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This study aimed to examine the relationship between maternal anxiety levels and the timing of Early Initiation of Breastfeeding (EIBF) among primiparous mothers. EIBF, also known as Inisiasi Menyusu Dini (IMD), is a vital procedure that supports the establishment of effective breastfeeding and is recommended globally. Nevertheless, various maternal factors, particularly psychological conditions, may influence the implementation of EIBF. The main objective of this research was to determine whether increased anxiety during the peripartum period is associated with delays in initiating breastfeeding. A correlational analytic design with a cross-sectional approach was utilized in this investigation. The study population consisted of 77 eligible participants, while the final sample included 69 primiparous mothers who met the inclusion and exclusion criteria. Participants were chosen through purposive sampling. The independent variable was the maternal anxiety level, and the dependent variable was the timing of EIBF implementation. Data were gathered using a structured self-administered questionnaire designed to measure both variables. Statistical analysis was conducted using the Mann-Whitney U test. The findings demonstrated a p-value of 0.0389, which was below the significance threshold of 0.05 (p < 0.05), indicating the rejection of the null hypothesis. Therefore, the results revealed a significant relationship between anxiety levels and the timing of EIBF among primiparous mothers. Elevated anxiety was identified as a factor contributing to delayed initiation of breastfeeding. These findings highlight the importance of regular psychological screening and effective anxiety management for first-time mothers during childbirth to facilitate optimal postnatal care, particularly the timely initiation of EIBF.

This study examines postpartum nursing care for mothers undergoing Sectio Caesarea (SC) with the primary nursing diagnosis of ineffective breastfeeding. The purpose is to evaluate the effectiveness of oxytocin massage intervention in improving breastfeeding outcomes in post-SC mothers. The study was conducted in Mawar Ward, RSUD dr. H. Soewondo Kendal, involving four patients experiencing delayed lactation, difficulty in baby latching, and psychological challenges such as anxiety and lack of confidence. The intervention was based on the Indonesian Nursing Intervention Standards (SIKI), focusing on observation, therapeutic actions, education, and collaboration with healthcare teams and family members. Oxytocin massage was performed 2–3 times daily, complemented by warm compresses, breastfeeding position training, and emotional support. The results indicated significant improvements: increased breast milk production, better baby latching, reduced maternal anxiety, and higher self-confidence in breastfeeding. This evidence-based approach highlights that comprehensive postpartum nursing care—integrating physical, psychological, and family support—plays a crucial role in ensuring breastfeeding success and overall maternal recovery after SC.

Maternal knowledge of newborn care plays an important role in maintaining neonatal health and preventing early complications. Parity is considered one of the factors that affect the mother's level of knowledge, as previous childbirth experiences can improve the understanding and skills of caring for the baby. However, primipara mothers often face challenges due to limited experience. This study aims to analyze the relationship between parity and newborn care knowledge in primipara mothers at the Tumpunglaung Health Center. The research method uses an analytical quantitative design with a cross-cutting approach. The study population was mothers who had just given birth at the Tumpunglaung Health Center, with a sample of 30 primipara mothers selected through purposive sampling. Data were collected using a structured questionnaire that included maternal characteristics and newborn care knowledge, including breastfeeding, hygiene, thermoregulation, and red flags. Data analysis was carried out by Chi-square test using SPSS at a significance level of p < 0.05. The results showed that most primitive mothers had moderate to low levels of knowledge, with a significant relationship between parity and newborn care knowledge. The conclusion of the study confirms the importance of strengthening education and counseling for primitive mothers to improve infant care practices and support neonatal health.

Background: Colostrum is the first natural food for newborns, containing essential nutrients and antibodies that protect against infection. Health education for pregnant women in their third trimester is crucial to enhance their knowledge and practices regarding colostrum provision. Despite the global decline in neonatal mortality, the rate remains high, partly due to limited access and low quality of neonatal care. In Indonesia, particularly in Semarang, although exclusive breastfeeding coverage has improved, many mothers still lack understanding of colostrum’s importance and remain influenced by misconceptions. Preliminary studies revealed insufficient knowledge among pregnant women about colostrum. Method: This study applied a quasi-experimental method with a pretest-posttest design and a control group. The intervention group received health education, while the control group did not. Results: Before intervention, most respondents in both groups had poor knowledge. After the intervention, knowledge in the intervention group increased significantly, with 88.8% reaching a good category, while the control group showed no significant change. Furthermore, 94.4% of mothers in the intervention group gave colostrum, compared with only 33.3% in the control group. Conclusion: Health education is an effective strategy to increase maternal knowledge and encourage colostrum practice, dispelling myths and promoting better neonatal outcomes.

