Woolwich Massage as a Non-Pharmacological Intervention to Enhance Breast Milk Production Among Postpartum Mothers: A Quasi-Experimental Study
DOI:
https://doi.org/10.53713/htechj.v4i5.755Keywords:
breast milk production, breastfeeding support, lactation intervention, postpartum mothers, woolwich massageAbstract
Insufficient breast milk production remains a major challenge during the postpartum period and may contribute to early discontinuation of exclusive breastfeeding. Non-pharmacological interventions that are safe, accessible, and applicable in maternal healthcare settings are needed to support improvements in lactation. Woolwich massage has been proposed as a supportive technique to stimulate physiological mechanisms associated with breast milk production; however, evidence regarding its effectiveness in specific postpartum care settings remains limited. This study aimed to evaluate the effectiveness of Woolwich massage in increasing breast milk production among postpartum mothers at KRI Madinah Pujon. A quasi-experimental study with a two-group pre-test and post-test design was conducted among 30 postpartum mothers. Participants were selected using quota sampling and divided into an intervention group that received Woolwich massage and a control group that received standard postpartum care. Breast milk production was assessed before and after the intervention. Data were analyzed using the Wilcoxon Signed-Rank Test at a significance level of p < 0.05. The findings showed an improvement in breast milk production following the Woolwich massage intervention. The mean production score increased from 9.377 before intervention to 11.310 after intervention. The Wilcoxon analysis demonstrated a significant difference between pre-test and post-test measurements (Z = −4.787; p < 0.001), indicating that Woolwich massage was associated with increased breast milk production among postpartum mothers. Woolwich massage represents an effective complementary intervention to support breast milk production during the postpartum period. The findings highlight its potential for integration into postpartum breastfeeding support programs as a practical, non-pharmacological approach to improving lactation outcomes. Further studies with larger sample sizes and rigorous experimental designs are recommended to strengthen the evidence for its clinical effectiveness.
Downloads
References
Agustia, N., & Camelia, R. (2025). Effect of lactation massage and oxytocin massage on milk production in postpartum women: A quasi-experimental study. Lentera Perawat, 6(2), 355–361. https://doi.org/10.52235/lp.v6i2.475
Allen, J., Gao, Y., Germain, J., O’Connor, M., Hurst, C., & Kildea, S. (2023). Impact of the Thompson method on breastfeeding exclusivity and duration: Multi-method design. International Journal of Nursing Studies, 141, Article 104474. https://doi.org/10.1016/j.ijnurstu.2023.104474
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 Journal, 4(3), e963. https://doi.org/10.52225/narra.v4i3.963
Beyene, B. N., Wako, W. G., Moti, D., Edin, A., & Debela, D. E. (2025). Postnatal counseling promotes early initiation and exclusive breastfeeding: A randomized controlled trial. Frontiers in Nutrition, 12, 1473086. https://doi.org/10.3389/fnut.2025.1473086
Bilgiç, F. Ş., & Bozkurt, G. (2024). Effect of online infant care training and postpartum counseling based on Meleis' transition theory on mothers' readiness for care and breastfeeding: A randomized controlled trial. Clinical and Experimental Pediatrics, 67(10), 521–530. https://doi.org/10.3345/cep.2024.00423
Chambers, A., Emmott, E., Myers, S., & Page, A. E. (2023). Emotional and informational social support from health visitors and breastfeeding outcomes in the UK. International Breastfeeding Journal, 18, Article 14. https://doi.org/10.1186/s13006-023-00551-7
Hannan, F. M., Elajnaf, T., Vandenberg, L. N., Kennedy, S. H., & Thakker, R. V. (2023). Hormonal regulation of mammary gland development and lactation. Nature Reviews Endocrinology, 19, 46–61. https://doi.org/10.1038/s41574-022-00742-y
Hoberg, M. G., Demirci, J. R., Sereika, S. M., Levine, M. D., & DeVito Dabbs, A. (2024). Mixed-methods assessment of maternal anxiety during the first 8 weeks after birth. Journal of Obstetric, Gynecologic & Neonatal Nursing, 53(4), 368–382. https://doi.org/10.1016/j.jogn.2024.01.003
Karthigesu, K., Balakumar, S., & Arasaratnam, V. (2023). Determinants of early cessation of exclusive breastfeeding practices among rural mothers from Jaffna District of Sri Lanka. International Breastfeeding Journal, 18, Article 42. https://doi.org/10.1186/s13006-023-00575-z
Kartilah, T., & Februanti, S. (2024). Emotional Freedom Techniques and oxytocin stimulation massages that effectively reduce anxiety and increase smooth breast milk production of nursing mothers. The Malaysian Journal of Nursing, 16(2), 46–53. https://doi.org/10.31674/mjn.2024.v16i02.005
Khatib, M. N., Gaidhane, A., Upadhyay, S., Telrandhe, S., Saxena, D., Simkhada, P. P., Sawleshwarkar, S., & Quazi, S. Z. (2023). Interventions for promoting and optimizing breastfeeding practices: An overview of systematic review. Frontiers in Public Health, 11, 984876. https://doi.org/10.3389/fpubh.2023.984876
Kılcı Erciyas, Ş., & 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. https://doi.org/10.1016/j.jnn.2023.10.003
Knutson, J., & Butler, J. (2022). Providing equitable postpartum breastfeeding support at an urban academic hospital. Nursing for Women’s Health, 26(3), 184–193. https://doi.org/10.1016/j.nwh.2022.03.002
