Marmet and Oxytocin Massage for Breast Milk Increase
The Effectiveness of the Marmet Technique and Oxytocin Massage on Breast Milk Quantity in Mothers Who Have Undergone Cesarean Section
Ege University
123 participants
Aug 25, 2025
INTERVENTIONAL
Conditions
Summary
This study is designed as a randomized controlled single-blind experimental study to examine the effectiveness of the oxytocin massage and Marmet technique applied to mothers who have undergone cesarean section on breast milk quantity and maternal state anxiety levels. The hypotheses of the study are as follows: H0.1. There is no difference in the amount of breast milk among mothers in the Marmet technique, oxytocin massage, and control (placebo) groups. H1.1. There is a difference in the amount of breast milk among mothers in the Marmet technique, oxytocin massage, and control (placebo) groups. H0.2. There is no difference in the state anxiety scale scores among mothers in the Marmet technique, oxytocin massage, and control (placebo) groups. H1.2. There is a difference in the state anxiety scale scores among mothers in the Marmet technique, oxytocin massage, and control (placebo) groups. Participants: Marmet technique, oxytocin massage, and control (placebo) groups will be informed about the study and asked to provide their consent. Participants will complete the descriptive questionnaire. Colostrum status will be checked and marked as "present" or "absent" on the "Breast Milk, Vital Signs, and Pain Level Form." Under researcher supervision, the mother will breastfeed her baby. Afterward, the State Anxiety Inventory will be administered. Two hours later, mothers will express milk using a hospital-grade pump, with 15 minutes on each breast (total 30 minutes). Milk volume, vital signs, pain levels, and milk flow rate will be recorded on the relevant form. Following this, mothers in the Marmet group will receive 10 minutes of the Marmet technique, mothers in the oxytocin group will receive 5 minutes of oxytocin massage, and mothers in the control group will receive 5 minutes of light touch on their wrists and shoulders. Immediately after, milk expression will again be performed with 15 minutes per breast (30 minutes total). The State Anxiety Inventory will be re-administered, and milk amount, vital signs, pain levels, and flow rate will be recorded again. All mothers will express milk using a hospital-grade breast pump, and the expression duration is standardized as 15 minutes per breast (30 minutes total) based on the literature. Two expressions will be performed - one before and one immediately after the intervention. Expressed milk will not be discarded and will instead be used to feed the babies via spoon or syringe under the researcher's supervision.
Eligibility
Inclusion Criteria15
- Aged between 18-35 years
- Literate
- Fluent in Turkish
- Volunteering to participate in the study
- Primiparous (first-time mothers)
- Within the first 2 hours postpartum (mothers performing their first breastfeeding under researcher supervision)
- Have a single baby with an appropriate birth weight for gestational age (\>2500 gr)
- Have their baby with them
- Received spinal anesthesia
- Neither the mother nor the baby has any acute or chronic illness
- Exclusively breastfeeding their baby
- Had a term (37 weeks gestation or more) and cesarean delivery
- Experienced no complications after the cesarean section
- No issues preventing breastfeeding
- Willing to breastfeed
Exclusion Criteria15
- Are under 18 or over 35 years old
- Are multiparous (have given birth before)
- Are encountered more than 2 hours postpartum
- Received general anesthesia
- Have any acute or chronic illness themselves or their baby
- Have conditions requiring mother and baby to be separated
- Report experiencing severe pain
- Formula-feed their baby or consume any milk-increasing medication or tea
- Gave birth before 37 weeks gestation or had a vaginal delivery
- Have an anatomical breast issue (absence of nipple, inverted nipple)
- Have swelling, ecchymosis, or wounds on their back (for the oxytocin massage group)
- Have a baby with a congenital anomaly
- Have an issue preventing breastfeeding
- Have a psychological issue
- Are unwilling to breastfeed
Interested in this trial?
Get notified about updates and connect with the research team.
Interventions
One of the traditional and natural efforts mothers can make to facilitate breast milk production postpartum is the Marmet technique. This technique embraces the principles of massage and stimulation of the milk ejection reflex (Widiastuti et al., 2015; Hairunisyah \& Kusumawaty, 2022). Furthermore, this technique provides a relaxing effect, reactivating the milk ejection reflex, which in turn stimulates spontaneous milk flow (Yuliani et al., 2015). In other words, the Marmet technique is a combination of expressing milk and massaging the breast by emptying the lactiferous sinuses located under the areola. The Marmet technique stimulates prolactin secretion and helps maximize the milk ejection reflex. The more milk that is withdrawn or emptied from the breast, the greater the milk production (Widiastuti et al., 2015).
Oxytocin massage is a type of massage performed to increase breast milk production. The massage is applied to the sides of the spine and the fifth to sixth ribs, and it stimulates the prolactin and oxytocin hormones after birth (Kosova et al., 2016). This massage serves to increase the oxytocin hormone, which can calm the mother, leading to an automatic flow of breast milk (Kilci \& Sevil, 2021). Research conducted by Azizah and Ambarika (2022) shows that a combination of the Marmet technique and oxytocin massage can increase breast milk production. Massaging or stimulating the spine sends a message to the hypothalamus in the posterior pituitary by directly stimulating the medulla oblongata via neurotransmitters to release oxytocin, which then causes milk secretion from the breasts (Lestari \& Linar, 2024).
No intervention will be made to the participants in this group. Superficial touch will be performed on women's wrists, elbows, and shoulders.
Locations(1)
View Full Details on ClinicalTrials.gov
For the most up-to-date information, visit the official listing.
NCT07077655