Proceedings of the International Conference on Nursing and Health Sciences, Volume 4 No 2, July - December 2023

e-ISSN 2774 – 5104, Global Health Science Group

http://jurnal.globalhealthsciencegroup.com/index.php/PICNHS

THE EFFECTIVENESS OF WOOLWICH MASSAGE AND ROLLING (BACK)

MASSAGE ON BREAST MILK QUANTITY
Nining Rohniyati*, Lili Farlikhatun
STIKES Abdi Nusantara, Jl. Swadaya No. 7, Jatibening, Pd. Gede, Bekasi, West Java 17412, Indonesia
*[email protected]

ABSTRACT
Inadequate breast milk production can cause breastfeeding to stop before the baby is 6 months old. One
effort that can be done to stimulate the hormones prolactin and oxytocin in the mother. There are 2 non-
pharmacological ways to maximize the production of prolactin and oxytocin, namely Woolwich massage
and rolling back massage. The purpose of this study was to look at the effectiveness of Woolwich massage
and rolling back on the expenditure or quantity of breast milk. This research is a type of intervention research
with experimental quasy design. The location used for this study is in the working area of the midwife
clinic Rahmawati Serang – Banten in June – July 2023. The samples used in this study were 15 people as
the woolwich group and 15 postpartum mothers as the rolling back group. The bivariate analysis used in
this study was to determine whether there was a relationship with the Chi-Square test. In the rolling massage
group there were 10 respondents (33.3%) and not much different in the Woolwich massage group also the
majority of breast milk volume >500 ml there were 11 (36.7%) respondents. Analysis results (OR: 0.73;
95% Confident Interval 0.15 – 3.49; p value 0.690).

Keywords: breast milk; woolwich massage; rolling back massage

INTRODUCTION
World Health Organization (WHO) and United Nations Children's Fund (UNICEF) recommends
exclusive breastfeeding, namely breast milk given to infants from birth for 6 (six) months, without
adding and/or replacing with other foods or drinks.(Rosyaria Badrus, 2018) In reality, exclusive
breastfeeding in Indonesia still has many obstacles. One of the factors that causes the failure of
exclusive breastfeeding is the lack of milk production so that it cannot cover the nutritional needs
of the baby. It takes an effort that can be done to stimulate the hormones prolactin and oxytocin in
the mother after giving birth is to give a relaxing sensation to the mother. There are several methods
that can be done to stimulate breast milk production, including breast care, breast massage, Early
Breastfeeding Initiation (IMD), back rolling massage and endhorphin massage. Back rolling
massage and Woolwich massage (Sholeha, 2019)(Retnosari, 2021)(Mayangsari, 2020)

One of the efforts that can be made to stimulate the hormones prolactin and oxytocin in mothers
after giving birth is to provide a relaxing sensation to the mother by doing Woolwich massage.
Woolwich massage is a massage performed in the area of the active sinuses precisely 1-1.5 cm
above the areola mamae, with the aim of removing milk in the active sinuses. Woolwich massage
will stimulate nerve cells in the breast. These stimuli will be forwarded to the hypothalamus and
responded by the anterior hyphaphysis to secrete the hormone prolactin which will be flowed by
the blood to breast myopitel cells to produce breast milk.(Dinengsih, 2020)(Aprianti,
2023)(Nurfija, 2020)

Another technique that has also been reported to have effectiveness in increasing milk production
is Rolling massage is a relaxation therapy aimed at stimulating the central nerves in the posterior
and anterior pituitary so as to increase milk production, especially in postpartum mothers and

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Proceedings of the International Conference on Nursing and Health Sciences, Volume 4 No 2, July - December 2023
e-ISSN 2774 – 5104, Global Health Science Group
http://jurnal.globalhealthsciencegroup.com/index.php/PICNHS
provide comfort and relaxation after delivery. Massage is one of the effective complementary
therapies to reduce physical discomfort as well as improve mood disorders. Reduction of
discomfort in nursing mothers will help smooth the release of breast milk. The purpose of this study
was to determine the effectiveness of Woolwich massage and rolling back massage on increasing
milk production.(Muryani, 2022)(Kartini, 2023)(Anggraini, 2022)

METHOD
This research is a type of intervention research with an experimental quasy design. The location
used for this research is in the working area of the Rahmawati Anyar midwife clinic, Serang City,
Banten Province in June – July 2023. The sample used in this study used a total sampling of 15
postpartum mothers as the woolwich group and 15 postpartum mothers as the rolling back group.
Inclusion criteria: Postpartum mother for at least 2 days and no abnormal bleeding or infection.
Intervention Woolwich massage is done in the area of the active sinuses precisely 1-1.5 cm above
the mammary areola, with the aim of removing milk in the active sinuses is done for 3-5 minutes.
Control intervention in the form of rolling back is massage of the spine (five-six costa), helps the
hormone oxytocin work in milk production and increases comfort after childbirth (Farida,
2022)(DELVIA REHULINA, 2020) The instrument used in the study was an observation sheet to
determine milk production in postpartum mothers with a cut off point of 500 ml. The bivariate
analysis used in this study was to determine whether there was a relationship with the Chi-Square
test.

