perbandingan pijat oksitosin dan pijat marmet untuk meningkatkan asi

1. By Sagita darma sari
Paper ID #1570489333

2. According to Basic Health Research (RISKESDAS), The pattern of
breastfeeding in the first 1 to 6 hours of 2010 was 40.7% and
decreased to 35.2% in 2013.
• WHO recommends exclusive breastfeeding until the baby is six months
old
• problems such as breast milk production are not optimal.
• hormones that play a role in breast milk production are estrogen,
progesterone and prolactin

3. Alternative methods that can help increase breast
milk production include marmet technique and
oxytocin massage.
•Research conducted by Hanum showed differences in breast
milk production results in postpartum mothers who were given
oxytocin massage (66.6%) and those who were not given
oxytocin massage (33.3%).
•The results of a study conducted by Mardyaningsih, breast milk
production increased by 85.2% after being given a combination
of marmet techniques and oxytocin massage compared to
mothers who were not treated.

5. Baby suction movements stimulate nerve fibers in
the nipples. This nerve fiber carries the demand
that milk passes through the spinal column to the
pituitary gland in the brain. The pituitary gland
responds to this message by releasing the
hormones prolactin and oxytocin. Prolactin
stimulates the breast to produce more milk.
Oxytocin stimulates the contraction of very small
muscles surrounding the duct in the breast. This
contraction compresses the duct and secretes milk
into the reservoir below the areola.

6.  This technique is a combination of how to
express breast milk and massage the breast so
that the reflex of breast milk can be optimized.
The technique is in principle aimed at emptying
the milk from the lactiferous sinuses located
below the areola. The emptying of breast milk in
the lactiferous sinus area will deliver impulses to
the hypothalamus in the anterior pituitary to
stimulate the release of the hormone prolactin.
This release of the prolactin hormone will then
stimulate the alveoli cells (mammary alveoli) to
produce breast milk. The more milk is removed
or emptied from the breast, the more milk will be
produced.

7. The steps of marmet technique are as follows:
1. Place your thumb and two other fingers about
1-1.5 cm from the areola. Place the thumb
above the areola at 12 o'clock and the other
finger at 6 o'clock
2. Push towards the chest
3. Roll using your thumb and other fingers
together
4. Move your thumb and other fingers until you
press the ASI warehouse until it is empty
5. Turn your thumb and other fingers to the other
ASI warehouse point. Likewise when flushing the
other breast, use both hands
6. these steps are carried out for 10 to 15 minutes

9. How to take out breast milk:
1) Massage (massage)
Massage breast milk production cells
and breast milk channels starting
from the top of the breast. With a
circular motion the breast massage
by pressing it towards the chest.
2) Stress (stroke)
Press the breast area from the top to
around the nipple with gentle
pressure, with fingers like tickling.
3) Shake (shake)
Shake the breast in a rotating
direction. This gravitational
movement will help the release
breast milk.

10.  Massage oxytocin is a massage along the spine
(vertebrae) to the fifth costae bone to stimulate
the hormone prolactin and oxytocin after giving
birth.
 This massage stimulates the hypothalamus in the
posterior pituitary and anterior pituitary, thus
secreting the hormone prolactin to produce
breast milk and the hormone oxytocin to
stimulate alveoli cells and myoepithelial cells to
produce breast milk, this massage can also
provide comfort and relaxation.

11. Steps to massage oxytocin :
1. Removing the upper part of the
mother's shirt
2. Mother tilted to the right and left,
then hugged the pillow
3. Lubricate both palms with oil or baby
oil.
4. Massaging along both sides of the
mother's spine using two fists, with
the thumb pointing forward.
5. Press firmly on both sides of the spine
to form small circular motions with
both thumbs
6. At the same time, massage both sides
of the spine down from the neck
towards the shoulder blade, for 2-3
minutes

12. Breast milk
production
Marmet Tecnique oxytocin massage
Emptying the lactiferous
duct
Send a signals to the hypothalamus
Anterior pituitary and posterior
pituitary
Produces Prolactin and Oxytocin
Hormones
- Stimulates uterine
contractions
- Provides comfort
- Relax the body
Stimulate the anterior
pituitary
Produces prolactin
hormone
Stimulates alveoli cells Stimulates alveoli cells and
myoepithelial cells

13.  Research design
This study uses a quasi-experimental
research design that is two group post-test,
namely intervention and control groups to
identify the effect of marmet technique
stimulation and oxytocin massage on breast
milk production

14. Population and sample
The population in this study were mothers who had
normal childbirth in maternity homes Mitra Ananda and
Husniatiprivate practice midwives. The sampling technique
used in this study is the purposive sampling technique,
which uses the inclusion criteria to determine the sample
to be studied. Inclusion criteria are as follows:
1. Willing to be a respondent
2. Postpartum first and third day
3. The psychological condition of the mother is good
4. Do not have systemic disease.
The number of samples used in this study was 30
respondents who were divided into two groups, the
treatment group, and the control group.