Post-Cesarean Section (C-Section) patients commonly experience pain caused by surgical incisions in the abdominal area. Unmanaged pain may hinder mobility, interfere with breastfeeding, reduce comfort, and negatively affect maternal psychological well-being. Non-pharmacological pain management is considered an alternative to reduce dependence on analgesics. Foot massage has been proven to improve blood circulation, stimulate endorphin release, and reduce pain intensity, while Qur’anic recitation therapy (murottal) provides psychological and spiritual relaxation that helps decrease pain perception. This study aims to examine the effect of combining foot massage and murottal therapy on pain levels in post-C-section patients at Wijaya Kusuma ward, Limpung General Hospital. The benefit of this study is expected to provide a reference for nursing practice, particularly in implementing holistic non-pharmacological interventions to enhance patient comfort. This research employed a case study design with a nursing care approach involving four post-C-section patients. Interventions included a scheduled combination of foot massage and murottal therapy. Pain levels were measured using the Numeric Rating Scale (NRS). Data were analyzed descriptively by comparing pain levels before and after intervention. The results showed a reduction in pain intensity from moderate to mild after the combination intervention. Patients also reported increased comfort, improved rest, and reduced anxiety. In conclusion, the combination of foot massage and murottal therapy effectively reduces pain in post-C-section patients. This intervention can be recommended as a non-pharmacological method in nursing care for post-C-section patients.

Mammary tumor is a condition where an abnormal mass or lump forms in the breast, caused by excessive and continuous cell reproduction. This condition often develops unnoticed and can be dangerous if not promptly treated. In 2018, the incidence rate of breast cancer in Indonesia was 136.2 per 100,000 people, making it one of the most common cancers in Southeast Asia, ranking 8th in the region. If untreated, mammary tumors have the potential to spread to other parts of the body, and in many cases, can be fatal for the patient. One of the common medical treatments for mammary tumors is surgery. This surgery aims to remove the tumor and prevent further spread. In this context, the role of nurses is critical, as according to Orem's theory, nurses have the responsibility to help improve the health status of patients, especially in situations where patients are unable to perform self-care. In such cases, nursing assistance is necessary to ensure that the patient can undergo proper post-operative care. This study aims to provide an overview of nursing care for patients with post-operative right mammary tumor in the Mawar 2 room at RSUD dr. Soeselo, Tegal Regency. The nursing care provided includes several important steps: patient assessment, nursing diagnosis, planning, implementation of care, and evaluation of the care outcomes. This research uses a descriptive case study design, offering an in-depth view of the nursing approach applied to patients after mammary tumor surgery. With this approach, the study aims to provide clearer insights into the role of nurses in supporting patient recovery and improving the quality of care in hospitals.

Post-operative care is a critical phase in the recovery process, beginning immediately after the completion of surgery until the patient is stabilized and transferred to the inpatient ward. Among various surgical procedures, lumpectomy is a common intervention performed to manage mammary tumors, aiming to preserve breast tissue while removing the tumor (Arif et al., 2021). This paper presents a case study of Mrs. D, a patient with an endocrine disorder who underwent a right breast lumpectomy at Mawar 2 Ward, Dr. Soeselo Regional General Hospital, Tegal Regency. The study employed a descriptive method to explore the patient’s condition and nursing interventions. Upon assessment, the main complaint reported by the patient was pain localized in the post-operative area. Based on the findings, two primary nursing diagnoses were established: acute pain related to surgical trauma and knowledge deficit related to post-operative care and self-management. Nursing interventions were designed and implemented according to the Indonesian Nursing Diagnosis Standard (SDKI), the Indonesian Nursing Outcomes Standard (SLKI), and the Indonesian Nursing Interventions Standard (SIKI). Interventions included pain management strategies, such as pharmacological support and non-pharmacological relaxation techniques, as well as health education to improve patient knowledge and self-care ability. The case highlights the importance of comprehensive nursing care that addresses both physical discomfort and the patient’s understanding of recovery, thereby promoting optimal health outcomes after breast surgery.