RESULT AND DISCUSSION

Based on the results of research that has been conducted, it is illustrated that the majority of
pregnant women are the most in productive age, which is between 20 – 35 years old with 20 people
or equivalent to 66.7%, most of which are first or primiparous childbirth, namely 20 (66.7%) and
mayotitas respinden have completed education in high school as many as 26 respondents (86.7%).

Table 1.
Characteristics of Respondents (n=30)
Characteristic f %
Age of Respondents
< 20 Years 7 23.3
20 – 35 Years 20 66.7
> 35 Years 3 10
Parity
Primipara 20 66.7
Multiparous 10 33.3
Education
Elementary (Elementary-Junior 4 13.3
High)
SMA 26 86.7
Based on cross-tabulations (table 2) it can be seen that the majority of respondents who received
Woolwich massage intervention and rolling massage had a fairly high volume of breast milk > 500
ml. In the rolling massage group there were 10 respondents (33.3%) and not much different in the
Woolwich massage group also the majority of breast milk volume >500 ml there were 11 (36.7%)
respondents.

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Proceedings of the International Conference on Nursing and Health Sciences, Volume 4 No 2, July - December 2023
e-ISSN 2774 – 5104, Global Health Science Group
http://jurnal.globalhealthsciencegroup.com/index.php/PICNHS

Table 2.
Cross Tabulation of Breast Milk Volume Woolwich Massage Group and Rolling back Massage
Group
Group
Volume of Woolwic Percentage Rolling Back Percentage Total Percentage
breast milk h (%) Massage (%)
Massage
< 500 ml 4 13.3 5 16.7 9 30
> 500 ml 11 36.7 10 33.3 21 70

Table 3.
Analysis of the Effectiveness of Woolwich Massage and Rolling Back Massage on Increased
Breast Milk Levels
Risk Estimate Value 95% Confident Interval P Value
Lower Upper
Odds Ratio for Breast Milk 0.73 0.15 3.49 0.690
Levels
Based on the results of the analysis, the odds ratio value (OR: 0.73; 95% Confident Interval 0.15 –
3.49; p value 0.690) can be concluded that there is no significant difference between the
intervention of Woolwich massage and rolling back massage on improving the quality of breast
milk. Both interventions have been shown to increase breast milk production. This result is in line
with research reporting that based on the Independent t-test obtained p value = 0.77> α (0.05) so
that there was no effect on the average milk adequacy of the woolwich massage group and oxytocin
massage on the back.(Dinengsih, 2020) Rolling Massage or massage of the spine (costae to five-
six), helps the hormone oxytocin work in milk production and increases comfort after childbirth.
Massage of the spine ranging from costae five-six to the scapula, will accelerate the
parasympathetic nerves convey signals to the back brain to stimulate the work of oxytocin in
flowing milk out by stimulating the hormones prolactin and oxytocin (Savitri, 2018).(Ari Shanti,
2018)

Massage or stimulation of the spine, neurotransmitters will stimulate the medulla oblongata directly
send a message to the hypothalamus in the posterior hypophyse to secrete oxytocin causing the
breasts to secrete milk. Massage in the spinal area will also relax tension and relieve stress and thus
one solution to overcome the smoothness of milk production and assisted by baby suction on the
areola (Amalia, (2022, July)) Woolwich massage is a massage performed in the area of the active
sinuses precisely 1-1.5 cm above the mammary areola, with the aim of removing milk in the active
sinuses. With this massage can stimulate nerve cells in the breast, the stimulation is forwarded to
the hypothalamus and responded by the anterior pituitary to release the hormone prolactin which
will be flowed by the blood to the breast myopitel cells to produce milk, increase breast milk
volume, and prevent breast dams that cause swollen breasts.(Sinaga, 2022)(Malatuzzulfa, 2022)

Woolwich massage is given to postpartum mothers 2 times / day in the morning and evening at
least done for 3 days. The procedure for doing woolwich massage is done circular massage using
both thumbs in the area of the active sinuses exactly 1-1.5 cm outside the areola mamae for 15
minutes (LEDYSANI, 2020). This woolwich massage method is based on the observation that the

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Proceedings of the International Conference on Nursing and Health Sciences, Volume 4 No 2, July - December 2023
e-ISSN 2774 – 5104, Global Health Science Group
http://jurnal.globalhealthsciencegroup.com/index.php/PICNHS
drainage of breast milk is more important than the secretion of milk by the breast milk glands. The
production and expenditure of breast milk is influenced by two hormones, namely prolactin and
oxytocin. Prolactin affects the amount of milk production, while oxytocin affects the process of
milk production. Prolactin is related to maternal nutrition, the better the nutritional intake, the
production produced is also a lot. In other words, the working system and mechanism of woolwich
massage and rolling back have many similarities so that both can be effective for use in efforts to
increase breast milk.(Risakotta, 2023).

CONCLUSION
There was no significant difference between the Woolwich massage intervention and rolling back
massage on improving breast milk quality. Both interventions have been shown to increase breast
milk production

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e-ISSN 2774 – 5104, Global Health Science Group
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