International Journal of Trend in Scientific Research and Development (IJTSRD)

International Open Access Journal | www.ijtsrd.com

ISSN No: 2456 - 6470 | Volume - 2 | Issue – 6 | Sep – Oct 2018

Effectiveness of Hot Application with Breast Massage on

Breast Engorgement Among the Postnatal Mothers
Thakur1, Mrs. Gomathi B2, Ms. Kanchan Bala2
Ms. Sangeeta Tha
1
M.Sc. Nursing, 2Assistant professor
Himalayann College of Nursing, Swami Rama Himalayan University,
University
Dehradun, Uttarakhand, India

ABSTRACT
Breast engorgement is one of the most common breast joyful event, when a woman gives birth to a baby,
implications occur on 2nd and 3rd postnatal days. A discomfort 1
despite of tremendous pain and discomfort.
quasi experimental time series design stu study was
conducted to assess the Effectiveness of hot Various physiological changes occurs in the body of
application with breast massage on breast women during pregnancy. Breast engorgement is a
engorgement among the postnatal mothers. The study painful condition which is mostly occur on 2nd and 3rd
was conducted on 60 postnatal mothers who had postpartum period which makes the breasts feel
breast engorgement which were randomly divided swollen, sore, tingly, and unusually sensitive to
into two groups (300 in experimental group and 30 in touch.2
control group) and samples were selected through
purposive sampling technique. The study was Breast engorgement prevents the baby from latching
explained to participants and consent was taken. The preventing effective breast milk flow. This leads to
data were collected by six point breast engorgement severe breast engorgement, which can cause great gre
scale, numerical pain scale
ale and through oppinionaire. discomfort and pain. Insufficient
ficient breast milk intake
For the experimental group sponge cloth over the will subsequently occur and hinder normal infant
breast for a total duration of 20 minutes for 3 times in growth and health of mother.3
day continues for 2 days. Posttest for breast
engorgement and pain was assessed in study and Global rate of exclusive breastfeeding according to
control group at the same interval.
nterval. Homogeneity was WHO (2013) is 37%. Indian statistics suggests 96%
maintained for demographic variables in both groups. of the children aree breastfed, of that only 29% of the
The result showed that there was significant urban population and 21% of the rural population are
difference between both the groups showed a breastfed within an hour immediately after birth.
significant reduction in breast engorgement at p<0.05 Breastfeeding problems such as breast engorgement,
This study found that hot application ion with breast flat or inverted nipple or mastitis were detected in
massage is effective in reducing the breast 4.9% of the women in India. 4
engorgement among postnatal mothers.
PROBLEM STATEMENT
Keyword: Effectiveness, hot application, breast “A study on effectiveness of hot application with
massage, breast engorgement, postnatal mother. breast massage on breast engorgement among the
postnatal mothers admitted in postnatal ward of
INTRODUCTION selected hospital, Dehradun, Uttrakhand.”
Breast feeding is a natural human activity and best
method for feeding an infant. World health OBJECTIVES:
organization suggest that exclusive breast feeding for 1. To assess the effect
ect of hot application with breast
at least six months of life and continue supplement massage on breast engorgement among the
breast feeding for at least one year. Mother ship is a postnatal mothers with breast engorgement.

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 International Journal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456-6470
2456
2. To find association between the level of breast Section A. Demographic variables:
variables consists of Age,
engorgement with their selected demographic Parity, Type of family, Occupation, Type of delivery,
variables of postnatal mothers Educational status, No. of postpartum days, Initiation
3. To assess the opinion
pinion of postnatal mothers about of breast feeding, Maternal position for breast
hot application with breast massage. feeding, Frequency of breast feeding

HYPOTHESES Section B. Breast engorgement scale:scale It was

All hypotheses were tested at p< 0.05 level of developed by Hill&Humenick.
Humenick. It was used to assess
significance the: degree of breast engorgement which given the
H1: There would be significant reduction in the scoring ranges from 1to 6.
mean breast engorgement score of postnatal
mothers of experimental group than in control Section C. Opionionnaire: To assess the opinion of
group. postnatal mother regarding hot application with breast
bre
H2: There would be significant association between massage.
the breast engorgement score and the selected
demographic variables of postnatal mothers. Presentation of the data
The data was entered in a master sheet, for tabulation
METHODOLOGY and statistical processing. In order to find the
The research design used in this study was quasi relationship, the data was tabulated, analyzed and the
experimental with time series design. The study was interpreted using descriptive and inferential statistical
conducted at Himalayan Hospital, Dehradun, methods. The data was analyzed and the interpretation
Uttarakhand.6060 postnatal mothers were randomly were drawn
assigned into 30 in experimental and 30 in control
group through purposive sampling technique. The SECTION- A:
data were collected
cted by demographic variables, six This section deals with the distribution of the study
point breast engorgement scale, numerical pain scale subjects based on their demographic variables such as
and oppinionaire the study was explained to Parity, Type of family, Occupation ,Type of delivery,
participants and written consent was taken. The data Educational status, Initiation of breast feeding
were collected with the help of various tools ,Maternal position for feeding and Frequency of
consisting of feeding.

