Nipple Pain Research Articles

Barrier and Motivation to Exclusive Breast Feeding Amongst Mothers Accessing Care at the University of Abuja Teaching Hospital

This study was carried out to identify barriers and motivation for exclusive breastfeeding practice amongst mothers accessing care at the University of Abuja Teaching Hospital, ( UATH) — Abuja — Nigeria. The study was a cross-sectional survey that utilized a structured questionnaire in the collation of quantitative data from 288 participants. The data and result showed that approximately 53.5% of the respondents reportedly do not have enough breast milk, 13.9% think that the breast milk will not be enough for their babies because of the size of their breast, 0.69% were the students with attendant challenges, 1.4% were career women, 1.7% said their difficulty was painful nipples, one person was afraid that the baby may refuse other feeds at a later age while one respondent said it was time-consuming. It is captivating to know that, the respondents’ motivation based on whether exclusive breastfeeding is beneficial to baby and mother shows that 99.6% claimed that exclusive breastfeeding is beneficial, and contribute to the good well-being of the baby, while 98.2% declared that exclusive breastfeeding is beneficial to the nursing mother as well. The study evaluated the barriers, and motivations of the mother to tell the benefits of breast milk are natural and renewable food. Therefore, ensuring active support through an efficient health education/promotion as primary prevention in public health/clinical practice and establishing/sustaining the practices that are appropriate among mothers. Generally, the study showed some barriers to exclusive breastfeeding and their associated motivations among mothers.

The Effect of Dexpanthenol on the Treatment of Nipple Injuries in Breastfeeding Mothers: A Randomized Control Trial

Background: Considering the importance of treatment of sour nipples in breastfeeding mothers, the aim of this study was to evaluate the effect of dexpanthenol creams on the treatment of traumatic nipples. Materials and Methods: This study was a double-blinded, randomized, control trial, in which 82 postpartum mothers with nipple injuries who had attended health centers and Children’s Hospital of Sanandaj, Iran, participated. The participants were randomly divided into two groups of dexpanthenol and control. Nipple pain and trauma was measured using Storr and Champion scale. Analysis was done through chi-square and ANOVA tests using SPSS software version 13.0. P value less than 0.05 was considered significant. Results: The results of this study demonstrated that the mean score of pain and trauma in third, seventh, and fourteenth days of study in intervention group was decreased. In addition, there was significant differences in pain and trauma scores between dexpanthenol and control groups. Conclusion: Dexpanthenol is advised as an effective, simple, and non-invasive technique with no side effects for the treatment of nipple fissures and pain.

APOIO SOCIAL E INTERCORRÊNCIAS MAMÁRIAS EM NUTRIZES QUE AMAMENTAM EXCLUSIVAMENTE

Objetivo: Avaliar a associação entre o apoio do cônjuge e de familiares a nutrizes assistidas em um Programa de Puericultura de um Banco de Leite Humano e as intercorrências mamárias durante o período de aleitamento materno exclusivo (AME). Métodos: Estudo transversal com 169 nutrizes assistidas pelo Programa de Puericultura de um Banco de Leite Humano em São Luís-MA. Aplicou-se um questionário semiestruturado para a coleta de dados socioeconômicos e demográficos, condições do pré-natal, apoio social e intercorrências mamárias. O Teste Qui-quadrado e o Teste Exato de Fischer foram empregados para verificar as associações entre as covariáveis e o desfecho de interesse (p<0.05). Resultados: Todas as nutrizes se submeteram ao pré-natal (100%), das quais 81,3% realizaram seis ou mais consultas, em sua maioria na rede pública de saúde (94,7%). Mais da metade das nutrizes não recebeu orientações a respeito do aleitamento materno (55,4%), de posições do bebê para amamentar (63,7%) e dos cuidados com as mamas durante o pré-natal (59,2%). Aproximadamente 82% receberam apoio do companheiro, no entanto, na presença de dores nos mamilos (41,1%) e mamilos ausentes, planos ou invertidos (13,2%), a maioria (86,8%) não recebeu tal suporte durante o AME (p=0,021). Conclusão: Houve considerável apoio social dirigido às nutrizes, mas dentre as que apresentaram intercorrências mamárias, a maior parte não recebeu esse apoio. Reforça-se a necessidade de maior participação dos atores que compõem a rede social da gestante no pré-natal e nos cuidados com a saúde da criança.DOI: 10.12957/demetra.2019.43824

Mothers' Reasons for Early Breastfeeding Cessation.

The purpose of this review is to assess maternal explanations for early breastfeeding cessation in economically developed countries. The electromic databases EBSCO, CINAHL, Child Development & Adolescent Studies, PsycInfo, Health Source: Nursing/Academic Edition, Nursing and Allied Health; ProQuest databases: Family Health Database, Health and Medical Collection, Nursing and Allied Health, Psychology Database, and Public Health Databases were searched using the terms breastfeeding, cessation, stop, discontinuation, early weaning, quit*, early termination, and six months. Inclusion criteria included infants born at least 37 weeks gestation, single birth, and infant birthweight > 2,500 g. Initial literature search yielded 117 studies; 10 studies met inclusion criteria. The two most common reasons for early breastfeeding cessation were perceived inadequate milk supply and maternal breast or nipple pain. Research on maternal reasons for early breastfeeding cessation is limited. Reasons for early breastfeeding cessation are varied; however, the most common themes were perceived inadequate supply and breast or nipple pain. Nurses should tailor assessment of each breastfeeding mother-baby couplet and associated interventions based on these findings.