Breast tumors are masses or lumps in the breast. Treating breast tumors requires several treatment methods, such as surgery. One of the impacts that arise after surgery is infection. One effort to prevent infection during hospitalization and after the patient returns home from the hospital is by providing sterile kit care education to increase independence in preventing infection in post-operative wounds. The purpose of this study was to determine of the effectiveness of "Sterile Kit Care" education on the level of patient independence in preventing infection in post-operative wounds of breast tumors at Harapan Anda Islamic Hospital, Tegal. The research design used in this study was a quasi-experimental with a pretest and posttest design with a control group. The sample of this study was 70 respondents using a purposive sampling technique. Data analysis techniques used the Wilcoxon test and the Mann-Whitney test. Before the intervention, the intervention and control groups had a sufficient level of independence. After the intervention, the intervention group had a sufficient level of independence, while the control group had a sufficient level of independence. There was a difference in the level of patient independence in preventing infection in post-operative wounds of breast tumors after being given sterile kit care education between the intervention group and the control group p value (0.000). Sterile kit care education was effective in increasing the level of patient independence in preventing infection in post-operative wounds of breast tumors at Harapan Anda Islamic Hospital, Tegal (0.018). It is hoped that sterile kit care education can be a routine activity for all mothers with a history of breast tumors by providing an explanation of good and correct wound care regarding the prevention of post-operative wound infections of breast tumors.

The family has an important role in the treatment process of cancer patients, especially in providing motivation during treatment. Social support from families has a great influence on the psychological condition of breast cancer patients undergoing chemotherapy. As the health workers who interact most intensely with patients, nurses play a role in empowering families through education and counseling to improve the quality of support provided. This study aims to analyze the relationship between social support and motivation to recover in breast cancer patients at RSI Sultan Agung Semarang. The study used a correlational descriptive design with a cross-sectional approach. The sample consisted of 77 respondents who were selected using purposive sampling techniques based on certain inclusion criteria. Data collection was carried out through a structured questionnaire, and statistical analysis was carried out using the Pearson correlation test. The results showed a significant relationship between social support and motivation to recover, with a correlation value of 0.478 and a p-value of 0.000 (p < 0.05). These findings suggest that the higher the level of social support patients receive, the greater their motivation to recover. The conclusion of this study is that social support has a positive contribution to increasing the healing motivation of breast cancer patients. Therefore, nursing interventions that actively involve families need to be improved as part of a holistic approach to the care of cancer patients.

Breast milk (ASI) is the primary and natural food for newborns, providing the necessary energy and nutrients from birth to six months of life, promoting optimal growth and development. However, according to information obtained, about 30% of mothers face challenges in breastfeeding, particularly during the first few days after delivery. To address this issue, interventions such as breast care and oxytocin massage can stimulate breast milk production and prevent issues like mastitis. Oxytocin massage helps stimulate the milk ejection reflex, while breast care ensures the cleanliness of the breasts, making it easier for the baby to latch. The aim of this community service activity is to enhance mothers' knowledge through an educational program focused on oxytocin massage and breast care to improve milk production in postpartum mothers. The method used for this activity is an interactive educational session using tools like PowerPoint and leaflets, followed by a Q&A session and discussion. The evaluation was conducted through oral questioning, as well as by observing participants' enthusiasm during the session. The expected outcome of this activity is to provide mothers with practical knowledge and skills on breast care and stimulating breast milk production, ultimately supporting successful exclusive breastfeeding.

