2nd International Conference on Applied Science and Health

Research for Better Society: Developing Science and Technology to Improve

Health and Well-being

ICASH-A07

COMPARING EFFECTIVENESS OF PALM DATES AND OXYTOCIN

MASSAGE IN STIMULATING BREASTMILK PRODUCTION OF
POST PARTUM MOTHER
Siti Roudhotul Jannah*, Melyana Nurul Widyawati

Postgraduate Applied Science Program in Midwifery,

Poltekkes Kemenkes Semarang, Semarang, Indonesia

*Corresponding author’s e-mail: [email protected]

ABSTRACT

Backgrounds: The coverage of exclusive breastfeeding in the world is still low. It is influenced by the
limited number of breastfeeding counselors, the lack of education, advocacy and coaching breastfeeding
support groups, maternal health and physiological factors (prolactin and oxytocin hormones). Dates
contains oxytocin and many chemical elements which are good for breastfeeding mothers. Regular
oxytocin massage therapy is also shown to increase the production of the oxytocin hormone.
Aims: To compare the effectiveness of palm dates and oxytocin massage in stimulating breastmilk
production of postpartum mothers.
Methods: it is a literature review study, using keywords breastfeeding, palm dates and oxytocin
massage from national and international journals.
Results: The results shown that palm date and oxytocin massage have been proven to increase the
oxytocin hormone that is influential on the smoothness of breastfeeding in postpartum mothers. Some
studies noted that the palm dates contain potuchin hormone that serves spur blood vessel contractions
around the breast spurring mammary gland to produce milk. In addition, there is the hormone oxytocin
can help stimulating the contractions of the muscles of the uterus to facilitate childbirth. While oxytocin
massage can increase milk production and the baby's weight and also to drive a contraction in the veins
surround the breast and spurring the milk glands to produce milk.
Conclusion: The results of several studies suggest that the oxytocin massage is more effective applied
to increase oxytocin than the consumption of palm dates.

Keywords: Breastfeeding, palm date, oxytocin massage

INTRODUCTION
Mother's milk is the best, naturally available babies’ meal. A high nutritional content and the presence
of immune substances make breast milk superior to the more expensive, man-made formula milk.
Baby's nutritional needs can be met by providing breast milk alone or known as the "exclusive
breastfeeding".(1) A study in Ghana shows that immediate breastfeeding from the moment of child’s
birth can prevent infant mortality by 16% and if breastfeeding begins within the first hour after the birth,
the figure rises to 22%. (2)
The Indonesian government has enacted the regulation no. 33 of 2012 on Exclusive Breastfeeding,
stating that babies should be exclusively breastfed without substituting and/or supplementing with other
food or beverages for the first six months. (3) However, according to the World Health Organization
(WHO) in 2014 as much as 85% of infants are not given breast milk, meanwhile achievement of

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 2nd International Conference on Applied Science and Health
Research for Better Society: Developing Science and Technology to Improve
Health and Well-being

breastfeeding in Indonesia in 2011 by 54%, in 2012 by 52%, in 2013 amounted to 51.07%, and declined
in 2014 by 49.7%.
The low performance of breast feeding is influenced by several factors, one of which is the mother's
health condition that causes a decrease in milk production.(4) The prolactin and oxytocin hormones
play an important role in the production of breast milk. Production of prolactin hormone determine and
maintain the secretion of milk, while oxytocin causes the muscle cells around the alveoli drives milk
into storage.(5) Breastfeeding early in the first hour of birth overcomes the problem of low breast milk
production because the babies sucking the nipple stimulates the secretion of the oxytocin hormone.
Other methods to generate the hormone production are through consuming fruits that contain oxytocin
and also through regular oxytocin massage therapy.
Dates are one of the fruits with the complete nutrition that provide the nutritional needs of nursing
mothers. One of the advantages of dates is the chemical elements contained in the palms’ oxytocin. The
content of oxytocin in palms can stimulate nervous impulses in the posterior pituitary granular, causing
myoepithelial cells around the alveoli to contract and push the milk into the ampulla vessels. The
hormone oxytocin induces a lot of milk to many and the baby's needs.(6)
Oxytocin massage is a massage performed along the spine (vertebrae) until the fifth and sixth costae
bone as well as an attempt to stimulate the prolactin and oxytocin hormones after delivery.(7-9) In
addition to stimulate the “let down” reflex, oxytocin massage also provides comfort to the mother,
reduce swelling (engorgement), reduce blockages breast milk, stimulates the release of the hormone
oxytocin, and maintain the milk production when the mother and the baby are sick.(10)