A study to assess the effectiveness of lukewarm water compress on prevention of nipple pain among primi parous mother

Parenthood is a very civilizing experience. Mother is placed at the level of soul to provide sacrifice, love and affection and satisfy the need of her child. It is generally a cheerful event. The word ‘postnatal’comes from Latin word ‘post’ means ‘secundum', and ‘nativitas’ means ‘delivery’. The postpartum period begins immediately after the birth of a child and extends up to the first six weeks. The main aim to assess the effectiveness of lukewarm water compress on prevention of nipple pain among primi parous mother. The study was conducted in Thiruvallur district headquarters hospital with 60 samples. The information was collected using a non-probability convenience sampling technique. The result indicates that the application of lukewarm water compress is effective on nipple pain among primi parous mother.

Musculoskeletal Impairment: Causes of Pain with Breastfeeding Insight into 11 Cases

Objective: To determine the possible relationship between pain experienced by mothers with breastfeeding and musculoskeletal impairment commonly seen in physiotherapy practice. Evidence-based principles of the evaluation and treatment of musculoskeletal impairment used in physiotherapy practice were applied and adapted to manage pain experienced by mothers with breastfeeding.Subjects and Methods: This report describes 11 mothers referred to a breastfeeding clinic for pain with breastfeeding. Mothers were initially assessed by a physician and a nurse clinician, both International Board-Certified Lactation Consultants, to rule out causes of breast or nipple pain. When the cause remained unexplained, it was deemed musculoskeletal, and mothers were referred to a physiotherapist for assessment and treatment with manual orthopedic therapy and mobilization of the myofascial system.Results: The physiotherapist's objective musculoskeletal assessment and mothers' impression showed an improvement in the overall clinical picture after the first appointment in most mothers. Pain was resolved or alleviated by 80% in five mothers after 1–3 weekly treatments. The most useful therapeutic approach was to make afflicted mothers aware of their posture to maintain spinal alignment and avoid shear posture (lateral displacement of the trunk). Shear posture is a consequence of sitting leaning to one side. This posture is exacerbated by thoracic rotation and flexion, for example, when turning the trunk and bending over the baby while giving the breast.Conclusion: Treating musculoskeletal impairment referred pain to the breast or nipple with physiotherapy practices used in a nonbreastfeeding clientele can help alleviate or resolve pain with breastfeeding.

Thermal physiology of the lactating nipple influences the removal of human milk

The nipple has a critical role in successful breastfeeding. Nipple trauma or pain may negatively impact breastfeeding duration which has significant public health implications. The aim of this study was to examine changes in nipple temperature during breastfeeding and pumping within participants. Thirty lactating women participated in two pumping (electric breast pump) and one breastfeeding session. Nipple temperature of both breasts was monitored for two minutes before and after each session with the non-pumped/non-suckled nipple temperature recorded throughout each session. The mean increase in nipple temperature after milk removal by the infant was 1.0 ± 1.6 °C (range −3.2–3.2) and after expression was 1.8 ± 1.4 °C (range −0.9–6.1). Nipple temperature pre expression was significantly lower than post expression (Pre 32.6 ± 1.6, Post 34.3 ± 1.3, p < 0.001) with no difference between the two pumping sessions. For every 1 °C rise in temperature an additional 10 mL of milk was removed on average. The breastfed nipple temperature was significantly lower pre feed than post feed (Pre 32.4 ± 1.6, Post 33.2 ± 1.2 p = 0.01) with a significant but smaller change in nipple temperaturecompared to pumping (Breastfeed 1.0 ± 1.6, Pumping 1.7 ± 1.4, p = 0.03). Nipple temperature increases during pumping and breastfeeding suggesting the breasts have a similar physiological response to different stimuli. Further, the increased temperature potentially plays a role in effective milk removal.

Understanding the causes and treatments of nipple pain secondary to breastfeeding

Understanding the causes and treatments of nipple pain secondary to breastfeeding

Factors associated with exclusive breastfeeding in relation to knowledge, attitude and practice of breastfeeding mothers in Rabigh community, Western Saudi Arabia.

