How to cite:
Yulli Fety. (2022). The Effect of Giving Papaya & Honey (Carica
Papaya L and Apis) Juice on Increasing The Production of Breast Milk
Journal Eduvest. Vol 2(2): 270-279
E-ISSN:
2775-3727
Published by:
https://greenpublisher.id/
Eduvest – Journal of Universal Studies
Volume 2 Number 2, February 2022
p- ISSN 2775-3735 e-ISSN 2775-3727
THE EFFECT OF GIVING PAPAYA & HONEY
(Carica papaya L and
Apis)
JUICE ON INCREASING THE PRODUCTION OF BREAST
MILK
ARTICLE INFO ABSTRACT
Received:
January, 26
th
2022
Revised:
February, 17
th
2022
Approved:
February, 18
th
2022
Interviews conducted by researchers on midwives and 10
postpartum mothers at the Ranomeeto Health Center, the
midwife said that in January, February, March 2020 there
were 51 babies but only 15 babies were given exclusive
breastfeeding due to the lack of milk production in post
partum mothers in the Ranomeeto Health Center area so
that some mothers giving formula milk from the time of
the newborn with the reason that breast milk has not
come out after giving birth, this study aims to determine
the effect of giving papaya leaf juice and honey to
increase milk production in nursing mothers in the
working area of the Ranomeeto Health Center, South
Konawe Regency. This study uses quantitative (analytic)
research methods using a quasi-experimental design.
Quasi experimental. The total population of 51
respondents and the number of samples of 21
respondents. This sampling was taken using purposive
sampling technique. The results of statistical tests using
Shapiro Wilk's statistics show the P Value is 0.000 so it can
be concluded that there is an effect of giving papaya leaf
juice and honey on increasing breast milk production for
breastfeeding mothers in the Ranomeeto Health Center
area, South Konawe Regency. So it is suggested to the
Puskesmas to provide recommendations to mothers who
are about to give birth and breastfeeding to use papaya
leaf juice and honey to support smooth breastfeeding. For
breastfeeding mothers, use papaya leaf juice to support
Yulli Fety
The Effect of Giving Papaya & Honey (Carica Papaya L And Apis) Juice on Increasing
The Production of Breast Milk 271
smooth breastfeeding.
KEYWORDS
Breast Milk Production, Papaya Leaf Juice, Ranomeeto Health
Center
This work is licensed under a Creative Commons
Attribution-ShareAlike 4.0 International
INTRODUCTION
Substandard milk production due to lack of nutritious food intake, lack of
knowledge, family economy, and mother's psychology when giving breast milk to her
baby, exclusive breastfeeding has a major impact on reducing infant mortality.
Breastfeeding after the baby is born until the baby is 2 years old is really is the foundation
of the formation of quality human resources (Wiknjosastro, 2010).
Infant mortality, as a result of not giving exclusive breastfeeding can cause
diarrhea as much as 67%, ARI as much as 39%, and the risk of obesity as much as 42%
(Kemenkes RI, 2015). This is in line with the research conducted by Lilin Turlina (2015)
on the effect of giving papaya leaf powder on the smoothness of breast milk in
postpartum mothers at BPM Mrs. Hanik Dasiyem, Amd. Kebdi Kedungpring, Lamongan
Regency that babies who were exclusively breastfed for 6 months experienced fewer
morbidity due to infection, develop optimally and do not get sick easily, compared to
infants who are not breastfed. With the results of his research, there was a significant
effect in giving papaya leaf drink to the smoothness of breast milk in postpartum mothers
with a value of p = 0.004 (p <0.05). Seeing the results of this study, it is recommended for
postpartum mothers to often consume papaya leaf drinks to help facilitate the release of
breast milk in the mother.
The Sustainable Development Goals in The 2030 Agenda for Sustainable
Development target by 2030 to reduce the neonatal mortality rate by at least 12 per 1,000
live births and death in children under the age of 5 years by at least 25 per 1,000 live
births. One of the ways to achieve this is by properly implementing exclusive
breastfeeding (United Nations). However, only 44 percent of newborns in the world are
breastfed within the first hour of birth, and even a few babies under the age of six months
are exclusively breastfed (WHO, 2014).
Various efforts have been made to support exclusive breastfeeding in Indonesia.
