Marmet and Oxytocin Massage for Breast Milk Increase

NCT07077655 | Recruiting

• 1 other identifier: EgeUniAYalc001
• Study Type: interventional
• Target: 123
• Locations: 1 country
• Sites: 1

Brief 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.

Conditions

Healhty

Keywords

breastmilk; mother; massage techniques; marmet technique; oxytocin massage

Outcome Measures

Primary Outcomes (1)

• Breast milk volume

  It's the amount of milk measured before and after the procedures applied to the mother.

  up to 4 months

Secondary Outcomes (1)

• State Anxiety Scale Score

  up to 4 months

Study Arms (3)

ARM1 (Marmet)

ACTIVE COMPARATOR

One of the traditional and natural methods mothers can use to facilitate breast milk production after childbirth is the Marmet technique. Ensure hand hygiene and make sure the hands are warm. Ask the mother to remove her clothing/bra (assistance will be provided at this stage). Gently stroke the breast downward toward the nipple to trigger the let-down reflex. Starting from the armpit, move toward the breast, continuing the massage with circular finger movements around and toward the nipple. Ask the mother to lean forward slightly to allow gravity and gentle breast shaking to create mild vibrations and facilitate milk flow and drainage. After the procedure, assist the mother in adjusting her position assist the mother in adjusting her position and help her get dressed. Perform hand hygiene again. This procedure will be performed for 5 minutes on each breast, totaling 10 minutes, to ensure the technique is effective and standardized according to the literature.

Other: Marmet Technique

ARM2 (Oxct.)

ACTIVE COMPARATOR

Oxytocin massage is a technique applied to increase breast milk production. In this study, the following steps will be followed when performing oxytocin massage (Sari et al., 2017): Ensure hand hygiene and make sure the hands are warm. Ask the mother to remove her clothing/bra (assistance will be provided at this stage). Position the mother in a comfortable way (since all mothers in the oxytocin massage group will be within the first 2 hours post-cesarean, they will be positioned in bed, and if necessary, supported with pillows or rolled sheets). Using both thumbs facing forward, apply massage from the spine to the area beside the fifth and sixth ribs in a clockwise direction, first downward then upward. After the massage, gently wipe the mother's back with a paper towel (if she expresses discomfort). Assist the mother in adjusting her position and help her get dressed. Perform hand hygiene again. The massage will be applied for 3 minutes.

Other: Oxytocin Massage

ARM3 (Plasebo)

PLACEBO COMPARATOR

A light touch will be applied to the women's wrists, elbows, and shoulders.

Other: Plasebo

Interventions

Marmet Technique OTHER

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).

Also known as: MarTec

ARM1 (Marmet)

Oxytocin Massage OTHER

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).

Also known as: OxyMas

ARM2 (Oxct.)

Plasebo OTHER

No intervention will be made to the participants in this group. Superficial touch will be performed on women's wrists, elbows, and shoulders.

ARM3 (Plasebo)

Eligibility Criteria

• Age: 18 Years - 35 Years
• Gender Eligibility Details: Since only biological women produce breast milk, only women can participate in the study.
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• Ege University: lead

Study Sites (1)

Ege University Faculty of Medicine Hospital

Izmir, 35030, Turkey (Türkiye)

RECRUITING

Related Publications (5)

• Jutte J, Hohoff A, Sauerland C, Wiechmann D, Stamm T. In vivo assessment of number of milk duct orifices in lactating women and association with parameters in the mother and the infant. BMC Pregnancy Childbirth. 2014 Apr 2;14:124. doi: 10.1186/1471-2393-14-124.

  PMID: 24694236 BACKGROUND

• Dhanawat A, Behura SS, Panda SK. Manual Method vs Breast Pump for Breast Milk Expression in Mothers of Preterm Babies During First Postnatal Week: A Randomized Controlled Trial. Indian Pediatr. 2022 Aug 15;59(8):608-612. doi: 10.1007/s13312-022-2572-8.

  PMID: 35962654 BACKGROUND

• Zakarija-Grkovic I, Stewart F. Treatments for breast engorgement during lactation. Cochrane Database Syst Rev. 2020 Sep 18;9(9):CD006946. doi: 10.1002/14651858.CD006946.pub4.

  PMID: 32944940 BACKGROUND

• Triansyah A, Stang, Indar, Indarty A, Tahir M, Sabir M, Nur R, Basir-Cyio M, Mahfudz, Anshary A, Rusydi M. The effect of oxytocin massage and breast care on the increased production of breast milk of breastfeeding mothers in the working area of the public health center of Lawanga of Poso District. Gac Sanit. 2021;35 Suppl 2:S168-S170. doi: 10.1016/j.gaceta.2021.10.017.

  PMID: 34929803 BACKGROUND

• Alus Tokat M, Sercekus P, Yenal K, Okumus H. Early postpartum breast-feeding outcomes and breast-feeding self-efficacy in Turkish mothers undergoing vaginal birth or cesarean birth with different types of anesthesia. Int J Nurs Knowl. 2015 Apr;26(2):73-9. doi: 10.1111/2047-3095.12037. Epub 2014 Jun 5.

  PMID: 24897921 BACKGROUND

Study Officials

• Aysima YALÇINTEPE

  Ege University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Aysima YALÇINTEPE

CONTACT

+90 507 168 99 84; aysima.ylcntepe@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: The study will be conducted in a single-blind design, meaning participants will be blinded to the intervention they receive. They will not be told what procedure is being performed; only the researcher will know.
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Midwife and Master's Student

Model Details: In this study, there are three intervention groups. While two groups will receive an intervention, one group will serve as a placebo. The first group will be the Marmet technique group, the second group the oxytocin massage group, and the third group will be the placebo group. The study is designed as a randomized controlled single-blind study.

Study Record Dates

• First Submitted: July 3, 2025
• First Posted: July 22, 2025
• Study Start: August 25, 2025
• Primary Completion: December 30, 2025
• Study Completion: December 30, 2025
• Last Updated: September 22, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)