Nursing care for post-caesarean mothers with ineffective breastfeeding through oxytocin massage combined with breastfeeding education and breast care

Ika Priyatminingsih; Indah Wulaningsih

doi:10.34310/jbsh.v3i2.354

Authors

Ika Priyatminingsih Nursing Study Program, Faculty of Nursing and Health Sciences, Karya Husada University, Jalan Kompor R. Soekarno No. 46, Sambiroto, Tembalang, Semarang, Central Java 50276, Indonesia Author
Indah Wulaningsih Nursing Study Program, Faculty of Nursing and Health Sciences, Karya Husada University, Jalan Kompor R. Soekarno No. 46, Sambiroto, Tembalang, Semarang, Central Java 50276, Indonesia Author

DOI:

https://doi.org/10.34310/jbsh.v3i2.354

Keywords:

Caesarean Section, Ineffective Breastfeeding, Nursing Care, Oxytocin Massage, Breastfeeding Education

Abstract

Background: Ineffective breastfeeding is common among post-caesarean mothers and may be associated with delayed milk flow, postoperative pain, difficulty with breastfeeding positioning and attachment, nipple problems, and limited maternal knowledge. Oxytocin massage is a supportive nursing intervention intended to promote maternal relaxation and support the milk-ejection reflex. Objective: This case study described nursing care for post-caesarean mothers with ineffective breastfeeding through oxytocin massage combined with breastfeeding education and breast care. Methods: A descriptive case study used a nursing-process approach comprising assessment, diagnosis, planning, implementation, and evaluation. Three primiparous post-caesarean mothers (aged 23–28 years) were selected by convenience sampling. Baseline assessment, three days of intervention, and final evaluation were conducted between 25 and 28 April 2026. Data were collected through interviews, observation, physical examination, and documentation, with breastfeeding status rated using the Indonesian Nursing Outcome Standards (SLKI). The intervention combined oxytocin massage with breastfeeding education, positioning and latch-on training, breast and nipple care, milk-expression education, and family support. Results: At baseline, all three mothers showed breastfeeding difficulties, including limited or absent milk flow, positioning and latch difficulties, and nipple problems. After three days, all three improved on selected indicators, including attachment, positioning, milk flow, maternal confidence, and sucking. Shared SLKI scores rose from 2 to 4, against a target of 5. Conclusion: Oxytocin massage combined with breastfeeding education and breast care was followed by improvement in selected indicators over three days. As a descriptive case study, it cannot establish intervention efficacy or effects on exclusive breastfeeding. Controlled studies are needed to test its independent effectiveness.

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References

Afriani, A., Jamaluddin, M., & P, S. (2024). The effect of oxytocin massage education on postpartum mother breastfeeding behavior at Muhammadiyah Rodliyah Achid Moga Hospital. Journal of Biomedical Sciences and Health, 1(2), 105–110. https://doi.org/10.34310/jbsh.v1.i2.90

Anita, Lajuna, L., & Ramli, N. (2022). The challenges of early initiation of breastfeeding in post sectio caesarea patients. Science Midwifery, 10(4), 2809–2816.

Astuti, A. A. A., Nurjanah, S., Puspitaningrum, D., & Dewi, M. U. K. (2023). Hubungan intensitas nyeri pada ibu post sectio caesaria dengan kecukupan ASI di Rumah Sakit Umum Islam Harapan Anda Kota Tegal. Seminar Nasional Kebidanan UNIMUS, 1–7.

Badan Kebijakan Pembangunan Kesehatan. (2023). Survei Kesehatan Indonesia (SKI) dalam Angka. Jakarta: Kementerian Kesehatan Republik Indonesia.

Dennis, C. L. (2003). The Breastfeeding Self-Efficacy Scale: Psychometric assessment of the short form. Journal of Obstetric, Gynecologic & Neonatal Nursing, 32(6), 734–744.

Ekasari, T. D., & Adimayanti, E. (2022). Pengelolaan menyusui tidak efektif pada ibu post sectio caesarea di Desa Ngaglik Argomulyo Salatiga. Pro Health Jurnal Ilmiah Kesehatan, 4(1), 185–190.

Golzar, J., Noor, S., & Tajik, O. (2022). Convenience sampling. International Journal of Education & Language Studies, 1(2), 72–77.

Kent, J. C., Prime, D. K., & Garbin, C. P. (2012). Principles for maintaining or increasing breast milk production. Journal of Obstetric, Gynecologic & Neonatal Nursing, 41(1), 114–121.

Betrán, A. P., Ye, J., Moller, A.-B., Souza, J. P., & Zhang, J. (2021). Trends and projections of caesarean section rates: global and regional estimates. BMJ Global Health, 6(6), e005671.

Brockway, M., Benzies, K., & Hayden, K. A. (2017). Interventions to improve breastfeeding self-efficacy and resultant breastfeeding rates: A systematic review and meta-analysis. Journal of Human Lactation, 33(3), 486–499.

McFadden, A., Gavine, A., Renfrew, M. J., Wade, A., Buchanan, P., Taylor, J. L., … MacGillivray, S. (2017). Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database of Systematic Reviews, (2), CD001141.

Erciyas, S. K., & Kavlak, O. (2024). The effect of back and breast massage on the amount of milk and anxiety level of mothers with preterm birth: A randomized controlled study. Journal of Neonatal Nursing, 30(3), 251–257.

Persatuan Perawat Nasional Indonesia. (2018a). Standar Diagnosis Keperawatan Indonesia (SDKI) Edisi 1. Jakarta: DPP PPNI.

Persatuan Perawat Nasional Indonesia. (2018b). Standar Luaran Keperawatan Indonesia (SLKI) Edisi 1. Jakarta: DPP PPNI.

Persatuan Perawat Nasional Indonesia. (2018c). Standar Intervensi Keperawatan Indonesia (SIKI) Edisi 1. Jakarta: DPP PPNI.

Persatuan Perawat Nasional Indonesia. (2021). Pedoman Standar Prosedur Operasional Keperawatan Edisi 1. Jakarta: DPP PPNI.

Astuti, D., Rahfiludin, M. Z., Dwidiyanti, M., & Denny, H. M. (2024). Enhancing oxytocin and prolactin levels to address oligogalactia through emotional management and massage in working mothers. Narra J, 4(3), e963.

Wulandari, S., Triharini, M., & Wahyuni, S. D. (2020). The effect of a combination of oxytocin massage and music therapy on breast milk production and breastfeeding self efficacy in primipara post partum mothers. Pediomaternal Nursing Journal, 6(1), 49–56.

Uvnäs-Moberg, K., Ekström-Bergström, A., Berg, M., Buckley, S., Pajalic, Z., Hadjigeorgiou, E., … Dencker, A. (2019). Maternal plasma levels of oxytocin during physiological childbirth: A systematic review with implications for uterine contractions and central actions of oxytocin. BMC Pregnancy and Childbirth, 19(1), 285.

World Health Organization. (2015). WHO statement on caesarean section rates. Geneva: World Health Organization.

World Health Organization & UNICEF. (2018). Implementation guidance: Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services – the revised Baby-friendly Hospital Initiative. Geneva: World Health Organization.