so that ASI RESULTS AND DISCUSSION
automatically comes out (Yohmi & Roesli, 2009, The research began on July 18-30, 2016. The
p. 92). method of data collection was done by interview
based

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the questionnaire was prepared and then carried out
oxytocin massage in accordance with the circumstances
of the respondent at that time with their own awareness
and without coercion of anyone.
The number of research samples is 21
respondents. The study was conducted for 2 weeks
where respondents code 1-10 were conducted
on Sunday first
while respondent code 11-21
done in the second week. Researchers conducted
home visits during 3 consecutive days to do
oxytocin massage and on day 4 the researchers
asked again about the production of breast milk
after an oxytocin massage and the researchers
noted in the questionnaire that was provided.
The beginning of this research process is
before the breastfeeding mothers do an oxytocin
massage, the mother is welcome to sit as prepared
by the researchers, then the mother's vital signs are
measured first namely blood pressure, pulse, and
breathing, if the vital signs of the normal mother are
carried out an oxytocin massage. If the mother's
blood pressure, pulse and breathing are not normal
then we cannot begin oxytocin massage, we wait for
the vital signs
it is normal with
rest mother first. The results of these studies can
be seen in the table below.

Table 1
Distribution of Average Distribution of Asi Production Before Oxytocin Massage Intervention Is Given
On W § Pusk e Smas Plus Mandiangi n 2016 Variables
The mean Elementary school Min - Max

ASI production 7.05 0.740 6-8

pretest

Based on table 1 above, the results show that before giving oxytocin massage the average milk production of
respondents was 7.05 with a standard deviation of 0.740, the minimum-maximum milk production with a value of 6-8.

Oxytocin massage is an act of spinal massage
starting from the 5th to 6th nerves to the scapula
which will accelerate the work of the
parasympathetic nerve to deliver commands to
the back of the brain so that oxytocin is released
(Hamranani, 2010).
Research conducted by Albertina (2015)
with the title Relationship of oxytocin massage
with smooth ASI production in post partum
mothers after cesarean days 2-3. 24 respondents
(50%) smooth ASI production and 11 respondents
(22.9)
ASI production no
While 13 respondents (27.1%) who were massaged did
not comply with procedures as many as 2 respondents
(4.2%) who produced smooth milk and 11 respondents
(22.9%) produced non-smooth milk. According to the
analysis of researchers, the lack of milk production can
be caused by lack
hormone stimulation
prolactin and oxytocin which are very instrumental in
the smooth production of breast milk. Other factors
that affect milk production such as
baby sucking that doesn't
perfect or very small nipples of the mother will make
the production of the hormone oxytocin and the
hormone prolactin continues to decrease and milk will
stop. In addition, milk production is strongly influenced
by psychiatric factors, mothers who are always deep
smoothly.

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state of distress, sadness, lack of confidence and
various forms of emotional tension will reduce the
volume of milk will not even occur in milk
production. To produce good milk, it must be
calm. The age factor will also affect milk
production because
getting older someone will
affect the production of the prolactin and oxytocin
hormones of nursing mothers. One of the
complementary therapies that can be done to
increase breast milk production is oxytocin massage.

Table 2
Distribution of Average Asi Production After Oxytocin Massage Intervention Is Given In The Region
Community Health Center Work P l us Mandiangin Tah un 2016
Variable The mean Elementary school Min - Max

ASI production 9.00 1,183 6-10

posttest

Based on table 2 above, the results show that after giving oxytocin massage the average milk production of
respondents was 9.00 with a standard deviation of 1.183, the minimum-maximum milk production with a value of 6-10.

