Association between breast care knowledge and smooth breast milk production in post-caesarean mothers
Hubungan antara pengetahuan perawatan payudara dengan kelancaran produksi ASI pada ibu pasca operasi caesar
Keywords:
Breast care, Breastfeeding, Cesarean section, Maternal health, LactationAbstract
Background: Sectio caesarean (SC) is increasingly common, with significant challenges for breastfeeding due to factors like postoperative pain and mobility limitations. Proper breast care can support milk production, yet many mothers lack adequate knowledge about its importance and techniques. Understanding the relationship between breast care knowledge and breastfeeding outcomes in post-SC mothers is critical to improving maternal and child health.
Objective: This study aimed to examine the relationship between breast care knowledge and smooth breast milk production among post-SC mothers.
Method: A cross-sectional study was conducted among 30 post-SC mothers at Ibunda Mother and Child Hospitals, Tanah Laut, from September to November 2023. Participants were selected through accidental sampling. Data on breast care knowledge and milk production were collected using validated instruments and analyzed using chi-square tests.
Results: Most respondents had sufficient breast care knowledge (73%), and 90% reported smooth breast milk production. However, no significant association was found between breast care knowledge and milk production (p = 0.78). This indicates that while knowledge is vital, other factors such as psychological and physiological conditions also play a role.
Conclusion: Although most participants demonstrated good knowledge and milk production, this study highlights that breastfeeding success is multifactorial, requiring holistic approaches that address physical, psychological, and social dimensions. Integrating education with practical support could enhance breastfeeding outcomes.
References
Agalianou, A., Bothou, A., Daglas, M., Vivilaki, V., & Palaska, E. (2024). Maternal self-esteem and self-efficacy as factors affecting maternal long-term breastfeeding: Α comprehensive review of the literature. World Journal of Advanced Research and Reviews, 22(1), 1360–1367. https://doi.org/10.30574/wjarr.2024.22.1.1215
Ahmad, M. (2021). Oxytocin; Effects on milk production. Pure and Applied Biology, 10(1). https://doi.org/10.19045/bspab.2021.100034
Anshari, Z. (2023). Analysis of breast care factors for increasing breast milk production in Pagar Merbau Public Health Community Center, Medan. Buletin Farmatera, 8(1). https://doi.org/10.30596/bf.v8i1.5522
Anita, Lia Lajuna, & Nurlaili Ramli. (2022). The challenges of early initiation of breastfeeding in post sectio caesarea patients. Science Midwifery, 10(4), 2809–2816. https://doi.org/10.35335/midwifery.v10i4.722
Araújo Maciel, G., Priscilla Araújo Maciel, D., Cristina Araújo Vieira, I., Dos Santos Silva, T., Mateus Alexandrino de Brito, S., Paula de Jesus Anunciaçao, L., Silva Soares, J., Claudia Espelho de Almeida, A., Domingos de Oliveira Junior, A., Caparroz Nogueira, M., Salomão Henrique Robles, E., & Carolina Beltrami, A. (2024). The benefits of breastfeeding for the health of the infant, the mother and the impact this has on public health in Brazil. International Seven Journal of Multidisciplinary, 3(2), 386–401. https://doi.org/10.56238/isevmjv3n2-002
Asimaki, E., Dagla, M., Sarantaki, A., & Iliadou, M. (2022). Main biopsychosocial factors influencing breastfeeding: A systematic review. Maedica - A Journal of Clinical Medicine, 17(4). https://doi.org/10.26574/maedica.2022.17.4.955
Berra, A. L. (2024). 391 Correlation between social determinants of health and early initiation of breastfeeding after cesarean birth. American Journal of Obstetrics and Gynecology, 230(1), S217–S218. https://doi.org/10.1016/j.ajog.2023.11.417
Brown, A., Rance, J., & Bennett, P. (2016). Understanding the relationship between breastfeeding and postnatal depression: the role of pain and physical difficulties. Journal of Advanced Nursing, 72(2), 273–282. https://doi.org/10.1111/jan.12832
Dewi, A. D. C., & Susmita. (2022). Breast Care for Pregnant Women and Postpartum Mothers. Jurnal Pengabdian Masyarakat Formosa, 1(5), 551–556. https://doi.org/10.55927/jpmf.v1i5.2338
Fatmawati, Meldawati, Palimbo, A., & Mahdiyah, D. (2024). Effect of demonstration-method counseling on the understanding of correct breastfeeding techniques among pregnant women. Health Sciences International Journal, 2(2), 60–73. https://hsij.anandafound.com/journal/article/view/25
