Prevalence and factors associated with cracked nipples in the first month postpartum.

Kamila Juliana Da Silva Santos,Géssica Silva Santana,Elsa Regina Justo Giugliani,Tatiana De Oliveira Vieira,Carlos Antônio De Souza Teles Santos,Graciete Oliveira Vieira

doi:10.1186/s12884-016-0999-4

Abstract

BackgroundTo assess the prevalence and factors associated with the occurrence of cracked nipples in the first month postpartum.MethodsThis was a cross-sectional study nested in a cohort of mothers living in Feira de Santana, state of Bahia, northeastern Brazil. Data from 1,243 mother-child dyads assessed both at the maternity ward and 30 days after delivery were analyzed. The association between cracked nipples as reported by mothers and their possible determinants was analyzed using Poisson regression in a model where the variables were hierarchically organized into four levels: distal (individual characteristics), distal intermediate (prenatal characteristics), proximal intermediate (delivery characteristics), and proximal (postnatal characteristics).ResultsThe prevalence of cracked nipples was 32 % (95 % confidence interval [95 % CI] 29.4–34.7) in the first 30 days postpartum. The following factors showed significant association with the outcome: poor breastfeeding technique (prevalence ratio [PR] = 3.18, 95 % CI 2.72–3.72); breast engorgement (PR = 1.70, 95 % CI 1.46–1.99); birth in a maternity ward not accredited by the Baby-Friendly Hospital Initiative (PR = 1.51, 95 % CI 1.15–1.99); cesarean section (PR = 1.33, 95 % CI 1.13–1.57); use of a feeding bottle (PR = 1.29, 95 % CI 1.06–1.55); and higher maternal education level (PR = 1.23, 95 % CI 1.04–1.47).ConclusionsThe prevalence of cracked nipples was high in our sample. Most of the factors associated with cracked nipples were related to postnatal characteristics, especially poor breastfeeding technique, which could be improved to help prevent the condition.

Highlights

To assess the prevalence and factors associated with the occurrence of cracked nipples in the first month postpartum
The results reported in the present study refer to the data collected at the maternity ward and at the 30-day follow-up interview
Prevalence of cracked nipples in the first month postpartum The prevalence of cracked nipples was 32 % (398/1,243; 95 % 95 % confidence interval (CI) 29.4-34.7), but all mothers were still breastfeeding at the 30-day follow-up interview, even in the presence of the outcome

Summary

Introduction

To assess the prevalence and factors associated with the occurrence of cracked nipples in the first month postpartum. Nipple trauma presents a high incidence, especially in the first 30 days postpartum [1, 2]. Because it is a painful condition, it often causes interruption of exclusive breastfeeding and early weaning [3, 4]. 25 % higher risk of interruption of exclusive breastfeeding was found in the first month of lactation when cracked nipples were present [4]. Knowledge of the factors involved in the genesis of this condition in specific populations is extremely important to help establish preventive measures, especially because of the little effectiveness associated with the treatment options available [12, 13]

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Discussion

Conclusion