Exclusive breastfeeding is one of the indicators of household Clean and Healthy Behavior
(PHBS). Efforts have been made such as the Community Cares for Breastfeeding
Movement, the Policy to Increase the Use of Mother's Milk (PP-ASI) and the National
Movement to Increase the Use of Mother's Milk (GNPP-ASI). However, the program did
not run as expected because the coverage of exclusive breastfeeding in Indonesia was still
low (Nurlinawati et al 2016).
Breastfeeding puts a metabolic burden on the physiological processes of the
mother's body, requiring a minimum of 480 kcal per day for daily milk production to be
able to carry out the exclusive breastfeeding process. Therefore, mothers need additional
nutrition to increase milk production in order to carry out their role properly when
breastfeeding. Other previous efforts to increase breast milk production, namely research
with intervention methods conducted by Dharmawati et al (2008), showed that an early
increase in milk production was carried out through a combination of areola massage with
rolling massage for mothers at the Pamulang and Cikupa Health Centers, Banten.
However, this study has not looked at the effectiveness of the intervention on the smooth
Eduvest – Journal of Universal Studies
Volume 2 Number 2, February 2022
272 http://eduvest.greenvest.co.id
production of breast milk. While research conducted by Nurlinawati et al (2016) The
breastfeeding process can also be assisted by consuming galaktogogue, examples of
galactogogue that have been researched and succeeded in increasing breast milk
production are katuk leaves, green bean and fennel juice, papaya fruit boiled water and
papaya leaf powder.
Papaya leaf is a plant that contains vitamins needed for baby growth and maternal
health, so it can be a very potential source of nutrition. The content of high protein, high
fat, vitamins, calcium (Ca), and iron (Fe) in papaya leaves functions to increase the
formation of hemoglobin in the blood, it is hoped that oxygen in the blood will increase,
metabolism will also increase so that brain cells function properly. In addition, papaya
leaves also contain papain and potassium enzymes, the function of which enzymes are to
break down the protein eaten while potassium is useful to meet the needs of potassium
during lactation. Because if there is a lack of potassium, the body will feel tired, and a
lack of potassium also causes mood swings to become depressed, while breastfeeding
mothers must think positively and be happy (Turlina, 2015). This is in line with Hesty's
(2016) research that papaya leaves are an ingredient raw materials that contain high
protein and calories so that it affects the volume of breast milk produced to produce
breast milk in sufficient quantities. With the results of his research there was an effect of
papaya leaf extract on the adequacy of breast milk (p = 0.038, = 0.05).
Interviews conducted by midwife researchers and 10 postpartum mothers at the
Ranomeeto Health Center, the midwife said that in January, February, March 2020 there
were 51 babies but only 15 babies were given exclusive breastfeeding due to the lack of
milk production in post partum mothers in The area of the Ranomeeto Health Center so
that some mothers give formula milk from the time of the newborn with the reason that
there is not much milk production after giving birth, and 3 post partum mothers said that
they gave breast milk and additional foods such as bananas and water, 5 mothers said
they had insufficient breast milk. a lot, 2 mothers give breast milk, porridge and formula
milk to their babies on the grounds that their babies are fussy because it is not enough to
drink only breast milk. and obesity.
Based on the background and the initial survey conducted by the researcher, the
researcher is interested in the use of papaya leaves and honey to overcome the lack of
breast milk production which can be done in simple ways such as trying traditional
ingredients. One of the plants that can increase breast milk production is honey papaya
leaves. Through several studies, it is indeed useful to increase breast milk production.
This study aims to determine the effect of giving papaya juice & honey (Carica
Papaya L and Apis) to increasing breast milk production of nursing mothers before and
after being given papaya leaf juice.
RESEARCH METHOD
This study uses quantitative (analytic) research methods using a quasi-experimental
design. Quasy experimental aims to investigate the possibility of a causal relationship by
conducting treatment or intervention to one or more experimental groups, then the results
of the intervention are compared with the group that is not subject to treatment (Control)
(Notoatmodjo 2015). The approach of this research is to use a one group pretest-posttest
approach, which is to compare the conditions before being given treatment and after
being given treatment.
The place and time of this research was carried out in the area of the Ranomeeto
Health Center in August 2020. This research was carried out on breastfeeding mothers in
Yulli Fety
The Effect of Giving Papaya & Honey (Carica Papaya L And Apis) Juice on Increasing
The Production of Breast Milk 273
the working area of the Ranomeeto Health Center. The population in this study were all
breastfeeding mothers aged 0-6 months who were at the Ranomeeto Public Health Center,
which amounted to 51 people.