Agustina, F., Darussalam, H., & Julia, I. (2024). Application of breast care to prevent breast milk dams in postpartum mothers. Lentera Perawat, 5(2), 209–217. https://doi.org/10.52235/lp.v5i2.344
Fatmawati, Meldawati, Palimbo, A., & Mahdiyah, D. (2024). Effect of demonstration-method counseling on the understanding of correct breastfeeding techniques among pregnant women: Pengaruh konseling metode demonstrasi terhadap pemahaman teknik menyusui yang benar pada ibu hamil. Health Sciences International Journal, 2(2), 60-73. https://hsij.anandafound.com/journal/article/view/25
Frey, W. D., Sharma, K., Cain, T. L., Nishimori, K., Teruyama, R., & Kim, J. (2018). Oxytocin receptor is regulated by Peg3. PLOS ONE, 13(8), e0202476. https://doi.org/10.1371/journal.pone.0202476
Galaupa, R., Embay, E., & Sampara, N. (2022). Effectiveness of combination of breast care and lactation massage six hours post partum in primipara on smooth breast milk production [in Indonesia]. JIK Jurnal Ilmu Kesehatan, 6(2), 448. https://doi.org/10.33757/jik.v6i2.538
Kamal, S. H., Sembiring, E. F., Yanata, T. V, Utomo, M. T., & Izzati, D. (2022). Description of the supporting and inhibiting factors for the success of exclusive breastfeeding. International Journal of Research Publications, 115(1). https://doi.org/10.47119/IJRP10011511220224375
Herlina, H., & Aprilia Wardani, R. (2024). The effect of lactation massage on breast milk production in breastfeeding mothers. Jurnal Midpro, 15(2), 237–245. https://doi.org/10.30736/md.v15i2.692
Hidayah, N., & Fariana, Y. R. N. (2024). Lactation preparation for pregnant women to prevent stunting: Persiapan Laktasi Bagi Ibu Hamil untuk Mencegah Stunting. Health Sciences International Journal, 2(2), 169-176. https://hsij.anandafound.com/journal/article/view/42
Hindriyawati, W., Samosir, L. F. B., & Untari, S. (2024). Postpartum breast care for smooth breastfeeding at Purwodadi I Community Health Center. The Shine Cahaya Dunia Kebidanan, 9(01). https://doi.org/10.35720/tscbid.v9i01.492
Hutabarat, V., Natalia, K., Sitepu, S. A., & Yanti, M. D. (2022). Differences in the effectiveness of back massage and warm breast compress on increasing smooth breast milk production at Wirnata Clinic, Medan Sunggal District [in Indonesia]. Jurnal Penelitian Kebidanan & Kespro, 4(2), 23–31. https://doi.org/10.36656/jpk2r.v4i2.842
Islam, Md. A., Shanto, H. H., Jabbar, A., & Howlader, Md. H. (2022). Caesarean section in Indonesia: Analysis of trends and socio-demographic correlates in three demographic and health surveys (2007–2017). Dr. Sulaiman Al Habib Medical Journal, 4(3), 136–144. https://doi.org/10.1007/s44229-022-00011-0
Kusasira, L., Mukunya, D., Obakiro, S., Kenedy, K., Rebecca, N., Ssenyonga, L., Immaculate, M., & Napyo, A. (2023). Prevalence and predictors of delayed initiation of breastfeeding among postnatal women at a tertiary hospital in Eastern Uganda: a cross-sectional study. Archives of Public Health, 81(1), 56. https://doi.org/10.1186/s13690-023-01079-2
Louise, A., Supriadi, M. H., & Wahyuni, R. (2023). The relationship between postpartum mother’s knowledge about breast care and breastfeeding at technical implementation unit linggang bigung health center. KESANS : International Journal of Health and Science, 2(6), 403–411. https://doi.org/10.54543/kesans.v2i6.145
Masi, A. C., & Stewart, C. J. (2024). Role of breastfeeding in disease prevention. Microbial Biotechnology, 17(7). https://doi.org/10.1111/1751-7915.14520
Meira, M. M., Ibarra, S. D. A., & Santos, E. K. A. dos. (2008). Inibição da lactação: (re) visitando a literatura. Revista Eletrônica de Enfermagem, 10(3). https://doi.org/10.5216/ree.v10.46699
Mitchell, K. B., & Johnson, H. M. (2022). Breast conditions in the breastfeeding mother. In Breastfeeding (pp. 572–593). Elsevier. https://doi.org/10.1016/B978-0-323-68013-4.00016-X
Nathalia, A., Rahmawati, D., Nastiti, K., & Salmarini, D. D. (2024). Factors influencing the occurrence of exclusive breastfeeding failure in six-month-old infants. Health Sciences International Journal, 2(2), 96–103.
Nurlaily Z, S., Pulukadang, A., Rasyid, P. S., Saleh, U. K. S., Ida, A. S., & Hikmandayani, H. (2023). The relationship between the knowledge of third trimester pregnant women and the implementation of early breastfeeding initiation. Jurnal Info Kesehatan, 21(1), 166–173. https://doi.org/10.31965/infokes.Vol21.Iss1.885
Nursalam. (2017). Metode penelitian ilmu keperawatan: Pendekatan praktis. Jakarta: Salemba Medika.