METHODS
The method used in this paper was Literature Review that was conducted from 2012 to 2016. The
literature was taken from various from National and International Journals obtained from Google
Scholar, Nurse Media Journal of Nursing & Dama International Journal of Researchers (DIJR) using
keywords Breastfeeding, Exclusive Breastfeeding, Date Palm and Oxytocin Massage. Research criteria
used in the form of experimental research, pre-test and post-test design to know the extent of
effectiveness of Dates and Massage of Oxytocin in influencing the smoothness of breast milk.

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 2nd International Conference on Applied Science and Health
Research for Better Society: Developing Science and Technology to Improve
Health and Well-being

RESULTS
The search through Google Scholar, Nurse Media Journal of Nursing & Dama International Journal of
Researchers (DIJR) found several journals related to date palm and oxytocin massage and then re-
examined with criteria of literature collection such as experimental research, pre-test, post-test, date
palm for mothers and breastfeeding mothers, oxytocin massage for breastfeeding mothers and found
nine journals that correspond to the researchers’ theme, three journals on date palms and six journals
on oxytocin massage.

Palm date
The results showed that date palm are able to increase the expenditure of the hormone oxytocin that is
very influential on the smoothness of breast milk in postpartum mothers. Dates are one of the fruits with
complete nutrition that can be given to meet the nutritional needs of breastfeeding mothers. The research
conducted by Suroso and Paryono mentioned that the date palm contain potuchin hormone that serves
to spur blood vessel contractions around the breast which in turn spur the milk glands to produce milk
(11) In addition, three sources also mentioned that date palm contain oxytocin hormone that can help
stimulating contractions in the muscles of the uterus and spur contractions in the veins around the
mother's breast, thus increasing milk production.(11-18)
From three research on the benefits of dates for labour and fluency, it was found that the number of
samples studied varies considerably from 56-75. The research used in the form of experimental research
with pre-test and post-test design. In terms of literature utilization, most studies use national and
international health journals, medical books, health bulletins, health centres and previously established
researches.
In the research there are several forms of intervention used; dates can be consumed directly (63%), used
as palm juice (25%) and mixed in yogurt (12%). The combination of dates and yogurt can potentially
be developed into a probiotic product that enhances the functional effectiveness of the dates and does
not reduce the ingredients therein. Intervention time varies between four weeks and two weeks, with
six seeds every day, 45-50 grams of dates every day and 500 grams of dates in yogurt.
Oxytocin Massage
Oxytocin massage proved significantly through several studies to stimulate the release of the oxytocin
hormone.(19-24) In addition to stimulating the release of oxytocin hormone, oxytocin massage also
provides comfort to the mother, reduces engorgement, reduces breast milk blockage and maintains milk
production when the mother and baby are sick.(10)
Samples from the research ranged from 20 to 95 postpartum mothers. The research used in the form of
experiment with pre-test – post-test design. In terms of literature utilization, most studies use health
journals (national and international), medical books, health bulletins, health centres and previously
established researches. In the six researches, the time taken to perform the massage is 3-10 minutes
(40%), 15-20 minutes (40%) and 45-50 minutes (20%) for 3 (67%) - 5 days (33%). Final value are
observed in milk production, infant weight, cortisol levels and oxytocin levels by blood tests.