RESULT AND DISCUSSION
A. Research Place Profile
The Ranomeeto Health Center is located on Jalan Poros Haluoleo Airport,
Ranomeeto District, Konawe Selatan Regency with the working area bordering:
1. To the north, it is bordered by Baruga District
2. To the south, it is bordered by Landono District,
3. In the west, it is bordered by Lameuru District
4. In the east it is bordered by Konda District
The Ranomeeto Health Center has 12 Villages/Kelurahan working areas
including:
Table 3. The working area of the Ranomeeto Public Health Center, South
Konawe Regency
No
Village
Total population
1
Langgea
2.539
2
Kota Bangun
2.325
3
Kel. Ranomeeto
2.598
4
Laikaaha
1.310
5
Ranooha
1.178
6
Onewila
1.418
7
Ambaipua
2.385
8
Amoito
1.142
9
Amoito Siama
855
10
Rambu-Rambu Jaya
1.754
11
Duduria
621
12
Boro-Boro R
840
Total
18.965
B. Research Result
1. Characteristics of respondents
a. Education
The results of the research on the characteristics of respondents based on
education can be seen in the following table:
Table 4. Distribution of Respondents by Education Level
No
Respondent's Education
Total
n
%
1
2
3
College
Senior High School
Primary school
11
4
6
52,3
19,0
28,7
Total
21
100
Source: Primary Data 2020
Based on table 4, it can be seen that of the 21 respondents, the education category
of PT was 11 people (52.3%), SMA was 4 people (19%) and elementary school was 6
people (28.7%).
Eduvest – Journal of Universal Studies
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274 http://eduvest.greenvest.co.id
b. Age group
The results of the research on the characteristics of respondents based on age
groups can be seen in the following table:
Table 5. Distribution of Respondents by Age Group
No
Age group
Total
n
%
1
2
30 – 35 Year
> 35 Year
13
8
61,9
38,1
Total
21
100
Source: Primary Data 2020
Based on table 5, it can be seen that of the 21 respondents the most age group is
30-35 years as many as 13 people (61.9%) and the lowest is > 35 years with 8 people
(38.1%).
c. parity
The results of the research on the characteristics of respondents based on parity
groups can be seen in the following table:
Table 6. Distribution of Respondents by Parity
No
Parity
Total
n
%
1
2
Primipara
Multipara
9
12
42,9
57,1
Total
21
100
Source: Primary Data 2020
Based on table 6, it can be seen that of the 21 respondents in the parity group the
most were multiparas as many as 12 people (42.9%) and the lowest were primiparas with
9 people (57.1%).
2. Univariate Analysis
a. Breast milk production in breastfeeding mothers in the working area of the Ranomeeto
Health Center before being given treatment
Table 7. Distribution of breast milk production in breastfeeding mothers in the
working area of the Ranomeeto Health Center before being given treatment
No
Breast milk production
Pre test Measurement
n
%
1
2
Increase
Not increasing
4
17
19
81
Total
21
100
Source: Primary Data 2020
Based on table 7 above, it can be seen that before giving the treatment, the
respondent's milk production was in the sufficient category as many as 4 people (19%)
and the less category as many as 17 people (81%).
b. Breast milk production in breastfeeding mothers in the working area of the Ranomeeto
Health Center after being given treatment
Table 8. Distribution of breast milk production in breastfeeding mothers in the working
area of the Ranomeeto Health Center after being given treatment
Yulli Fety
The Effect of Giving Papaya & Honey (Carica Papaya L And Apis) Juice on Increasing
The Production of Breast Milk 275
No
Breast milk production
Pre test Measurement
n
%
1
2
Increase
Not increasing
18
3
85,7
14,3
Total
22
100
Source: Primary Data 2020
Based on table 8 above, it can be seen that after giving the treatment, the
respondent's milk production was in the sufficient category to 18 people (85.7%) and the
less category as many as 3 people (14.3%).