Table No. 1: Frequency and percentage distribution of demographic variables of postnatal mothers
Homogeneity
Sr. Experimental Control group
Demographic variables p-
no. Group n=30 n=30 χ2
value
Age
1. a. 19-27 17(56.6%) 20( 66.6)
b. 28-36 0.716" 0 .470
13(43.3%) 10 (33.3%)
Parity
2. a. Primiparous 17 (56.7%) 14 (46.7%) 0.475" 0.713
b. Multiparous 12 (43.3%) 16 (53.3%)
Type of family
3. a. Nuclear 8 (26.7%) 7 (23.3%) 0.345
b. Joint 22 (73.3%) 23 (76.7%)
Occupation
4. a. House wives 26 (86.7%) 26 (86.7%)
0.169
b. Working 4 (13.3%) 4 (13.3%)
Type of delivery
5. a. vaginal 10(33.3%) 13 (43.3%)
b. CS 1.000
20 (66.7%) 17 (56.7%)

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 International Journal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456-6470
2456
Educational status
a. No formal education 1(3.3%) 2(6.7%)
b. Primary 2(6.7%) 3(10.0%)
6.
c. Secondary 6(20.0%) 3(10.0%)
d. Higher secondary 5(16.7%) 5(16.7%) 17.423 ͌ 0.313
e. Graduate and above 16 (53.3) 17 (56.7%)
No. of post-partum
partum days
7 a. 2-4 days 29(96.6%) 27(90%) 0.385 ͌ 0.639
b. 5-7 days 1 (3.33%) 3(10.0%)
Initiation of breast feeding
a. Within ½ hour 3 (10.0%) 2 (6.7%)
8. b. ½ hour to 6 hour 5 (16.7%) 8 (26.7%)
c. 6hrs to 12 hrs. 10(33.3%) 14(46.7%) 13.140 ͌ 0.067
d. More than 12 hrs. 12(40.0%) 6(20.0%)
Maternal position for feeding
9. a. Sitting 17 (56.7%) 17 (56.7%)
b. Side lying 13(43.33%) 13 (43.3%) 2.222" 0.264
Frequency of feeding (in hours)

a. every1hour
hour 8 (26.7%) 3(10%)
10 b. every2 hour 9 (30.0%) 10 (33.3%)
c. every3 hour 3(10.0%) 2(6.7%)
d. Demand feeding 10(33.3%) 15(50.0%) 9.048 ͌ 0.370

df1=3.84 at p<0.05 level of significance

Chi- square test (") Fisher‘s exact test ( ͌ ) Yates ‘s correction test (y ) independent t test

Table no 1:: Shown that more than half of the mothers mothers initiates breast feeding
ding in more than 12 hrs.
in both group were in the age group between 19 19- i.e. (40.0%). Same as in the control group 46.4% of
27years. In experimental group more than half of the the mother initiate breast feeding between 6hrs to 12
mothers were Primi parous i.e. 56.7% where as in hrs. . In both groups the preferred maternal position
control group half of the mothers were multiparous for breast feeding were sitting position i.e. 56.7% in
i.e.53.3%. Majority of mothers were from joint each group. In both group, maximum number of the
families i.e. 73.3% from experimental group and postnatal mothers fed their baby on demand i.e.
76.7% from the control group. In view of 33.3% in experimental group and 50% in the control
occupational status most of the mothers were group. it can also interpreted that the study
housewife (86.7%) from both groups. In both groups, participants in experimental and control group were
majority of the postnatal motherss undergone through equally distributed in terms
rms of parity, type of family,
LSCS in both groups. In type of education more than occupation, type of delivery ,education , initiation of
half of the mothers were found graduated and above breast feeding., maternal position, frequency of
53.3% in experimental group and 56.7% in the control feeding.
group. In experimental group maximum number of

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 International Journal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456-6470
2456
Figure no 1: Comparison of level of breast engorgement scores betwe
between
en and with experimental and
control group.

Figure no 1: showed comparison of level of breast where as 5.93 ± 0.254 in control group. Hence, the
engorgement scores between and within experimental null hypothesis was rejected and the research
and control group it depicts that at baseline the mean hypothesis was accepted. Thus it can be interpreted
breast engorgement score and SD was5.305.30 ± 0.702 in that the hot application with breast massage is
experimental group whereas 4.40 ± 0.770 in control effective in reducing breast engorgement in
group. In the observation 6 mean breast engorgement experimental group than in control group
g as compared
score and SD was 1.60 ± 0.563 in experimental group to the control group.

Table no 2: Association of breast engorgement score with selected demographic variables of postnatal
mothers with breast engorgement.
Breast engorgement score
S. No. Demographic variables Chi-sq. Df p- value
3–4 5-6
Type of family
1
a. Nuclear 10 (16.6%) 5(8.33%)
b. Joint 15 (25%) 30(50%) 5.143" 1 0.035

Table no 2: showed that there was significant it can be interpreted that demographic variables did
association found between level of breast not have any influence on breast score of postnatal
engorgement score with type of family ((5.143) Hence mothers except type of family.

Table no 3: Frequency and percentage distribution of opinionnaire of postnatal mothers regarding hot
application with breast massage.
n=30
Strongly Agree Agree
S. No. Opinions
f % f %
1. I felt safe when receiving the intervention. 28 93.3 2 6.66
2. I felt relaxed when receiving intervention. 24 80 6 20
3. I felt relief from breast engorgement after receiving intervention 25 83.3 5 16.6
4. I fed comfortably after receiving the intervention 25 83.3 5 16.6
5. I can share this experience with others. 30 100 0 0
6. I can recommended this method to others. 30 100 0 0

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 International Journal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456-6470
2456
Table no 3: depicts the frequency and percentage postnatal mothers and the participants were
distribution of opinionnaire of mother regarding hot comfortable and cooperative throughout the study.
application with breast massage. The result showed From this it is concluded that hot application with
that most of the motherther 93.3% were strongly agree breast massage can be used as a cost effective nursing
whereas6.66%
6.66% 0f the mothers were agree that intervention in reducing the breast engorgement and
they felt safe during the time of intervention. Most of pain among postnatal mothers
the mothers 80% were strongly agree whereas
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