Anxiety is an emotional condition that causes feelings of discomfort, helplessness, and uncertainty, often without a clear reason. Among breast cancer (carcinoma mammae) patients, anxiety commonly arises due to treatment processes, physical changes, and uncertainty regarding recovery. Spirituality, which involves belief in God Almighty and connection with transcendental aspects, is believed to help individuals cope with uncertain and challenging situations, including serious illness. This study aimed to determine the relationship between spiritual level and anxiety level among breast cancer patients in Semarang. The research used a quantitative correlational design with a sample of 110 respondents selected through purposive sampling based on inclusion criteria. The instruments employed were the Depression Anxiety Stress Scale (DASS-42) to assess anxiety levels and the Daily Spiritual Experience Scale (DSES) to measure spirituality. Data were analyzed using the Chi-Square test to examine the relationship between variables. The results showed a p-value of 0.000 (p < 0.05), indicating a significant relationship between spirituality level and anxiety level in breast cancer patients. The findings suggest that higher levels of spirituality are associated with lower anxiety levels. Therefore, interventions that support and strengthen spiritual aspects may be effective in reducing anxiety among breast cancer patients. This study recommends that healthcare professionals incorporate spiritual approaches as part of holistic care to improve psychological well-being in patients undergoing cancer treatment.

Breech presentation is a condition in which the fetus is in an elongated position with the head at the uterine fundus and the buttocks in the lower part of the uterine cavity. This condition can increase the risk of labor complications, especially if accompanied by serotinus (post-term pregnancy). Based on data from the Indonesian Ministry of Health (2021), the maternal mortality rate caused by breech presentation and serotinus in Indonesia was recorded at 1,309 cases. In Central Java, the incidence of breech presentation reached 11.5% (Central Java Health Office, 2021). This study aims to determine the implementation of comprehensive midwifery care for Mrs. D, aged 24 years, with breech presentation and serotinus at Mrs. S's PMB in the Kaliwadas Community Health Center area in 2023. The research method used a qualitative descriptive design with a case study approach. Data collection was carried out through interviews, observations, physical examinations, documentation studies, and medical record searches. The results of midwifery care showed that during pregnancy, Mrs. D had a good quality of life. Mrs. D underwent three antenatal care (ANC) visits, during which signs of pregnancy complications suggestive of serotinus were detected. Delivery was performed via cesarean section due to serotinus and breech presentation. During the neonatal period, three visits were conducted, with the baby's examination results within normal limits. During the postpartum period, four visits were conducted, during which the mother's condition was generally good, but at the third postpartum visit, problems with breastfeeding were discovered. Mrs. D was also known not to be using postpartum contraception. The results of this study emphasize the importance of early detection and appropriate management of breech presentation and serotinus pregnancies to prevent complications that endanger the mother and baby. Comprehensive midwifery care covering pregnancy, labor, postpartum, and newborn care is an integral effort to ensure the safety of mothers and babies.  

The Caesarean Section (C-Section) procedure is one of the most common surgical methods for childbirth, performed through an incision in the abdominal wall (laparotomy) and the uterine wall (hysterotomy). Despite its effectiveness in ensuring maternal and fetal safety, one of the major postoperative complaints reported by patients is pain. Pain itself is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, which is subjective and can only be described by the person experiencing it. Unmanaged pain may negatively affect postoperative recovery, emotional well-being, mobility, and breastfeeding initiation. Therefore, appropriate nursing care interventions are essential to help patients achieve comfort and recovery. This scientific paper explores the implementation of sacral plexus therapy as part of nursing interventions to address pain problems in post-C-section patients. The study employed a case study approach that applied the nursing care process, which includes comprehensive assessment, formulation of nursing diagnoses, planning, implementation of interventions, and evaluation. Nursing care was carried out over a period of 72 hours (3x24 hours), with pain intensity and patient comfort levels monitored throughout the process. The evaluation results showed that all nursing diagnoses related to pain were successfully resolved within the given timeframe. Specifically, the application of sacral plexus therapy proved effective in reducing the intensity of postoperative pain and improving overall comfort, enabling patients to gradually regain mobility and adapt to their postpartum condition. In conclusion, sacral plexus therapy can serve as a complementary and non-pharmacological intervention within nursing care to effectively manage pain in post-C-section patients. These findings highlight the importance of innovative and holistic approaches in nursing practice to improve patient recovery and quality of care after surgical childbirth.