This research shows the compatibility with the room midwifery Home Sick
theory, by doing massage on Muhammadiyah Bandung.
as long as bone back In line with research Sofia (2011) with the
(vertebrae) until the bones up to the fifth-sixth title Difference Let Down
costae bone will stimulate the hormones prolactin Before and After Oxytocin Massage
and oxytocin, so breast milk can automatically be Vertebrae on Breastfeeding Mothers in Candi Jati
smoother. Besides expediting breast milk, Village, Jember Regency with the results of the
oxytocin massage provides comfort study showed that let down before oxytocin
mother, massage vertebrae
reduce swollen (engorgement), 60% (9 people) did not smoothly, 40% (6 people)
reduce breast milk blockage, stimulate release smoothly while after the intervention the data showed
hormone oxytocin, 86.7% (13 people) categories
maintain breast milk production. let down smoothly and 13.3% (2 people) have let
The results of this study are in line with down not smooth.
the research of Siti Nur Endah (2011) with the title Researchers argue that, physiologically
Effect of Oxytocin Massage on Colostrum massage oxytocin through
Expenditures in Post Partum Mothers in Midwifery neurotransmitter will stimulate
Room Bandung Muhammadiyah Hospital, medullla oblongata by sending a message to hypotalamus
showing the average time spent in colostrum in posterior hypophise
treatment group is 5.8 hours, while the length of it stimulates the oxytocin reflex or reflex let down to
time a group control is flat secrete the hormone oxytocin into the blood.
Oxytocin massage will further facilitate milk
- an average of 5.89 hours. This research was production in nursing mothers
conducted on post partum mothers who gave birth at 2
hours post partum / after post partum mothers did and also give
early mobilization to comfort to mother.

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Table 3
The Effect of Ositosin Massage on Increasing Breastmilk Production of Breastfeeding Mothers Work Areas
Puskesmas Plus Mandiangin Bukittinggi Tahun 2016
Variable The mean Elementary school P-value n
ASI production

Pre Post 7.05 0.740

Difference 9.00 1,183 0,000 21
- 1,952 1,161

Based on table 3 above, the average milk production before oxytocin massage is obtained
7.05 and standard deviation of 0.740 and average milk production after oxytocin massage of 9.00 and standard
deviation of 1.183. While the difference in ASI production between pre and post measurements is an average of -1.952
with a standard deviation of 1.161. Statistical test results obtained p-value of 0.000, it can be concluded that there is an
effect of oxytocin massage on milk production, because there is a significant difference between milk production before
and after treatment

Not all breastfeeding mothers express sufficient can be influenced psychologically and
milk for their babies where the inhibiting factor in environmental conditions when breastfeeding;
breastfeeding is the production of breast milk itself. self-confidence so there is no perception of
Lack of milk production and slow release can cause inadequacy ASI supply,
the mother to not give enough milk to her baby. In get close to the baby; relaxation is a relaxing or
addition to the prolactin hormone, the lactation calming exercise such as meditation, yoga,
process also relies on the hormone oxytocin, which
is released from the posterior pituitary in reaction to and relaxation progressive could
suction help restore nerve imbalance
and hormones and provide natural
nipples. Oxytocin calmness, touch and massage. When
influence the cells mioepitel that breastfeeding, husband and family support, drinking
surrounds mammae alveoli so that the alveoli coffee because it contains caffeine,
contract and secrete milk that has been secreted by warm breast,
the gland stimulate the nipples by gently pulling and rotating
Mammae, This oxytocin reflex is influenced by the mother's the nipples with her fingers (Astutik, 2014). with his
soul. If there is anxiety, stress and doubt that occurs, then fingers (Astutik, 2014). In this study there were 4
the expenditure of milk can be hampered (Kodrat, 2010). breastfeeding mothers who did not experience
increased milk production. This can be caused by
Besides the mother must pay attention to factors sharing factors such as age, nutrition and maternal
that influence the success of oxytocin massage, psychology. In this study there were mothers aged
namely listening to the baby's voice that can trigger 42 years and 39 years. Age is one
a flow that shows how milk production

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factors that can affect milk production, mothers 2 The average milk production of respondents after
whose age is younger (21-35 years) will produce done massage oxytocin occur
more milk compared to mothers whose age is older significant increase in milk production.
(Biancuzzo, 2003). However, not all mothers aged
over 35 years do not increase breast milk, this can 3 There is an effect oxytocin massage has on
be caused by good nutrition and good psychological milk production, because there is a significant
mother. difference between milk production before and after
treatment.

Based on the theory and research above, researchers THANK-YOU NOTE

argued that with Speech thank you delivered
oxytocin massage will provide a relaxed, calm, and to: Mr. Yendrizal Jafri, S.Kp, M. Biomed as the
comfortable so that it will increase the hormone Chairperson of Padang Pioneering STIKes, Mr.
oxytocin so that it will increase the expenditure of Chairman of Mandiangin Plus Bukittinggi
milk. Oxytocin massage can reduce Puskesmas, Mr. and Ibuk staff of Mandiangin Plus
swollen Puskesmas Bukittinggi Puskesmas.
( engorgement) and reduce the blockage of breast milk. The
smooth production of breast milk is strongly influenced
by some factor BIBLIOGRAPHY
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