3. Bivariate Analysis
a. Normality test
Table 9 Distribution of Data Normality Test Results
No
Breast milk production for breastfeeding mothers
P value
Α
1
Pre Test
0,85
0,05
2
Post Test
0,112
0,05
Source: Primary Data 2020
Based on table 9 above, it shows that the results of the normality test using the
Shapiro Wilk test because the number of samples is less than 50 and using 2 groups
(Arikunto, 2010) shows that the p value (0.85) > (0.05), meaning that the data normally
distributed; and after being given treatment, it shows that the p value (0.112) > (0.05),
meaning that the data is normally distributed.
b. Differences in breast milk production in breastfeeding mothers in the working area of
the Ranomeeto Health Center before and after being given treatment
Based on the measurement results of breast milk production before and after
treatment, the following results were obtained:
Table 10. Mean measurement results of breast milk production
Measurement
Pre test
Pos test
Different
P Value
Mean
Mean
Breast milk
production
1,19
1,86
0,67
0,000
Source: Primary Data 2020
Based on table 10, it can be seen that the difference in the mean value of the milk
production category between the pre-test value of 1.19 and the post-test value of 1.86
with a large difference of 0.67.
The results of statistical tests show that the P Value is 0.000 so it can be
concluded that there is an effect of giving papaya leaf juice on increasing breast milk
production for nursing mothers at the Ranomeeto Health Center, South Konawe Regency.
A. Discussion
1. Production of breast milk before being given treatment in the Work Area of the
Ranomeeto Health Center, Konawe Selatan Regency
Before giving the treatment, the respondent's milk production was in the
sufficient category as many as 4 people (19%) and the less category as many as 17 people
(81%). This shows that there has been a very significant change, especially the number of
mothers whose breast milk production category is sufficient to 18 respondents.
Eduvest – Journal of Universal Studies
Volume 2 Number 2, February 2022
276 http://eduvest.greenvest.co.id
While 3 respondents remained in the less category this was due to the physical
condition of the mother's breasts such as nipples that did not come out. It was obtained
information that during pregnancy the mother did not do breast care, especially for
mothers with first-time pregnancies. However, the change in symptoms felt by the mother
was slightly reduced compared to before being given treatment, including breast milk but
not sufficient for the baby's needs.
Breast milk production can be influenced by many factors. The main factors that
can influence are hormonal factors, namely prolactin and oxytocin hormones. Babies who
suck the mother's breast will stimulate neurohormonal in the mother's nipple and areola.
The stimulation will be transmitted to the pituitary via the vagus nerve and continued to
the anterior lobe. The prolactin hormone will be released when the stimulus reaches the
anterior lobe, enters the blood circulation and reaches the milk-making gland which will
then stimulate the gland to produce milk.
The hormone oxytocin stimulates milk production. Babies have a reflex turning
their head towards the mother's breast when brought close to the mother's breast, which is
called the rooting reflex (turning reflex), this causes stimulation of the release of the
hormone oxytocin.
Papaya leaf is a type of plant that contains laktagogums which have the potential
to stimulate the hormones oxytocin and prolactin such as alkaloids, polyphenols,
flavonoid steroids and other substances that are most effective in increasing and
facilitating breast milk production. Hormonal prolactin reflex to produce breast milk,
when the baby sucks the mother's nipple, neurohormonal stimulation occurs on the
mother's nipple and areola. This stimulation is transmitted to the pituitary via the vagus
nerve, then to the anterior lobe. From this lobe will release the hormone prolactin, into the
blood circulation and up to Pol. Pepper glands that make breast milk. This gland will
stimulate to produce breast milk (Istiqomah, et al 2014).
The hormones prolactin and oxytocin play a role in increasing milk production.
Prolactin plays a role in the synthesis of milk, while the activity of oxytocin in the
mammary glands causes contraction of myoepithelial cells, so that milk will be pushed
into the milk ducts.
Giving papaya leaf juice which contains alkaloids, saponins can increase
prolactin levels. This is because the juice works as a dopamine antagonist. Increased
prolactin levels can play a role in stimulating lactation.
2. Respondents' milk production after being given treatment in the working area of the
Ranomeeto Health Center, Konawe Selatan Regency
After giving the treatment, the respondent's milk production was in the sufficient
category to 18 people (85.7%) and the less category as many as 3 people (14.3%). The
increase in breast milk production is influenced by the presence of polyphenols and
steroids that affect the prolactin reflex to stimulate the alveoli which work actively in the
formation of breast milk. The increase in breast milk production is also stimulated by the
hormone oxytocin, the increase in the hormone oxytocin is influenced by the polyphenols
present in young papaya leaves which will make breast milk flow more profusely
compared to before consuming papaya leaf juice.