Breast milk production in the early postpartum period is a crucial factor for successful breastfeeding, particularly among primiparous mothers who often experience lactation difficulties during days 3–7 after childbirth. Non-pharmacological interventions such as oxytocin massage and breast care are considered effective approaches to support milk production by enhancing hormonal release and breast stimulation.This study employed a quantitative quasi-experimental design with a one-group pretest–posttest approach. The study was conducted at the Sahu Public Health Center, West Halmahera, involving 20 primiparous breastfeeding mothers on days 3–7 postpartum selected through purposive sampling. Oxytocin massage and breast care were administered according to standardized procedures. Breast milk production was assessed before and after the intervention using observational indicators of milk flow. Data were analyzed using the Wilcoxon Signed Rank Test. The results showed a significant improvement in breast milk production after the intervention. The mean breast milk production score decreased from 1.95 before the intervention to 1.15 after the intervention, indicating smoother milk flow. Statistical analysis revealed a significant difference in breast milk production before and after oxytocin massage and breast care (Z = −3.358; p = 0.001). Oxytocin massage combined with breast care significantly improves breast milk production among primiparous breastfeeding mothers during days 3–7 postpartum. These non-pharmacological interventions are safe, practical, and effective, and are recommended to be integrated into routine postpartum care to support early lactation success.

Giving breast milk (ASI) exclusively during the first six months of a baby's life is very important in supporting the baby's growth and development and body resilience. However, the practice of giving formula milk is still quite high and is a challenge in fulfilling exclusive breastfeeding. This study aims to determine the determining factors for giving formula milk to babies aged 0-6 months in the work environment UPT Primary Health Care Pujon. This research design uses a descriptive analytical approach with a cross-sectional method to identify factors associated with exclusive breastfeeding. The research population was all mothers who had babies with a sample of 52 respondents obtained through total sampling. Data analysis was carried out using the Chi-Square test and logistic regression to determine the most dominant factors. The research results showed that all variables had a p value > 0.05, namely age (p=0.274), education (p=0.156), occupation (p=0.384), parity (p=0.280) and socio-culture (p=0.711), so there was no significant relationship between these variables and exclusive breastfeeding. The logistic regression model was also not significant (p=0.308), indicating that there were no dominant factors influencing the practice of exclusive breastfeeding among respondents. Thus, the low coverage of exclusive breastfeeding in this study may be influenced by other factors outside the variables studied.

The Student Care for Stunting Program is an innovation by BKKBN in collaboration with universities to support the acceleration of stunting reduction through real work lectures or other community service activities. This program is part of the government's efforts to achieve the target of reducing the stunting rate to 14% by 2024, as mandated by the President. This study identifies the implementation of the BKKBN Student Program for Stunting Prevention in Banten Province, specifically in Kilasah Village, as well as the challenges faced in its implementation. The study employs government action theory and the welfare state theory using a legal-empirical method through a qualitative field approach. Data was collected through literature reviews and interviews, analyzed descriptively and analytically. The results show that the program's implementation has included 15 outreach and mentoring activities. Fifteen adolescents received reproductive health education, 21 pregnant and breastfeeding mothers received nutrition and pregnancy health counseling, and 20 prospective couples participated in socialization on healthy pregnancy planning and the use of the Elsimil application. Growth monitoring was conducted at nine Posyandu centers with a total of 60 infants, and 37 cases of infants indicated as stunted were identified. Challenges faced include the absence of specific regulations regarding the program and resistance from the target groups, particularly adolescents and prospective brides and grooms who struggled to understand the Elsimil app. In conclusion, the program has a positive impact on efforts to accelerate stunting reduction, although improvements are still needed in terms of regulations, coordination, and culture-based education.

The use of formula milk for infants is still common in the early stages of life and has the potential to hinder successful breastfeeding, even though the benefits of breast milk have been widely proven. Education and lactation counseling are considered important strategies to support breastfeeding practices and reduce the unnecessary use of formula milk. However, empirical evidence on the effectiveness of lactation counseling in reducing the intensity of formula milk use is still limited, especially in the context of primary health care in Indonesia. This study aims to analyze the effectiveness of lactation counseling in reducing the intensity of formula feeding in infants. This study uses a quantitative approach with a one-group pretest–posttest pre-experimental design. The sample consisted of 20 mothers who had infants and met the inclusion criteria in the Popayato Community Health Center working area, selected using total sampling technique. The intervention took the form of structured lactation counseling provided by health workers. The intensity of formula feeding was measured before and after the intervention using a structured questionnaire. Data analysis was performed descriptively and bivariately using the Wilcoxon Signed Rank Test. The results showed a decrease in the intensity of formula feeding after lactation counseling. The Wilcoxon test showed a significant difference between the intensity of formula feeding before and after education (p = 0.000). Lactation counseling was proven to be effective in reducing the intensity of formula feeding in infants. This educational intervention has the potential to be an important promotional strategy in maternal and child health services to support more optimal breastfeeding practices..

