Black maternal filicide is a rare but devastating form of family violence that remains poorly understood within women's mental health research. Existing scholarship has often emphasized individual psychiatric pathology while paying less attention to the structural conditions that shape maternal psychological distress, access to care, and opportunities for prevention. This study advances a structural psychological analysis of Black maternal filicide, examining how structural adversity contributes to severe mental health crises. Using a qualitative comparative case study design, we examined four highly publicized cases of Black maternal filicide in the United States between 2011 and 2022. Data were drawn from publicly available court records, media reporting, and psychological evaluations where available. Guided by structural determinants of health, structural violence, Black feminist thought, and reproductive justice frameworks, we conducted a cross-case thematic analysis examining maternal psychological symptoms, institutional responses, and post-event narratives. Four interrelated themes emerged: severe psychological distress including depression, dissociation, and psychosis occurring without sustained access to mental health care; socioeconomic precarity, particularly housing instability, that intensified maternal stress; institutional surveillance without meaningful support across child welfare, housing, and mental health systems; and racialized media and legal responses that prioritized punishment over prevention. Across cases, maternal psychological crises unfolded within conditions of cumulative structural adversity and chronic trauma. These findings suggest that maternal filicide in these cases cannot be understood solely as individual pathology but must also be examined within broader structural environments that shape maternal mental health. Addressing maternal psychological distress requires structural interventions that expand access to mental health care, reduce socioeconomic precarity, and shift institutional responses from surveillance to prevention.

The modifying role of maternal adverse psychological status on the association between prenatal exposure to per- and polyfluoroalkyl substances and infant atopic dermatitis: A nested case-control study.

Children with intellectual disabilities display fewer prosocial behaviours and increased behavioural and emotional problems compared to children without intellectual disabilities. Mother-child closeness may be an important factor in improving behavioural and emotional outcomes in children with intellectual disabilities over time. We aimed to examine the covarying relationship between mother-child closeness and child externalising and internalising behaviour problems, and child prosocial behaviour, respectively, over time. Parallel process growth modelling was conducted using data from 353 maternal primary caregivers who took part in three waves of the 1000 Families Study. Mother-child closeness was measured at each wave using the Child-Parent Relationship Scale. Child behavioural and emotional outcomes were measured using the Strengths and Difficulties Questionnaire. We controlled for time-varying and time-invariant covariates including the child's level of communication skills, autism diagnosis, maternal psychological distress and family economic adversity. The trajectory of mother-child closeness remained relatively stable across the three waves. After controlling for covariates, the trajectories of mother-child closeness and child prosocial behaviour significantly covaried. However, the trajectory of mother-child closeness did not significantly covary with the trajectory of either child internalising or externalising behaviour problems. Interventions aiming to improve child prosocial behaviour and/or mother-child closeness in families of children with intellectual disabilities may benefit from considering the relationship between mother-child closeness and child prosocial behaviour. Findings highlight the need for additional research to understand the relationship between these factors and further examine underlying individual differences in these families.

Given the known link between maternal and child mental health, it is likely that children whose mothers experienced more distress because of the COVID-19 pandemic were at greater risk for increased behavior problems. Yet research to date has not tested this hypothesis among families who were hit hardest by the pandemic-those with low incomes and from Black and Hispanic backgrounds. Research is also needed that focuses on young children and uses a longitudinal design. We harmonized data from 4 cohorts originally designed to study pediatric parenting interventions with underresourced families in 2 US cities. We examined, first, whether maternal distress because of the pandemic was associated with change over the next 1 to 2 years in preschool-aged children's anxiety/depression and aggression, and second, whether such associations were moderated by maternal depression. Maternal pandemic-related distress predicted a small increase in child aggression but no change in anxiety/depression. There was no moderation by maternal depression. Among families at risk of the most severe health and financial hardships because of the pandemic, maternal pandemic-related distress was associated with increases in child aggression 1 to 2 years later. Maternal mental health must be made a priority in the future disasters not only in its own right but also because of possible spillover effects on young children.

Association of maternal antenatal distress with child amygdala-prefrontal cortex functional connectivity at 2-3 years in a South African birth cohort study.

