ASUHAN KEPERAWATAN PADA IBU POSTPARTUM DENGAN MASALAH KETIDAKEFEKTIFAN PEMBERIAN ASI MELALUI INTERVENSI PIJAT OKSITOSIN DI PUSKESMAS MELUR KOTA PEKANBARU

Abstrak

Ketidakefektifan pemberian ASI merupakan tantangan utama bagi ibu postpartum, khususnya primipara, yang sering kali dipicu oleh hambatan pengeluaran ASI akibat stres dan kelelahan. Kondisi ini menyebabkan let-down reflex tidak optimal sehingga ASI menjadi "macet". Pijat oksitosin merupakan intervensi non-farmakologis yang bertujuan menstimulasi hormon oksitosin untuk melancarkan pengeluaran ASI dan memberikan efek relaksasi. Mendeskripsikan asuhan keperawatan pada ibu postpartum dengan masalah ketidakefektifan pemberian ASI melalui penerapan intervensi berbasis bukti (Evidence Based Nursing) berupa pijat oksitosin. Penelitian ini menggunakan pendekatan studi kasus klinis pada Ny. H (G1P1A0) postpartum hari kedua di wilayah kerja Puskesmas Melur, Kota Pekanbaru. Intervensi dilakukan selama tiga hari berturut-turut dengan frekuensi dua kali sehari selama 3–5 menit. Instrumen evaluasi yang digunakan meliputi instrumen LATCH (Breastfeeding Assessment Tool), frekuensi pernapasan untuk mengukur relaksasi, serta indikator luaran Status Menyusui berdasarkan SLKI. Pengkajian awal menunjukkan skor LATCH 4 (kategori kurang), payudara bengkak, dan ASI hanya keluar beberapa tetes. Setelah diberikan intervensi pijat oksitosin dengan melibatkan peran suami, didapatkan hasil signifikan pada hari ketiga: skor LATCH meningkat menjadi 10 (kategori baik), frekuensi pernapasan ibu stabil (18x/menit), pancaran ASI lancar, dan bayi tidak lagi rewel dengan frekuensi miksi > 8 kali per 24 jam. Penerapan pijat oksitosin efektif dalam mengatasi masalah ketidakefektifan pemberian ASI dan menurunkan kecemasan ibu postpartum. Keterlibatan keluarga dalam teknik ini sangat mendukung keberhasilan laktasi secara mandiri di rumah.

Ineffective breastfeeding is a major challenge for postpartum mothers, especially primiparas, often triggered by inhibited milk ejection due to stress and fatigue. This condition leads to an suboptimal let-down reflex, causing breast milk to become "stagnant." Oxytocin massage is a non-pharmacological intervention aimed at stimulating the hormone oxytocin to facilitate milk ejection and provide a relaxation effect. To describe nursing care for postpartum mothers with ineffective breastfeeding problems through the application of Evidence-Based Nursing (EBN) in the form of oxytocin massage.This study used a clinical case study approach on Mrs. H (G1P1A0), a second-day postpartum mother in the working area of the Melur Health Center, Pekanbaru City. The intervention was carried out for three consecutive days with a frequency of twice a day for 3–5 minutes. Evaluation instruments included the LATCH (Breastfeeding Assessment Tool) instrument, respiratory rate to measure relaxation, and Status Breastfeeding outcome indicators based on the Indonesian Nursing Outcome Standard (SLKI). Initial assessment showed a LATCH score of 4 (poor category), swollen breasts, and milk only coming out in a few drops. After providing oxytocin massage intervention involving the husband's role, significant results were obtained on the third day: the LATCH score increased to 10 (good category), the mother's respiratory rate stabilized (18x/minute), breast milk flow was smooth, and the baby was no longer fussy with a micturition frequency of > 8 times per 24 hours.The application of oxytocin massage is effective in overcoming ineffective breastfeeding problems and reducing anxiety in postpartum mothers. Family involvement in this technique strongly supports the success of independent lactation at home.