Inadequate breast milk production remains a significant challenge in achieving exclusive breastfeeding success during the postpartum period. This study aimed to analyze the effectiveness of oxytocin massage intervention on breast milk quantity among postpartum mothers at Hospital X. A quasi-experimental design with one-group pretest-posttest approach was employed, involving 17 postpartum mothers who met the inclusion criteria. Data collection utilized demographic questionnaires and measuring instruments to assess milk volume before and after the intervention. Oxytocin massage was performed using back massage technique for 30-60 minutes duration. Statistical analysis employed Wilcoxon signed-rank test due to non-normal data distribution. Results demonstrated significant improvement in milk volume from mean 12.95 ml (pretest) to 50.59 ml (posttest) with p-value 0.000 (p<0.05), indicating statistical significance. The intervention showed substantial effectiveness with approximately 291% increase from baseline condition. These findings suggest that oxytocin massage represents an effective non-pharmacological modality for optimizing lactogenesis through neurohormonal stimulation mechanisms, supporting milk ejection reflex enhancement in postpartum mothers.

One of the influences on the success of exclusive breastfeeding is the role of midwives, namely providing counseling on preparation for exclusive breastfeeding, Early Breastfeeding Initiation (IMD) during childbirth, how to do breast care during pregnancy and the benefits of exclusive breastfeeding. The purpose of Community Midwifery Intervention Practice is to educate in order to increase public awareness of the importance of exclusive breastfeeding and good and correct breastfeeding methods. The method of activity is through counseling by providing material directly using supporting media power points and booklets given to pregnant women, breastfeeding mothers, and grandmothers who take care of their grandchildren and discussions about the importance of exclusive breastfeeding and good and correct breastfeeding methods and there is an evaluation through pre and post-test with 10 questions. The results of 30 respondents can be seen from the pre-test with good knowledge of 9 people (30%) and after the counseling there was an increase in the results of the post-test with good knowledge of 30 people (100%), indicating an increase of 70%. with ρ value = 0.000 (ρ <0.05) meaning that there is an influence on the Importance of Exclusive Breastfeeding and Good and Correct Breastfeeding Methods and a t value of 8.226. In conclusion, there is an influence on increasing knowledge of the Importance of Exclusive Breastfeeding and Good and Correct Breastfeeding Methods after counseling at Posyandu Mawar Indah 02.

The postpartum period, which begins with the delivery of the placenta and ends when the reproductive organs return to their pre-pregnancy state, lasts approximately 6-8 weeks. During this period, many mothers face challenges related to breast milk production, resulting in insufficient or absent milk flow. This condition, if untreated, can hinder the breastfeeding process and affect both maternal and infant health. To address these challenges, several interventions such as warm compresses and oxytocin massage have been explored. The aim of this study was to assess the effectiveness of these two methods in improving breast milk flow among postpartum mothers. A quasi-experimental design was employed, utilizing a non-equivalent control group with pre-test and post-test measurements. The study targeted postpartum mothers who were experiencing difficulties with breast milk production. Purposive sampling was applied to select participants who met the inclusion criteria. The results showed significant differences between the effects of warm compresses and oxytocin massage on postpartum breast milk flow, with a p-value of 0.002 (<0.05), indicating that both methods positively influenced milk production. However, it was found that oxytocin massage had a more pronounced effect on milk flow compared to warm compresses. These findings suggest that oxytocin massage may be a more effective intervention for enhancing breast milk production in postpartum mothers, thus providing valuable information for healthcare professionals aiming to support new mothers in the breastfeeding process. The study also highlighted the importance of personalized care based on individual needs. Further research is recommended to investigate the long-term impact of these interventions and their broader application in various postpartum care settings. Additionally, exploring other complementary approaches could offer a more comprehensive strategy for managing breastfeeding difficulties in the postpartum period.