While polycyclic aromatic hydrocarbons (PAHs) and maternal psychological distress (anxiety/depression) are risk factors for adverse birth outcomes, their joint effects remain poorly understood, particularly across different pre-pregnancy BMI categories. To examine the individual and combined effects of prenatal PAHs exposure and maternal psychological distress on birth outcomes, with emphasis on effect modification by pre-pregnancy BMI. In this prospective cohort study, we enrolled 699 pregnant women from two primary hospitals in Hefei, China, from April 2020 through October 2022. Urinary PAHs were assessed using gas chromatography tandem triple quadrupole mass spectrometry (GC-MS/MS). Anxiety and depression symptoms were assessed via Generalized Anxiety Disorder Scale (GAD-7) and Edinburgh Postnatal Depression Scale (EPDS), respectively. Logistic regression and BKMR models were used to explore the individual and combined effects of prenatal PAHs exposure and psychological distress on birth outcomes. Logistic regression revealed significant associations between PAHs and anxiety symptoms with adverse birth outcomes. In the overall population, 1-OHPHe is significantly associated with low birth weight (LBW) (OR: 2.21, 95% CI: 1.25, 4.03), 2-OHDBF and 2-OHPHe were significantly associated with preterm birth (PTB), respectively (1.43, 95% CI: 1.04, 1.98; 1.38, 95% CI: 1.02, 1.90). GAD-7 score in the third tertile was positively linked to macrosomia (OR: 3.27, 95% CI: 1.28, 10.06). BKMR demonstrated that among pre-pregnancy overweight/obese women (BMI ≧ 24.0), combined exposure to PAHs, depression, and anxiety was positively associated with LBW. Meanwhile, among the women with normal pre-pregnancy BMI (18.5-23.9), combined exposure was positively associated with macrosomia and PTB. Study results indicate that combined exposure to PAHs, anxiety, and depression increases the risk of adverse birth outcomes in pregnant women. This study provides novel evidence that prenatal coexposure to PAHs and psychological distress differentially impacts birth outcomes based on maternal BMI. Our findings underscore the importance of considering both chemical and non-chemical stressors in prenatal care, particularly for at-risk subpopulations. These results inform targeted interventions to improve birth outcomes.

Telemonitoring in complicated pregnancies involves cardiotocography (CTG), blood pressure, and symptom reporting. Understanding the use of in-hospital care during telemonitoring is essential for effective implementation of hybrid antenatal care models. To evaluate unplanned hospital visits and re-admissions during telemonitoring in complicated pregnancies using a real-world cohort. This single-center retrospective cohort study (2017-2023) included patients enrolled in telemonitoring for premature rupture of membranes (PPROM), preeclampsia (PE), fetal growth restriction (FGR), history of fetal demise, congenital anomalies, or recurrent reduced fetal movements. Patients conducted home-based CTG, blood pressure, and temperature monitoring, reviewed real time by obstetric professionals. Primary outcome was the use of in-hospital care categorized by number and reason for unplanned hospital visits and re-admissions. Secondary outcomes included perinatal and neonatal clinical outcomes. A total of 210 women were included in telemonitoring, due to PPROM (13.8%), PE (17.1%), FGR (28.1%), history of fetal demise (5.7%), recurrent reduced fetal movements (20.9%), congenital anomalies (6.7%), and other reasons (7.6%). Median gestational age at telemonitoring initiation was 33weeks (range 26-39), with a median duration of 11days (range 1-89). Unplanned hospital visits occurred in 76.2% (160/210), with 335 visits during 2789 monitoring days (12.0%), median of 1.6 visits per patient. Purpose of hospital visits included uninterpretable CTG (34.3%), symptoms of PE, PPROM, or hemorrhage (27.5%), non-reassuring CTG (13.4%), and reduced fetal movements (6.3%). Re-admissions occurred in 38.6% (81/210), most frequently in those with PPROM (51.7%) and PE (50.0%). Re-admission causes included non-reassuring CTG (21.3%), imminent labor (14.3%), severe hypertension (12.2%) antepartum hemorrhage (8.2%), reduced fetal movements (6.1%), maternal distress (5.1%), or other maternal symptoms (32.8%). Seven CTGs (0.25%) led to emergency cesarean sections within 24h. No maternal severe adverse events or intrauterine deaths occurred during telemonitoring. Five neonatal deaths (2.4%) occurred, none of them were attributable to telemonitoring care. Telemonitoring of complicated pregnancies resulted in 1-2 unplanned hospital visits per patient on average. These findings reflect expected clinical needs in complicated pregnancies. Re-admissions occurred in 38.6% of patients. No adverse events were attributable to telemonitoring. To further enable hospital at home care, these results provide valuable insights for policymakers and professionals regarding the implementation of telemonitoring in complicated pregnancies. Telemonitoring in complicated pregnancies led to an average of 1-2 unplanned visits per patient and 38.6% re-admissions, without related adverse events. These findings support provide valuable insight for policymakers and professionals regarding the implementation of telemonitoring in complicated pregnancies.