Ogah, A. O., & Kapasa, M. (2023). Magnitude and determinants of delayed breastfeeding initiation among mothers who deliver by cesarean section in a rural general hospital in East Africa. https://doi.org/10.1101/2023.06.06.23290985
Putri, M. D. Y., Mufdlilah, M., & Kurniawati, H. F. (2023). Factors affecting the success of exclusive breastfeeding. Syntax Idea, 5(3), 306–323. https://doi.org/10.46799/syntax-idea.v5i3.2153
Rahayuningsih, T., Mudigdo, A., & Murti, B. (2016). Effect of breast care and oxytocin massage on breast milk production: A study in sukoharjo provincial hospital. Journal of Maternal and Child Health, 01(02), 101–109. https://doi.org/10.26911/thejmch.2016.01.02.05
Rollins, N. C., Bhandari, N., Hajeebhoy, N., Horton, S., Lutter, C. K., Martines, J. C., Piwoz, E. G., Richter, L. M., & Victora, C. G. (2016). Why invest, and what it will take to improve breastfeeding practices? The Lancet, 387(10017), 491–504. https://doi.org/10.1016/S0140-6736(15)01044-2
Sağlık, M., & Karaçam, Z. (2022). The Effectiveness of Structured Education and Follow-Up in the Management of Perceived Milk Insufficiency Breastfeeding Mothers: A Randomized Controlled Trial. https://doi.org/10.22541/au.164864312.23019233/v1
United Nations Children’s Fund (UNICEF). (2018). Breastfeeding: A mother’s gift, for every child. New York: UNICEF.
Vandenplas, Y., & Basrowi, R. W. (2023). Breastfeeding by working mothers: Global challenges. The Indonesian Journal of Community and Occupational Medicine, 3(1), 1–2. https://doi.org/10.53773/ijcom.v3i1.82.1-2
Victora, C. G., Bahl, R., Barros, A. J. D., França, G. V. A., Horton, S., Krasevec, J., Murch, S., Sankar, M. J., Walker, N., & Rollins, N. C. (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet, 387(10017), 475–490. https://doi.org/10.1016/S0140-6736(15)01024-7
Wagner, L. P. B., Mazza, V. de A., Souza, S. R. R. K., Chiesa, A., Lacerda, M. R., & Soares, L. (2020). Strengthening and weakening factors for breastfeeding from the perspective of the nursing mother and her family. Revista Da Escola de Enfermagem Da USP, 54. https://doi.org/10.1590/s1980-220x2018034303564
Wahyuningsih, S., Musviro, & Dyah Maharani, A. (2023). Increased production of mother’s milk: Literature review. Health and Technology Journal (HTechJ), 1(1), 30–37. https://doi.org/10.53713/htechj.v1i1.5
World Health Organization & United Nations Children’s Fund (UNICEF). (2018). Implementation guidance: protecting, promoting, and supporting breastfeeding in facilities providing maternity and newborn services: The revised Baby-friendly Hospital Initiative 2018. Geneva: World Health Organization & United Nations Children’s Fund (UNICEF).
Wyatt, S., Silitonga, P. I. I., Febriani, E., & Long, Q. (2021). Socioeconomic, geographic and health system factors associated with rising C-section rate in Indonesia: a cross-sectional study using the Indonesian demographic and health surveys from 1998 to 2017. BMJ Open, 11(5), e045592. https://doi.org/10.1136/bmjopen-2020-045592
Yulianti, I., Yani, L. Y., & Arishinta, C. H. (2024). Literature review study of lactational massage on the flow of breast milk. Journal of Scientific Research, Education, and Technology (JSRET), 3(1), 189–193. https://doi.org/10.58526/jsret.v3i1.344
Yulianti, L., Yunita, L., Mariana, F., & Palimbo, A. (2024). Early mobilization and length of wound healing post-sectio caesarean: A cross-sectional study: Mobilisasi dini dan lama penyembuhan luka pasca operasi caesar: Sebuah studi cross-sectional. Health Sciences International Journal, 2(2), 104-114. https://hsij.anandafound.com/journal/article/view/32
Zahroh, R. I., Disney, G., Betrán, A. P., & Bohren, M. A. (2020). Trends and sociodemographic inequalities in the use of caesarean section in Indonesia, 1987-2017. BMJ Global Health, 5(12), e003844. https://doi.org/10.1136/bmjgh-2020-003844
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Hellis Tria Agustin, Dwi Rahmawati, Eirene Eunika Meidiana Gaghauna, Siti Noor Hasanah
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Health Sciences International Journal (HSIJ) © 2023 by Ananda Health and Education Foundation is licensed under Attribution-ShareAlike 4.0 International