Oxytocin is a hormone that plays a role in encouraging the secretion of milk
(milk let down). The role of oxytocin in the mammary glands is to encourage the
contraction of the myopic cells that surround the alveolus to be pushed out into the milk
ducts, so that the alveolus becomes empty and spurs the next milk synthesis (Istiqomah,
et al 2014).
The increase in breast milk production is influenced by the presence of
polyphenols and steroids that affect the prolactin reflex to stimulate the alveoli which
Yulli Fety
The Effect of Giving Papaya & Honey (Carica Papaya L And Apis) Juice on Increasing
The Production of Breast Milk 277
work actively in the formation of breast milk and polyphenols also affect the oxytocin
hormone which will make breast milk flow more profusely compared to before
consuming papaya leaf juice (Istiqomah, et al, 2014). Other content contained in papaya
leaf juice, such as starch (43.28%), sugar (15.15%), protein (13.63%), fat (1.29%)
moisture (10.65%), fiber (1.88%) (Kharisma, 2017).
The mammary gland consists of many lobes, each lobe is divided into lobules,
and each lobule consists of alveoli. The contraction of myoepithelial cells causes the
synthesis of milk in the alveoli to be squeezed into the lactiferous ducts and then collects
in the ampulla. During lactation, the lumen of the alveoli is filled with secretions, so that
the lumen of the alveoli will appear stretched as breastfeeding increases.
Alveolar glands are composed of s cells Epithelial cells are highly proliferative,
their activity increases during the lactation period. This will be followed by an increase in
the proliferation of epithelial cells forming the alveoli. The production and expenditure of
milk involves prolactin and oxytocin which will stimulate the formation of more and
more new alveoli. At the beginning of lactation, the process of formation of new alveoli is
still found which is stimulated by good sucking of milk and increased levels of the
hormone prolactin. Oxytocin can also have a similar effect by accelerating the emptying
of the alveolar lumen through myoepithelial contraction and increasing the rate of protein
secretion in the secretory cells lining the walls of the alveoli.
The mechanism of action of laktagogums in helping to increase the rate of
secretion and production of breast milk is by directly stimulating protoplasmic activity in
the secretory cells of the mammary glands and secretory nerve endings in the mammary
glands which results in increased milk secretion, or by stimulating the hormone prolactin
which is a lactagonic hormone to the mammary glands in the breast. alveolar epithelial
cells that stimulate lactation.
Papaya as a plant that contains Lactogogum is a tropical fruit known as
Caricapapaya. Lactagogum is a drug that can increase or facilitate the release of milk
(Istiqomah, Wulandari, Azizah, 2015). Papaya leaf juice is also a plant that contains
enzymes, vitamins C, A, B and E, and minerals. As well as the chemical content of young
papaya fruit contains polyphenols, and steroids.
This study is in line with research by Istiqomah, et al. in 2014 about the effect of
young papaya on the smooth production of breast milk in nursing mothers. Proving that
from the results of 20 respondents who were given unripe papaya fruit experienced an
increase in breast milk production seen from the frequency of breastfeeding babies.
This study is in line with the research on the Effects of Young Papaya Fruit
Extract (Carica Pepeaya L) on Histological Description of the Lactational Mammary
Kenjer In 2011 the results showed that the average lactating mammary gland diameter of
mice in the young papaya extract group was larger than that of the lactating group.
negative control.
This research is supported by research by Istiqomah, et al (2014) about the effect
of giving young papaya fruit to the smooth production of breast milk in breastfeeding
mothers, namely the Paired T-Test test, the value of p = 0.0005 (p <0.05) means that there
is an effect of giving papaya fruit Young papaya fruit extract on the smooth production of
breast milk and in the study of the effect of the aqueous extract of young papaya (Carica
Papaya L) on the histological description of the mammary glands of lactating mice in
2011 the results showed that the diameter of the lactating mammary glands on average
was greater in the water extract group of young papaya fruit. compared to the negative
control group.
Eduvest – Journal of Universal Studies
Volume 2 Number 2, February 2022
278 http://eduvest.greenvest.co.id
CONCLUSION
The conclusion of this study is that there is an effect of giving honey papaya leaf
juice on increasing breast milk production for breastfeeding mothers in the Ranomeeto
Health Center area, South Konawe Regency.
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