Maternal psychological distress during pregnancy is known to elevate the risk of offspring asthma, but the impact of the timing of the distress remains poorly understood. To assess the individual and combined effects of maternal prenatal and postnatal depressive and anxiety disorders, both separately and longitudinally, on offspring asthma and its phenotypes. Healthcare register data on 310,701 children born 2001-2006 and their 232,240 mothers were collected. Maternal depressive disorder was defined by diagnoses F30, F31, F32-F34 and F38 and anxiety disorder as F40-F42, F44-F45 and F48. Timing of disorder was defined as prenatal (from one year before until labor) and postnatal periods (from birth until three years postpartum). Child outcomes were overall asthma diagnosis J45-J46 at 7-12years, further separated into allergic J45.0 and non-allergic J45.1 asthma phenotypes. Altogether, 19,000 (6.1%) children had asthma, 6517 (2.8%) mothers had depression, and 4189 (1.8%) had anxiety disorder. Child overall asthma was associated with maternal prenatal depression (adjusted odds ratio 1.28; 95% confidence interval 1.08-1.53) and anxiety disorders (1.30; 1.07-1.57), and with postnatal anxiety disorders (1.33; 1.15-1.54). Both maternal postnatal depression (1.36; 1.06-1.74) and anxiety disorders (1.45; 1.06-2.00) were associated with non-atopic asthma, and postnatal anxiety was associated with atopic asthma (1.34; 1.07-1.67). The comorbidity or longitudinality of maternal depressive and anxiety disorders didn't affect the associations. Maternal depressive and anxiety disorders were associated with offspring asthma, varying by phenotype and timing. The postnatal effect was significant, suggesting independent associations and possibly distinct pathways in child respiratory morbidity.

Objective: To establish an association between iron deficiency anemia and maternal psychological distress during pregnancy. Study Design: Cross-sectional study. Place and Duration of Study: Chemical Pathology & Endocrinology department of Armed Forces Institute of Pathology (AFIP), Rawalpindi Pakistan, from July to December 2022. Methodology: A total of 131 individuals were categorized into iron deficiency anemia (IDA) Group (n = 51) and non-IDA Group with normal pregnant females or those having anemias of etiology other than iron deficiency (n = 80) using a non-probability convenient sampling technique. The risk of psychological distress was measured by a scale adopted from Depression Anxiety Stress Scale 21. Results: Antenatal depression, anxiety and stress in IDA as compared to non-IDA Group (86.3 % vs 43.8 %, 84.3 % vs 51.2 %, and 91.1 % vs 66.3 %) showed significant difference (< 0.001) respectively. There was a significant negative correlation (r) of depression (r = -0.32), anxiety (r = -0.40), and stress (r = -0.37) with the serum ferritin levels (p= <0.001). Women having IDA were eight times more likely to develop depression (OR=8.08, CI 95% [3.25, 20.11]), five times more likely to develop anxiety (OR=5.11, CI 95% [2.14, 12.24]) and eight times more likely to develop stress (OR=8.15, CI 95% [2.32, 28.59]) than those without IDA during pregnancy. Conclusion: Iron deficiency anemia plays a significant role in increasing the risk of antenatal psychological distress when compared with non-IDA Group which should be addressed timely for better pregnancy outcomes.

To examine the associations of maternal psychological distress and neonatal medical risk during Neonatal Intensive Care Unit (NICU) hospitalization with child developmental outcomes, parental burnout, and perceived family impact at 18 to 24 months corrected age in a middle-income country setting with limited perinatal mental health infrastructure. This prospective, observational study included 175 mother-infant dyads admitted to a tertiary NICU transitional unit. Maternal depression and anxiety were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the Perinatal Anxiety Screening Scale-Turkish Version (PASS-TR), respectively. Neonatal medical complexity was quantified using a composite Neonatal Risk Score (NRS). At 18 to 24 months corrected age, 112 infants and 96 mothers completed follow-up assessments including the Ages and Stages Questionnaire (ASQ-3), the Parental Burnout Assessment, and the Impact on Family Scale. Maternal depressive (39.9%) and anxiety (75.8%) symptoms were common during the NICU stay but not linked to sociodemographic factors. Higher EPDS and PASS-TR scores were associated with developmental delays in communication, problem-solving, and personal-social domains. Parental burnout correlated with maternal depression, poorer child communication and motor outcomes, and higher NRS. Mothers of infants with hydrocephalus reported the highest distress and burnout. Maternal mental health and neonatal medical risk during NICU hospitalization were important correlates of later child and family outcomes. Routine psychosocial screening and risk stratification in NICU settings may facilitate early identification of at-risk dyads. In low-resource settings, integrated perinatal mental health support may be essential to improving long-term developmental and psychosocial outcomes.

