Combination of areola and rolling massage techniques on breast milk production in post-partum mothers, City of Lampung, Indonesia 10.55131/jphd/2025/230118
Main Article Content
Abstract
Postpartum mothers with low breast milk production tend not to provide sufficient breast milk to their babies, which causes various health problems. This study aimed to analyze the effects of areola massage and rolling massage techniques on breast milk production in postpartum mothers. The research was quantitative and used a quasi-experimental design with a post-test-only design. The study was conducted at the Panjang Health Center for the control group and Sumbersari Bantul Metro Health Center for the Intervention group. The study utilized purposive sampling was used to divide the 60 postpartum mothers into two groups, and data were collected through a questionnaire. A t-test was used for statistical analysis. The average time for the initiation of milk flow after delivery in the intervention group was 288.07 minutes, while the control group had an average discharge time of 1043.47 minutes, with the fastest and longest times being 180 and 2090 minutes respectively. There was a significant difference in breast milk production between the intervention and control (0.000). There were also differences in milk ejection time between the intervention and control groups, based on the length of time spent (≤ 12 and > 12 h) with a p-value of 0.000. In conclusion, the intervention significantly affected breast milk production and ejection time post-delivery, considering the significance of adequate care and support for breastfeeding mothers to enhance infant breastfeeding quality. The recommendation was to provide additional support and resources to breastfeeding mothers to improve milk production and ejection time. This could have included access to lactation consultants and breastfeeding education.
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Gayatri M. Exclusive Breastfeeding Practice in Indonesia: A Population-Based Study. Korean J Fam Med. 2021;42(5):395–402. doi: 10.4082/ kjfm.20.0131
Hadi H, Fatimatasari F, Irwanti W, Kusuma C, Alfiana RD, Asshiddiqi MIN, et al. Exclusive Breastfeeding Protects Young Children from Stunting in a Low-Income Population: A Study from Eastern Indonesia. Nutrients. 2021;13(12):4264. doi: 10.3390/ nu13124264
del Castillo-Hegyi C, Achilles J, Segrave-Daly BJ, Hafken L. Fatal Hypernatremic Dehydration in a Term Exclusively Breastfed Newborn. Children. 2022;9(9):1379. doi: 10.3390/ children9091379
AlThuneyyan DA, AlGhamdi FF, AlZain RN, AlDhawyan ZS, Alhmly HF, Purayidathil TS, et al. The Effect of Breastfeeding on Intelligence Quotient and Social Intelligence Among Seven- to Nine-Year-Old Girls: A Pilot Study. Front Nutr. 2022;9:726042. doi: 10.3389/fnut.2022.726042
Sokou R, Parastatidou S, Iliodromiti Z, Lampropoulou K, Vrachnis D, Boutsikou T, et al. Knowledge Gaps and Current Evidence Regarding Breastfeeding Issues in Mothers with Chronic Diseases. Nutrients. 2023; 15(13):2822. doi: 10.3390/nu15132822
Modak A, Ronghe V, Gomase KP. The Psychological Benefits of Breastfeeding: Fostering Maternal Well-Being and Child Development. Cureus. 2023; 15(10):e46730. doi: 10.7759/cureus. 46730
Murphy S, Carter L, Al Shizawi T, Queally M, Brennan S, O’Neill S. Exploring the relationship between breastfeeding and the incidence of infant illnesses in Ireland: evidence from a nationally representative prospective cohort study. BMC Public Health. 2023;23(1):140. doi: 10.1186/ s12889-023-15045-8
Gong QQ, Quan DD, Guo C, Zhang C, Zhang ZJ. Association between maternal breastfeeding and risk of systemic neoplasms of offspring. Ital J Pediatr. 2022;48(1):98. doi: 10.1186/ s13052-022-01292-9
Abraham M, Lak MA, Gurz D, Nolasco FOM, Kondraju PK, Iqbal J. A Narrative Review of Breastfeeding and Its Correlation With Breast Cancer: Current Understanding and Outcomes. Cureus. 2023;15(8):e44081. doi: 10.7759/ cureus.44081
A Assaf E, Al Sabbah H, Al-Jawadleh A. Analysis of the nutritional status in the Palestinian territory: a review study. Front Nutr. 2023;10:1206090. doi: 10.3389/fnut.2023.1206090
Mwene-Batu P, Bisimwa G, Ngaboyeka G, Dramaix M, Macq J, Hermans MP, et al. Severe acute malnutrition in childhood, chronic diseases, and human capital in adulthood in the Democratic Republic of Congo: the Lwiro Cohort Study. Am J Clin Nutr. 2021;114(1):70–79. doi: 10.1093/ajcn/nqab034
Laksono AD, Wulandari RD, Ibad M, Kusrini I. The effects of mother’s education on achieving exclusive breastfeeding in Indonesia. BMC Public Health. 2021;21(1):14. doi: 10.1186/s12889-020-10018-7
Kerautret Y, Di Rienzo F, Eyssautier C, Guillot A. Selective Effects of Manual Massage and Foam Rolling on Perceived Recovery and Performance: Current Knowledge and Future Directions Toward Robotic Massages. Front Physiol. 2020;11:598898. doi: 10.3389/fphys.2020.598898
Sri Wahyuningsih, Hayati N, Musviro, Agustina R. Oxytocin Massage Stramlining Breast Milk: Literature Riview. NHSJ. 2022;2(4):367–73.
