Midwifery Complementary Treatment with The Application of Oxytocin Massage Using Lavender Aromatherapy Oil on Breast Milk Production in Postpartum Mothers

Abstract


INTRODUCTION
WHO recommends that infants be exclusively breastfed for 6 months. Mother's milk is a natural baby nutrition with the most complete nutritional content to support optimal growth and development. Babies who are breastfed will reduce the risk of developing asthma, obesity, diabetes, lower respiratory tract infections, acute otitis media, sudden infant death syndrome and gastrointestinal infections [1]. The results of the study also show the opposite between exclusive breastfeeding and infant mortality in developing countries [2].
Data obtained from Riskesdas in 2018 [3], reports that exclusive breastfeeding in Indonesia is still in low coverage, namely 37.3%, partial breastfeeding 9.3 and predominant breastfeeding 3.3%. Nonexclusive breastfeeding which is mostly given to infants before the age of 6 months is formula milk (79.8%). Thus, it can be seen that the coverage of exclusive breastfeeding in Indonesia is still low. This can have an impact on the quality of life of the nation's next generation and also on the national economy. This is of course in line with the goals of the SDGs, namely eradicating poverty, economic growth, and reducing inequality within and between countries.
Phenomena that often occur in postnatal mothers are experiencing breastfeeding problems with inability to release breast milk, sore nipples and less milk production, so they decide to stop breastfeeding [4]. Mothers who experience stress, physical and emotional exhaustion can interfere with the reflex to express breast milk and the hormone oxytocin. Mothers who experience stress stimulate the hypothalamus to produce the hormone cortisol. The increase in the hormone cortisol will inhibit the production of breast milk [5]. Various efforts have been made to increase milk production with several methods, one of which is complementary therapy, which is a combination of massage and aromatherapy.
One of the massage techniques, namely oxytocin massage, influences breast milk production and the aromatherapy used is lavender which can increase the mother's comfort. Statistically there is a difference in the average milk production before and after oxytocin massage [6]. Oxytocin massage given to postpartum mothers has a positive effect on increasing milk production since the first massage was given [7]. Test.

Ethical Consideration
The researcher has applied for a research Based on the milk production before oxytocin massage with aromatherapy was carried out, it was informed that the milk production in the control group was higher than the treatment group, which was 11.7 ml.
The production of breast milk after oxytocin massage with aromatherapy, it shows that the milk production on day 6 in the treatment group was higher than the control group, which was 115 ml.
The effect of oxytocin massage using lavender aromatherapy oil on normal postpartum mother's milk production, could increase the breast milk production on day 6 in the treatment group from 11.2 mm to 115 ml with a sig value of 0.001 <0.05. Likewise, in the control group, there was an increase in breast milk production from 11.7 ml to 81.6 ml with a sig value of 0.001 <0.05, which means that there was a difference in milk production on day 6. Data on the difference in milk production produced by the two groups were analyzed using the Mann-Whitney test, the difference in milk production in the two groups is shown in Table 4 as follows.
Based on the calculation of the Mann-Whitney test, the sig value (p value) is 0.000.
Furthermore, testing the hypothesis with a value of = 0.05. Thus the value of sig 0.000 <0.05 so that it can be seen that Ho is rejected and Ha is accepted, which means that oxytocin massage using lavender aromatherapy oil has a significant effect on maternal milk production in normal postpartum.

DISCUSSION
Based on the results of data analysis, it can be seen that the milk production of mothers who were given oxytocin massage treatment using lavender aromatherapy produced milk with a higher amount than the control group. The milk production that can be produced by the treatment group during the observation period is an average difference of 103.8 ml, while the control group only produces breast milk with an average difference of 69.9 ml.
Then, after analyzing the data using statistical tests, the sig value (p value) was 0.000. The result of this study shows that the amount of milk production in mothers who were given oxytocin massage using lavender aromatherapy oil was more than the group who were not given oxytocin massage where they were only given breastfeeding assistance. With breastfeeding assistance, it still has the effect of increasing milk production, coupled with giving oxytocin massage with lavender aromatherapy will have a double effect and increase the mother's milk production [13]. Regular oxytocin massage on postpartum mothers who are assisted by their husbands will initiated the mother's milk production. The oxytocin massage by the husband can increase the production of breast milk in postpartum mothers as seen by the baby's weight, the frequency of the baby's defecation, the frequency of the baby's urination and the mother's sleep rest [14].
The use of lavender essential oil can help mothers relax and feel comfortable so that milk production is expected to increase. Some research results state that the use of aromatherapy can help to reduce complaints [15]. Lavender aromatherapy is ideal for postpartum maternal relaxation by achieving a significant improvement in sleep quality.
Inhaling lavender aromatherapy has a relaxing effect on the central nervous system, helping to increase the developmental hormone oxytocin, which has an effect on increasing breast milk production [9]. In addition, lavender aromatherapy can also cause the release of oxytocin by modifying the D3 subtype dopamine receptor homeostasis and its proliferation [16]. The results of other studies showed that there was a difference between oxytocin massage and no oxytocin massage on breast milk production in postpartum mothers in the working area of Ambarawa Health Center. Breast milk production in mothers who received oxytocin massage was more than mothers who did not receive oxytocin massage [11].

CONCLUSION
Based on the results and discussion of this study, the researchers concluded that