Maternal mental health is an important determinant of child development, yet most evidence relies on short exposure windows or single-wave measures. Less is known about how long-run maternal mental health relates to child outcomes when child development data are observed intermittently. Using nationally representative longitudinal household panel data, we examined associations between maternal mental health and child behavioural outcomes, academic performance, and expectations of future university participation. Child outcomes were observed in three survey waves, while maternal mental health was measured repeatedly over a longer period. Maternal mental health was operationalized as long-run averages of general mental health and psychological distress. Ordinary least squares models were estimated with adjustment for child, maternal, and household characteristics, and standard errors were clustered at the mother level. Higher maternal psychological distress was associated with poorer academic performance and less favourable behavioural and educational outcomes. Associations involving general maternal mental health were attenuated after full adjustment. Persistent maternal psychological distress is associated with poorer child academic outcomes. Although causal inference is not possible, the findings highlight maternal mental wellbeing as an important correlate of child development.

ABSTRACT Background Exclusive breastfeeding rates in Iran remain below international recommendations, while gestational diabetes mellitus (GDM) rates are increasing. Evidence from Western countries suggests GDM and postnatal psychological distress may hinder breastfeeding. We assessed associations between postnatal distress and breastfeeding in women with and without GDM in a Southwest Asia and North Africa (SWANA) population where cultural, social, and health system contexts differ. Methods Data were from the Isfahan site of the Prospective Epidemiological Research Studies in Iran (PERSIAN) Birth Cohort (n = 2,823). GDM was self-reported during pregnancy. Postnatal psychological distress was assessed at two months postnatal using a single-item measure of sadness/helplessness, which, although limited, may reflect the challenges in measuring mental health status in Iran. Breastfeeding outcomes were reported retrospectively at 12 months. Logistic and linear regressions adjusted for maternal age and education. Results Women with GDM were less likely to initiate breastfeeding (adjusted OR = 0.25, 95% CI = 0.16–0.40) and reported shorter exclusive breastfeeding (adjusted β = −0.47 months, 95% CI = −0.68 to −0.25). Psychological distress was not associated with breastfeeding initiation but was associated with shorter exclusivity (mild distress: β = −0.32 months; moderate – severe distress: β = −0.48 months). Interaction analyses suggested a stronger negative effect of GDM on exclusivity in women without distress, though this finding was exploratory. Conclusion GDM was associated with reduced breastfeeding initiation and shorter exclusivity, while distress modestly reduced exclusivity. The interpretation is limited by lack of validation for the psychological distress measure.

Psychological distress, such as stress, depression or anxiety, is a prevalent mental health concern during pregnancy. However, data on the association between prenatal maternal psychological distress and the risk of autism or autism spectrum disorders (ASD) in their offspring have not been synthesized systematically. We performed a meta-analysis to explore this issue and provide evidence regarding maternal mental health screening and ASD prevention. Six electronic databases were systematically searched up to June 2025. English-language full-text observational studies were included, with no geographic or race restrictions. Studies that quantitatively assessed the association between maternal psychological distress during pregnancy and the risk of ASD in offspring were eligible for inclusion. Pooled odds ratios (ORs) were calculated. Heterogeneity, publication bias, and sensitivity analyses were assessed. Among 484 full-text records screened, 22 studies were eligible. Data analysis demonstrated that offspring of mothers with prenatal psychological distress have a 72% higher likelihood of being diagnosed with ASD or autism after the age of two (OR = 1.72, 95% CI 1.50-1.97, p < 0.01) compared to those of mothers without distress. This association was observed across different study designs and ASD diagnostic ascertainment methods, although effect estimates varied. Substantial between-study heterogeneity was observed (I 2 = 87.90%), largely attributable to differences in study design, ASD ascertainment and distress assessment rather than psychological distress subtype. In this meta-analysis, prenatal maternal psychological distress was associated with an increased likelihood of an ASD diagnosis in offspring. Across the included studies, effect estimates were generally similar for stress, depression, and anxiety, despite substantial heterogeneity in study design and exposure assessment. This consistency suggests that elevated ASD risk is not confined to a single diagnostic category of maternal distress. At the same time, the findings should be interpreted considering the variability in how psychological distress was measured and controlled for across studies. Taken together, the results indicate that maternal psychological distress during pregnancy warrants attention in epidemiological research and routine antenatal care, without implying that specific psychiatric subtypes can be clearly distinguished in terms of offspring ASD risk. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251119825, PROSPERO: CRD420251119825.