Darmawati D, Kamil H, Rosmaidar R, Wardani E, Fajri N, Jannah SR, et al. The Effectiveness of the Rolling Massage Technique on Breast Milk Adequacy for the Baby in the COVID-19 Pandemic. Open Access Maced J Med Sci. 2022;10(G):435–9. doi: 10.3889/oamjms.2022.8882
Rahayu S, Umaroh U. Effect of rolling massage and ST-18 acupressure on breast milk production and decrease in fundal height. JNKI. 2022;10(2):142-150. doi: 10.21927/jnki.2022.10(2). 142-150
Lu P, Ye Z qi, Qiu J, Wang X yu, Zheng J juan. Acupoint-tuina therapy promotes lactation in postpartum women with insufficient milk production who underwent caesarean sections. Medicine. 2019;98(35): e16456. doi: 10.1097/MD.00000000 00016456
Rahmatul Ulya RU, Panduragan SL, Shentya Fitriana SF, Che Hassan H. The Effect of Lactation Massage Combination and Postpartum Breast Care Aged One to Three Days on the Experience of Adequate Breastfeeding. Malaysian Journal of Medicine and Health Sciences. 2023;19(s9):251–5.
Badan Pusat Statistik provinsi lampung. Bayi Umur 0-5 Bulan di Provinsi Lampung pada Tahun 2023 Mendapat ASI Eksklusif. 2024.
Kujawa-Myles S, Noel-Weiss J, Dunn S, Peterson WE, Cotterman KJ. Maternal intravenous fluids and postpartum breast changes: a pilot observational study. Int Breastfeed J. 2015;10:18. doi: 10.1186/s13006-015-0043-8
Shah R, Sabir S, Alhawaj AF. Physiology, Breast Milk. 2022 Sep 19. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 30969612.
Falci SGM, Marques LS. CONSORT: when and how to use it. Dental Press J Orthod. 2015;20(3):13–5. doi: 10.1590/ 2176-9451.20.3.013-015.ebo
Asbury MR, Butcher J, Copeland JK, Unger S, Bando N, Comelli EM, et al. Mothers of Preterm Infants Have Individualized Breast Milk Microbiota that Changes Temporally Based on Maternal Characteristics. Cell Host Microbe. 2020;28(5):669-682.e4. doi: 10.1016/j.chom.2020.08.001
Nagel EM, Howland MA, Pando C, Stang J, Mason SM, Fields DA, et al. Maternal Psychological Distress and Lactation and Breastfeeding Outcomes: a Narrative Review. Clin Ther. 2022; 44(2):215–227. doi: 10.1016/j. clinthera.2021.11.007
Magalhães M, Havelaar AH, Varma DS, Cacho N, Sullivan S, Parker LA. Leveraging mHealth and a milk expression frequency biomarker during postpartum to prolong lactation among parents of critically ill infants: a pilot study. Journal of Perinatology. 2023; 43(5):616–623. doi: 10.1038/s41372-023-01639-y
Rodríguez-Gallego I, Corrales-Gutierrez I, Gomez-Baya D, Leon-Larios F. Effectiveness of a Postpartum Breastfeeding Support Group Intervention in Promoting Exclusive Breastfeeding and Perceived Self-Efficacy: A Multicentre Randomized Clinical Trial. Nutrients. 2024;16(7): 988. doi: 10.3390/nu16070988
Bengough T, Dawson S, Cheng H, McFadden A, Gavine A, Rees R, et al. Factors that influence women’s engagement with breastfeeding support: A qualitative evidence synthesis. Matern Child Nutr. 2022; 18(4):e13405. doi: 10.1111/mcn.13405
Chang YS, Glaria AA, Davie P, Beake S, Bick D. Breastfeeding experiences and support for women who are overweight or obese: A mixed-methods systematic review. Matern Child Nutr. 2020;16(1):e12865. doi: 10.1111/mcn. 12865
Dini Setiarsih, Rizki Amalia, Rizki Nurmalya Kardina. Exclusive breast milk by working mothers as a new habit: a literature review. Bali Medical Journal. 2023;12(1):665–8.