Table 1: Analysis of the Journal

Place and
No Title Researcher Description
year
1. The Effect of Fenugreek Cairo Egypt, Abeer, Sample 75 postpartum mothers. Results p
Herbal Tea and Palm 2014. Salama, and = 0.001 concludes that dates and
Dates on Breast Milk Salama. fenugreek herbal teas appear to be useful
Production and Infant for increasing milk production during the
Weight early postpartum period.(18)

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 2nd International Conference on Applied Science and Health
Research for Better Society: Developing Science and Technology to Improve
Health and Well-being

Table 1: Analysis of the Journal

Place and
No Title Researcher Description
year
2. Pemberian Sari Kurma Semarang, Putriningtyas Sample 56 breastfeeding mothers.
pada Ibu Menyusui July and and Hidana. Results p = 0.001 concludes that there
Efektif Meningkatkan August 2015 was a significant difference for infant
Berat bayi Usia 0-5 weight gain for four weeks in both
Bulan. (Provision of groups.(15)
Date Palm Extract to
Breastfeeding Mothers
is Effective in Baby
Ages Zero to Five’s
Weight Gain)
3. Literature study on Lumajang, Wardani. The research used is literature study
Pengaruh Yogurt 2015. sourced from textbook, journal, scientific
Kurma sebagai article and literature review. Dosage for
Pelancar ASI. (The pregnant and lactating women 500
Impact of Date Palm mg/day, divided into two giving each 250
Yogurt in Expediting mg. The combination of dates and yogurt
Breast Milk Production) can potentially be developed into a
probiotic product that enhances the
functional effectiveness of the dates itself
in increasing breast milk production. (12)
4. The Effect of Oxytocin Jakarta Azriani and The subjects of this study were 60
Massage on Breast Milk Selatan, 2016. Handayani. postpartum mothers. With P= <0.005,
Production. the results of the hypothesis test show
that there is an effect of oxytocin massage
on the weight and breast milk of infant
production, so it is recommended that
oxytocin massage be used in postpartum
care. (21)

5. Semarang, The sample was 93 breastfeeding

Effects of acupoint 2016. mothers. Result p = 0.000 concludes that
stimulation with Digital Anggorowati, DMO stimulates and increases the
Massager of Oxytocin et al. production of working mother's milk. It
on the Breast Milk can also be an alternative to
Production of Working complementary therapies, especially for
Mothers. nursing care of nursing mothers.(22)
6. Massage Increases University of Morhenn, 95 people from UCLA participated in this
Oxytocin and Reduces California Los Beavin, and study. P = <0.005 the result is a
Hormoneadrenocorticot Angeles Zak. significant difference between the
ropin in Humans. (UCLA), Los groups. In conclusion, massage increases
Angeles, CA. OT and decreases ACTH, NO and
2012. BE.(20)
7. The Effect Of Oxytocin Surakarta, Sulaeman, et The subjects were 60 postpartum
Massage On The 2016. al. mothers. Result P value for Infant Weight
Postpartum Mother On = 0.000 whereas P value for ASI amount
Breast Milk Production. = 0,039. Conclusion There is an effect of
oxytocin massage on weight and breast
milk production and it is suggested that
oxytocin massage may be used in
postpartum care.(23)

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 2nd International Conference on Applied Science and Health
Research for Better Society: Developing Science and Technology to Improve
Health and Well-being

Table 1: Analysis of the Journal

Place and
No Title Researcher Description
year
8. Oxytocin Massage as an Semarang, Nurdiana, Samples were 20 postpartum mothers.
Alternative in 2016. Onny, The results show p = 0,000. Its
Increasing Prolactin Sumarni S, implications oxytocin massage can be
Hormone Level and Supriyana, applied to increase levels of prolactin
Lactation Process on Maharani Y, hormone and milk production for post
Post Sectio Caesarea Yunyaty W, et Sectio Caesarea women (infant
Women. at weight).(24)
9. Effect of Massage and Semarang, Widyawati, Subject 52 postpartum. The results were
Aromatherapy on Stress 2016. M.N., et al. three treatments with p = 0.001 and at
and Prolactin Level control p = 0.343. In conclusion Loving
among Primiparous Massage & Aromatherapy are proven to
Puerpural Mothers. reduce stress levels and can increase
prolactin levels in primipara
postpartum.(19)