ABSTRACT Research Findings: Relational aggression (RA) warrants further investigation due to its significant detrimental effects on child adjustment. This two-wave longitudinal study examined the contribution of maternal emotional distress to children’s RA with maternal psychological control (PC) as a mediator and mothers’ perceived normativeness of psychological control (PNPC) as a moderator. Participants were 175 Hong Kong Chinese families of preschool children (50.9% girls; M age = 60.93 months, SD = 5.59). Mothers reported their emotional distress and use of PC at Time 1 (T1) and their PNPC at Time 2 (T2; 6 months later). Mothers and fathers also reported children’s RA at T2. Results revealed that T1 maternal distress was positively related to T1 maternal PC, which in turn positively predicted T2 children’s RA. Further, T2 mothers’ PNPC attenuated the relation between T1 maternal PC and T2 children’s RA, thus the mediation effect was significant only when T2 mothers’ PNPC was low and medium, rather than high. Practice or Policy: Findings underscore the importance of culturally sensitive parenting interventions that reduce maternal distress and discourage the use of PC, particularly among mothers who perceive such practices as socially non-normative.

Prenatal and Postnatal Maternal Psychological Distress and the Metabolomic Profile of Human Milk.

According to global data from the World Health Organization (WHO), worldwide, approximately 10% of pregnant women and 13% of new mothers experience mental disorders, particularly depression. In developing countries, this figure is even higher, at 15.6% during pregnancy and 19.8% after childbirth. In severe cases, maternal distress can be so severe that they may even commit suicide. Furthermore, affected mothers are unable to function properly. As a result, child growth and development can also be impaired (WHO, 2023). The purpose of this study was to determine the relationship between family support and anxiety in third-trimester pregnant women facing childbirth at Dr. Sobirin Regional Hospital, Musi Rawas Regency in 2025.The study used a cross-sectional design. Data were collected by distributing questionnaires to 33 respondents, including pregnant women in their third trimester at Dr. Sobirin Regional Hospital, Musi Rawas Regency, using a total sampling technique. Univariate analysis revealed that more than half of the respondents, or 54.5%, were in the third trimester of pregnancy. Musi Rawas Regency in 2025 experienced poor family support, and more than half of respondents, or 57.6%, of third-trimester pregnant women, experienced high levels of anxiety during childbirth at Dr. Sobirin Regional General Hospital (RSUD) in Musi Rawas Regency in 2025. Bivariate analysis revealed a significant relationship between family support and third-trimester anxiety levels during childbirth at Dr. Sobirin Regional General Hospital (RSUD) in Musi Rawas Regency in 2025, with a p-value of 0.003.Dr. Sobirin Regional General Hospital (RSUD) in Musi Rawas Regency and related institutions should improve antenatal care services that focus not only on the physical aspects but also on the psychological aspects of pregnant women.

Exclusive breastfeeding is recommended for the first 6 months of life. However, many full-term infants require supplementation in the first few days of life, with formula often being the only supplementation option provided. With increased awareness and availability, donor human milk is becoming a viable alternative for supplementation in full-term infants. This study aimed to understand how having a choice to supplement infants with donor human milk rather than formula informed maternal experiences with infant feeding. Using a qualitative descriptive design, we conducted 15 semi-structured interviews with mothers who chose to supplement their infant with donor human milk. The semi-structured interview guide was co-developed with milk banking associations to elicit feeding goals, perceptions of donor human milk, infant feeding experiences in the first weeks of life and perceived well-being, health, and feelings around supplementation. Interviews were analyzed using reflexive thematic analysis. Of the 15 participants, over half delivered via cesarean section (n = 8), the majority were primiparous and had no previous breastfeeding experience (n = 12) and most wanted to exclusively breastfeed their infant (n = 11). Four overarching themes were identified: (1) feeding experience, (2) supplementation, (3) maternal well-being, and (4) feasibility. Choosing donor human milk positively impacted participant mental health, helped relieve stress from the pressure to breastfeed, and provided peace of mind. Donor human milk may provide a feasible intervention that may help to mitigate maternal distress by providing a supplement that is more to similar breastmilk, while breastfeeding is being established.