Sumiatik. The Effect of Woolwich Massage on Breast Milk Production in Postpartum Mothers at the Marbau Health Center, Marbau District, Labuhan Batu Utara Regency in 2021. Science Midwifery. 2022;10(5):3622–31.
Lyons KE, Ryan CA, Dempsey EM, Ross RP, Stanton C. Breast Milk, a Source of Beneficial Microbes and Associated Benefits for Infant Health. Nutrients. 2020;12(4):1039. doi: 10.3390/nu12041039
Piccolo O, Kinshella MLW, Salimu S, Vidler M, Banda M, Dube Q, et al. Healthcare worker perspectives on mother’s insufficient milk supply in Malawi. Int Breastfeed J. 2022;17(1): 14. doi: 10.1186/s13006-022-00460-1
Fei Y, Zhang ZY, Fu WN, Wang L, Mao J. Why do first-time mothers not intend to breastfeed? ——A qualitative exploratory study on the decision-making of non-initiation in Jingzhou, China. BMC Pregnancy Childbirth. 2022;22(1):183. doi: 10.1186/s12884-022-04494-5
Triansyah A, Stang, Indar, Indarty A, Tahir Muh, Sabir M, et al. The effect of oxytocin massage and breast care on the increased production of breast milk of breastfeeding mothers in the working area of the public health center of Lawanga of Poso District. Gac Sanit. 2021;35:S168–70. doi: 10.1016/ j.gaceta.2021.10.017
Shirima LJ, Mlay HL, Mkuwa S, Fabian A, Mushy SE, Ngalesoni FN, et al. Early Initiation of Breastfeeding and Associated Factors Among Women of Reproductive age in Simiyu Region, Tanzania. SAGE Open Nurs. 2023;9: 23779608231209142. doi: 10.1177/ 23779608231209142
Ulfa Y, Maruyama N, Igarashi Y, Horiuchi S. Early initiation of breastfeeding up to six months among mothers after cesarean section or vaginal birth: A scoping review. Heliyon. 2023;9(6):e16235. doi: 10.1016/j.heliyon.2023.e16235
Faraj K, Bouchefra S, El Ghouddany S, Elbaraka Y, Bour A. Early breastfeeding initiation: Exploring rates and determinants among postpartum women in Eastern Morocco. Sci Afr. 2023;21:e01883.
Deif R, Burch EM, Azar J, Yonis N, Abou Gabal M, El Kramani N, et al. Dysphoric Milk Ejection Reflex: The Psychoneurobiology of the Breast feeding Experience. Front Glob Womens Health. 2021;2:669826. doi: 10.3389/fgwh.2021.669826
Abdulahi M, Fretheim A, Argaw A, Magnus JH. Breastfeeding Education and Support to Improve Early Initiation and Exclusive Breastfeeding Practices and Infant Growth: A Cluster Randomized Controlled Trial from a Rural Ethiopian Setting. Nutrients. 2021;13(4):1204. doi: 10.3390/nu 13041204
Utami RB, Rohuna R. Loving Lactation of Massage Effectiveness to Accelerating Lactation Onset. Jurnal Kesehatan Masyarakat. 2021;17(1):58–66. doi: 10.15294/kemas.v17i1.25321
Namyalo H, Nankumbi J, Ngabirano TD. Perceived breast milk insufficiency: Prevalence and associated factors among women attending a young child clinic in Uganda. Int J Afr Nurs Sci. 2023; 19:100637. doi: 10.1016/j.ijans.2023. 100637