DISCUSSION
Breastfeeding is influenced by the feeding frequency, birth weight, gestational age at birth, age and
parity, stress and acute diseases, tobacco consumption, alcohol intake, hormonal contraceptive pills and
injections and physiological factors namely prolactin and oxytocin.(25). The date palm contains
potuchin hormone that serves to bind the uterus and uterine muscles that can help reducing postpartum
haemorrhage, spur blood vessel contractions around the breast and spur the milk glands to produce
milk.(11) In addition, there is the hormone oxytocin that helps stimulate contractions of the muscles of
the uterus to facilitate childbirth.(11-18) This hormone will also help spur a contraction in the veins that
surround the breast, thus spurring the milk glands to produce milk.(5)
A research conducted in Cairo, Egypt compared the consumption of fenugreek herbal tea one cup three
times a day with the consumption of ten date palm seeds for fourteen days. The result proved that the
consumption of the date palms increases breast milk volume at the beginning of postpartum and baby's
weight weighed on day to 0, 3, 7, & 14 using infant scale (p = 0.001). This result is also supported by a
research conducted in Semarang, Indonesia which stated that consumption of date juice can effectively
increase the weight of 0-5 Months old baby (p = 0.001). )
Massage may increase milk production by 11.5 times and decrease cortisol levels by 28%.(27) Oxytocin
Massage provides stimulation to the spinal muscles. The neurotransmitters stimulate the medulla
oblongata to send a message to the hypothalamus and to the posterior pituitary to secrete the oxytocin
hormone. Massaging the spinal muscles also reduces tension and relieves stress.(28) A study conducted
at the University of California Los Angeles (UCLA) showed that oxytocin massage can increase OT
(oxytocin) and decrease ACTH, NO and BE. As supported by previous study conducted in Southern
Jakarta, there is an effect of oxytocin massage on infant weight and breast milk production. Therefore,
it is suggested that oxytocin massage be used in postpartum care.(20) Supported by research in
Surakarta and Semarang also hold the theory that oxytocin massage proves to increase breast milk
production and baby's weight.(22-24)
From this literature study, it appeared that oxytocin massage is the more effective method to increase
oxytocin hormone compared to the consumption of date palms.

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 2nd International Conference on Applied Science and Health
Research for Better Society: Developing Science and Technology to Improve
Health and Well-being

CONCLUSION
Date Palm and Oxytocin Massage are proven to increase the oxytocin hormone that is very influential
on the smoothness of breastfeeding on post-partum mothers. Date palms contain complete nutrition that
can be given to meet the nutritional needs of pregnant women and maternity. It can be consumed
directly, made into date juice, or mixed with yogurt. The date palm contains potable hormone and
oxytocin hormone that can help stimulate contractions in the muscles of the uterus to ease the mothers’
pain while labouring. This hormone also helps spurring contractions in the veins of blood vessels around
the mother's breast, thus spurring the milk glands to produce milk. Oxytocin Massage spinal muscles
will stimulate the medulla oblongata to send a message to the hypothalamus and to the posterior
pituitary to secrete the oxytocin hormone that provide comfort, relieve stress, reduce swelling
(engorgement), reduce breast milk blockages, and maintain milk production when the mother and the
baby are sick.
This study used Literature Review which is helpful to see some research simultaneously to obtain a new
finding on a particular topic that has been studied. No research has been found that distinguishes the
two methods. From this literature study, it is proved that oxytocin massage is the more effectively
method to increase oxytocin than the consumption of date palms.

CONFLICT OF INTEREST
There is no conflict of interest.

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Research for Better Society: Developing Science and Technology to Improve
Health and Well-being

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