We aimed to determine the association between maternal bonding difficulty in the postpartum period and children's neurodevelopment, considering maternal psychological distress and child sex-specific differences. To evaluate the relationship, the dataset of the Japan Environment and Children's Study was used, as well as the Mother-to-Infant Bonding Scale (MIBS), the six-item version of the Kessler Psychological Distress Scale (K6) for mothers, and the Ages and Stages Questionnaires Third Edition for children aged 2 to 4 years. Maternal MIBS and K6 were administered at 1 year postpartum. Data from 24,798 boys and 24,025 girls were analyzed. Multivariate logistic regression analyses, with the reference groups being those with maternal MIBS scores ≤4 and K6 scores ≤4, were performed. The Benjamini-Hochberg procedure was employed to account for multiple testing. In boys, maternal bonding difficulty (MIBS score ≥5) without psychological distress (K6 score ≤4) was associated with a screen-positive result for neurodevelopmental delay in all five domains (communication, gross motor, fine motor, problem-solving, and personal-social) at ages 2 to 4 years. In girls, maternal bonding difficulty without psychological distress was associated with a screen-positive result for neurodevelopmental delay in all five domains at 2 years of age. However, at age 4 years, maternal bonding difficulty without psychological distress was no longer associated with a screen-positive result for problem-solving delay in girls. The association of maternal bonding difficulty without psychological distress at 1 year postpartum with screen-positive result for problem-solving delay persisted in boys, but at age 4 years in girls, the association no longer existed.

As maternal distress has many negative consequences both for mothers and for children, support from child and family services could be very effective in preventing maternal distress from escalating into more serious problems, such as mental illness or parental burnout. We studied the longitudinal and cross-sectional effects of the reported unmet need of support to the levels of daytime tiredness, stress, and depressive and anxiety symptoms of mothers with young children. The study uses data from the Child-Sleep birth cohort (2011-2013). Mothers were evaluated at a prenatal measurement point (n=1667) and 8 months (n=1298), 24 months (n=1038), and 5 years (n=722) postpartum using self-report questionnaires. Logistic regression was used to study the association between reported levels of daytime tiredness, stress, and depressive and anxiety symptoms and the reported unmet need of support from child and family services. We found that the reported unmet need had both a longitudinal and a cross-sectional association with increased depressive symptoms, stress and daytime tiredness among mothers with young children. Mothers who had reported unmet need at most timepoints had the highest odds of experiencing distress. Our results indicate that external support from child and family services might be an important tool for preventing and intervening in maternal distress.

Nipple wounds are common complications during breastfeeding and may lead to pain, early cessation of breastfeeding, and maternal distress. Various pharmacological and non-pharmacological approaches have been proposed for the prevention and treatment of nipple wounds; however, evidence regarding their effectiveness remains inconsistent. This systematic review aimed to comprehensively evaluate current evidence on methods used for both the prevention and management of nipple wounds. This systematic review was conducted in accordance with the PRISMA 2020 guidelines. Literature searches were performed between March and April 2024 using the databases PubMed, Cochrane Library, Web of Science, and Scopus. To ensure that the review reflects the most up-to-date evidence, the search was repeated in January 2026 using the same databases and search strategy. No additional studies meeting the inclusion criteria were identified. Only studies published in English were included, and grey literature was not considered. MeSH terms and keywords including “wound,” “nipple wound,” “nipple trauma,” “nipple fissure,” “prevention of nipple wound,” and “treatment of nipple wound” were used in various combinations. Randomized controlled trials (RCTs) published within the last nine years were included. Study selection followed the PICOS framework. The methodological quality of the included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists appropriate to each study design. Fifteen randomized controlled trials involving a total of 1,796 participants were included. The findings indicated that non-pharmacological interventions—such as proper breastfeeding techniques, nipple care education, breast milk application, and supportive devices—were effective in both preventing the development of nipple wounds and reducing the severity, pain, and healing duration of existing wounds. Compared with pharmacological treatments, non-pharmacological approaches demonstrated comparable or superior outcomes in several studies. The evidence suggests that non-pharmacological methods play a beneficial role in the prevention and treatment of nipple wounds. However, the effectiveness of these interventions should be interpreted with caution due to heterogeneity in intervention types, outcome measures, and variability in the methodological quality of the included studies. These interventions appear to be safe, accessible, and effective, particularly when integrated with breastfeeding education and support. Further high-quality randomized controlled trials (RCTs) with standardized outcome measures are needed to strengthen the evidence base and inform clinical practice.