Koca, A. G., & Yurdakul, M. (2026). Impact of web-based lactation support on exclusive breastfeeding, maternal motivation and breastfeeding challenges: A randomized controlled trial. BMC Pregnancy and Childbirth, 26, 269. https://doi.org/10.1186/s12884-026-08662-9
Lestari, P., Fatimah, F., Ayuningrum, L., Herawati, H. D., & Afifaturrohmah, N. (2022). Effect of oxytocin massage in reducing lactation problems and supporting infant growth. Open Access Macedonian Journal of Medical Sciences, 10(T8), 81–85. https://doi.org/10.3889/oamjms.2022.9487
Levene, I., Gardner, H., & Spiby, H. (2024). Relaxation therapy and human milk feeding outcomes: A systematic review and meta-analysis. Frontiers in Global Women’s Health, 5, 110749. https://doi.org/10.3389/fgwh.2024.110749
Lojander, J., Axelin, A., & Niela-Vilén, H. (2024). Breastfeeding exclusivity, difficulties, and support in the first days after hospital discharge: A correlational study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 296, 76–82. https://doi.org/10.1016/j.ejogrb.2024.02.029
Mollaahmetoglu, Ş. E., & Guvenc, G. (2025). The effect of breast massage and warm compress application on milk production and anxiety in mothers with premature newborn: A randomized controlled trial. Breastfeeding Medicine, 20(6), 416–423. https://doi.org/10.1089/bfm.2024.0382
Moriyama, Y., Nakao, Y., Yamamoto, N., & Oki, T. (2024). Dysphoric milk ejection reflex among Japanese mothers: A self-administered survey. International Breastfeeding Journal, 19, Article 21. https://doi.org/10.1186/s13006-024-00625-0
Mullen, A. J., O’Connor, D. L., Hanley, A. J., Piedimonte, G., Wallace, M., & Ley, S. H. (2022). Associations of metabolic and obstetric risk parameters with timing of lactogenesis II. Nutrients, 14(4), 876. https://doi.org/10.3390/nu14040876
Munsittikul, N., Tantaobharse, S., Siripattanapipong, P., Wutthigate, P., Ngerncham, S., & Yangthara, B. (2022). Integrated breast massage versus traditional breast massage for treatment of plugged milk duct in lactating women: A randomized controlled trial. International Breastfeeding Journal, 17, Article 43. https://doi.org/10.1186/s13006-022-00485-6
Nagel, E. M., Howland, M. A., Pando, C., Stang, J., Mason, S. M., Fields, D. A., & Demerath, E. W. (2022). Maternal psychological distress and lactation and breastfeeding outcomes: A narrative review. Clinical Therapeutics, 44(2), 215–227. https://doi.org/10.1016/j.clinthera.2021.11.007
Pados, B. F., & Camp, L. (2024). Physiology of human lactation and strategies to support milk supply for breastfeeding. Nursing for Women’s Health, 28(4), 303–314. https://doi.org/10.1016/j.nwh.2024.01.007
Patnode, C. D., Henninger, M. L., Senger, C. A., Perdue, L. A., Whitlock, E. P., & Chou, R. (2025). Interventions to support breastfeeding: Updated evidence report and systematic review for the U.S. Preventive Services Task Force. JAMA, 333(13), 1143–1154. https://doi.org/10.1001/jama.2024.27267
Peng, Y., Zhuang, K., & Huang, Y. (2024). Incidence and factors influencing delayed onset of lactation: A systematic review and meta-analysis. International Breastfeeding Journal, 19, 59. https://doi.org/10.1186/s13006-024-00666-5
Pérez-Escamilla, R., Tomori, C., Hernández-Cordero, S., et al. (2023). Breastfeeding: Crucially important, but increasingly challenged in a market-driven world. The Lancet, 401(10375), 472–485. https://doi.org/10.1016/S0140-6736(22)01932-8
Rios-Leyvraz, M., & Yao, Q. (2023). The volume of breast milk intake in infants and young children: A systematic review and meta-analysis. Breastfeeding Medicine, 18(3), 188–197. https://doi.org/10.1089/bfm.2022.0281
Rodríguez-Gallego, I., Corrales-Gutierrez, I., Gomez-Baya, D., & Leon-Larios, F. (2024). Effectiveness of a postpartum breastfeeding support group intervention in promoting exclusive breastfeeding and perceived self-efficacy: A multicentre randomized clinical trial. Nutrients, 16(7), 988. https://doi.org/10.3390/nu16070988
Saehoong, S., Pookboonmee, R., Daramas, T., Chansatitporn, N., & Nuntnarumit, P. (2024). Effects of an early breastfeeding education and proactive telephone support program for mothers of preterm infants: A quasi-experimental study. Pacific Rim International Journal of Nursing Research, 28(3), 548–562. https://doi.org/10.60099/prijnr.2024.268608
Şimşek-Çetinkaya, Ş., Gümüş Çaliş, G., & Kibris, Ş. (2024). Effect of breastfeeding education program and nurse-led breastfeeding online counseling system (BMUM) for mothers: A randomized controlled study. Journal of Human Lactation, 40(1), 101–112. https://doi.org/10.1177/08903344231210813
Sweet, L., & Vasilevski, V. (2022). Evaluation of a new lactation device “Lactamo” designed to apply massage, heat or cold, and compression to the breast. International Breastfeeding Journal, 17, Article 23. https://doi.org/10.1186/s13006-022-00466-9
Titaley, C. R., Dibley, M. J., Ariawan, I., Mu’asyaroh, A., & the BADUTA Study Team. (2022). The impact of a package of behaviour change interventions on breastfeeding practices in East Java Province, Indonesia. Maternal & Child Nutrition, 18(4), e13362. https://doi.org/10.1111/mcn.13362
Wang, T., Shang, M., & Chow, K. M. (2023). Effects of breastfeeding training programmes for midwives on breastfeeding outcomes: A systematic review and meta-analysis. BMC Pregnancy and Childbirth, 23, Article 262. https://doi.org/10.1186/s12884-023-05540-6