15. • Research procedure
The first step the researcher divided the sample into two
groups randomly according to the inclusion criteria. After
getting the sample in the treatment group, the researchers
gave a combination of marmet techniques and oxytocin
massage to postpartum mothers starting from the first day
to the third day. In the control group, postpartum mothers
were only given proper breastfeeding counseling. Every
day each group measured breast milk production by
accommodating breast milk with a milk bottle and then
measuring it using a syringe. The results of the
measurements are recorded on the observation sheet that
has been provided then the results of the breast
milkproduction measurements are analyzed to determine
the comparison of the number of breast milkproduction
between groups

16. Group n Average p
Treatment 15 1,113
0,007
Control 15 0,547
Based on table, it can be seen that the T-Test parametric test results obtained p
(0.007) < α 0.05, this shows that Ho is rejected, which means there is a significant
effect on the combination of marmet techniques and oxytocin massage on
postpartum maternal breast milk production. The average production of breast milk
in the treatment group was 1.113cc more than the control group of 0.547cc.
Tabel Comparison of treatment and control groups

17. Prolactin and oxytocin after giving birth so that it can help the
production process of breast milk. Based on the results of research
on the amount of breast milk production in postpartum mothers
who were given a combination of marmet and oxytocin massage
techniques, the average breast milk production on day 1 was 0.1 cc,
day 2 was 0.3 cc and day 3 was 0.7 cc and increased from day 1 to
day 3 is the total breast milk of 0.4 cc – 2.1cc. This is because the
marmet technique aims to empty the milk from the lactiferous
sinuses located below the areola so that it will deliver impulses to
the hypothalamus in the anterior pituitary to stimulate the release of
the hormone prolactin. The release of the prolactin hormone will
then stimulate the alveoli cells (mammary alveoli) to produce breast
milk and oxytocin massage aims to stimulate the hypothalamus in
the posterior pituitary and anterior pituitary, thus releasing the
hormone prolactin to produce breast milk and the hormone
oxytocin to stimulate alveoli cells and myoepithelial cells to excrete
breast milk.

18. While the group that was not given a combination of
marmet and oxytocin massage techniques on average breast
milk production on day 1 was 0.093 cc, day 2 was 0.147 cc
and day 3 was 0.307 cc and only a few respondents
experienced an increase in breast milk production which was
0 - 1.5 cc. Some respondents who experience increased milk
production can be caused by other factors such as Early
Breastfeeding Initiation (IMD) and frequent breastfeeding of
babies in the first days after delivery, because baby suction
can trigger the release of breast milk from the mammary
alveoli through the lactiferous duct. Suction stimulates the
production of oxytocin by the posterior hypophysis gland.
Oxytocin enters the blood and causes contraction of special
cells (myoepithelial cells) that surround the mammary
alveolus and lactiferous duct. Contraction of these
specialized cells pushes the milk out of the alveoli through
the lactiferous duct.

19. Breast milk production results in this study are in accordance with
the theory according to Marliandiani that on the first day of normal
conditions breast milk production is around 10-100cc/ 24 hours
and continues to increase every day up to 150-300 cc/ 24 hours,
breast milk production in this study is 2,1cc on evaluation 30
minutes after combination of marmet technique and oxytocin
massage so that milk production per day is 96 cc / 24 hours. The
results of this study are reinforced by the results of previous studies
according to Mardiyaningsih on effectiveness of the combination of
marmet and oxytocin massage techniques on maternal breast milk
production post section that there is a difference in the proportion
of smooth breast milk production between the treatment and
control groups with p-value (0,000) while the OR value (11,5) which
means that the treatment group has an 11.5 times greater chance of
smooth as compared to the control group. The results of Kiftia's
research on the effectiveness of oxytocin massage on postpartum
maternal breast milk production with p-value 0.001 <α (0.05)
showed a significant difference in mean values before and after
oxytocin massage.

20. The average amount of breastmilk production
of postpartum mothers was given a
combination of marmet technique and oxytocin
massage as much as 1.113cc while the average
breast milk production of postparum women
who were not given treatment was 0.547cc.
Statistical test results show that the
combination of marmet techniques and
oxytocin massage can increase breast milk
production in postpartum mothers.

21. [1] Marliandiani Y and Ningrum N 2015 Buku Ajar Asuhan Kebidanan Pada Masa Nifas dan
Menyusui
[2] Cadwell K and Turner-Maffei C 2011 Buku saku manajemen laktasi Jakarta EGC
[3] Roesli U 2000 Mengenal ASI eksklusif (Niaga Swadaya)
[4] Widodo Y 2011 Cakupan pemberian asi eksklusif: akurasi dan interpretasi data survei
dan laporan program Gizi Indones.34
[5] Hanum S M F and Purwanti Y 2016 EFEKTIVITAS PIJAT OKSITOSIN TERHADAP PRODUKSI
ASI J. Kebidanan Midwiferia1 1–7
[6] Rusli H U 2008 Inisiasi menyusui dini plus ASI eksklusif (Puspa Swara)
[7] Maryunani A 2012 Inisiasi menyusui dini, ASI eksklusif dan manajemen laktasi Jakarta
Tim
[8] Sulistyawati A 2009 Buku ajar asuhan kebidanan pada ibu nifas Yogyakarta Andi Offset
1–6
[9] Endah S N and Masinarsah I 2011 Pengaruh pijat oksitosin terhadap pengeluaran
kolostrum pada ibu post partum di ruang kebidanan Rumah Sakit Muhammadiyah
Bandung Tahun 2011 J. Kesehat. Kartika 1–9
[10] Ummah F 2014 Pijat oksitosin untuk mempercepat pengeluaran ASI pada ibu pasca
salin normal di Dusun Sono Desa Ketanen Kecamatan Panceng Gresik J. Surya2
[11] Mardiyaningsih E and Sabri L 2011 Efektifitas kombinasi teknik marmet dan pijat
oksitosin terhadap produksi ASI ibu post seksio di Rumah Sakit Wilayah Jawa Tengah J.
Keperawatan Soedirman6 31–8