There is much concern about declining rates of exclusive breastfeeding (EBF) all over the world including Saudi Arabia which deprives infants from many immunological, nutritional, and psychosocial benefits. This study was performed to determine EBF prevalence and factors influencing EBF in relation to knowledge, attitude and practice (KAP) of breastfeeding mothers (BFM) in Rabigh, Western Saudi Arabia. Data about factors that could be associated with EBF and KAP of BFM were collected by cross-sectional questionnaire-based study from 420 BFM. Prevalence of EBF for 6months was 27.6% which is far below World Health Organization recommendations. Demographic, socioeconomic, biomedical as well as most studied variables of KAP of 50% to over 90% of participating mothers were adequate to account for low EBF rate. Proper knowledge about benefits of colostrum and continuation of breastfeeding for 2years was given by only 86.2% and 36.7% of BFM, respectively. The most significant independent factors associated with EBF were perception of sufficient human milk [adjusted odds ratio (AOR) 2.89; 95% confidence interval (CI) 1.72-4.89], absence of nipple pain (AOR 2.77; 95% CI 1.72-4.45) and mothers without university education (AOR 1.86; 95% CI 1.15-3.01). Early introduction of formula in hospital after birth was the main inappropriate feeding practice in 76.2% of infants of BFM. Findings of this study should be utilized by Rabigh community and other national or worldwide communities with similar characters to promote EBF by targeted educational programs after identification of significant factors influencing EBF and gaps in KAP of BFM.

Upper lip frenotomy for neonatal breastfeeding problems

ObjectivesUpper lip tie, without concomitant tongue tie, can prevent proper flanging of the upper lip during breastfeeding, resulting in a poor seal and suck for the infant with nipple pain and maternal dissatisfaction. Due to the lack of published studies on this subject, we report our technique and outcomes for in-office release of isolated upper lip tie. MethodsUsing CPT Code 40,806 for ‘incision of labial frenulum’, 22 mother-infant dyads with infant age under 60 days with breastfeeding problems and a restrictive upper lip frenum were identified. These infants underwent in-office release of upper lip tie as detailed below. Outcomes of the procedure were assessed by a telephone survey to mothers within the 4-week period post-procedure. Results82% of mothers reported an improved latch and 73% noted increased satisfaction with breastfeeding. Lip pain, if present, resolved within 24 h for most children. Recurrence was reported by 9% of mothers; no infection or other complications occurred. ConclusionUpper lip frenotomy, in properly selected infants, has favorable short-term outcomes with mild transient discomfort and a low rate of recurrence. Since our study was short-term and did not include a control group, we are unable to comment on procedure efficacy or long-term impact.

New progress in the diagnosis and treatment of natal teeth and neonatal teeth

There were great individual differences in eruption time of the teeth. Generally speaking, the deciduous teeth begin to erupt at 6 months after birth, but some babies are born with erupted teeth, which are called natal teeth; in addition, teeth erupted within 30 days after the baby is born are called neonatal teeth. Natal teeth and neonatal teeth may cause ulceration, aspiration, and nipple pain or trauma in the mother's breast during the time of breastfeeding. Extraction of the teeth may cause complications such as neonatal osteomyelitis. To avoid the complications caused by these diseases, and to alleviate the suffering of patients and their families, this article will introduce the clinical manifestations, etiology and related complications of natal teeth and neonatal teeth, and then give some treatment methods and nursing methods, especially to help clinical work.

The effect of a single irradiation of low-level laser on nipple pain in breastfeeding women: a randomized controlled trial.

Photobiomodulation with low-level laser therapy (PBM-LLLT) has been introduced as a new tool to relieve nipple pain and repair nipple damage in breastfeeding women; however, evidence is needed to assess its effectiveness. The aim was to evaluate the effect of a single application of PBM-LLLT for breastfeeding women with nipple pain and damage; side effects were also collected. We conducted a randomized double-blinded controlled trial with women with nipple damage who were exclusively breastfeeding and rooming-in at Amparo Maternal maternity service, São Paulo, Brazil (May 2016 to May 2017). Women were randomly assigned into laser (n = 40) or control group (n = 40). Intervention was a single irradiation (660nm, 100mW, 2J, 66.66J/cm2, 3.3W/cm2, 20s of irradiation, punctual, and continuous mode) applied directly. Women reported pain levels at recruitment (before and immediately after irradiation), 6 and 24h after the treatment. Pain level during a breastfeed was assessed using the Visual Analogue Scale (0 to 10). The primary outcome was the level of nipple pain immediately after the laser irradiation. Data were analyzed using hierarchical model and Wald test. At baseline, pain levels were similar (mean of 7.4 in laser group and 7.1 in control group). Women's perception of pain reduced approximately one point in both groups. Thirty-one percent of participants in the laser group (11/36) reported secondary effects, such as tingling (10/36) and pricking (2/36). The laser protocol of a single application was not effective in reducing pain in women with damaged nipples. Tingling sensation may be experienced by women receiving laser treatment for nipple damage.

Diagnosis, classification and management of ankyloglossia including its influence on breastfeeding.

Ankyloglossia is defined as a congenital malformation that alters lingua/ mobility and function. ft is listed as one of the possib/e reasons behind problems with breastfeeding. Due to current WHO recommendations that encourage mothers to breastfeed exclusively up to 6 months of age, quick recognition of any obstacles in the suction mechanism and determining the possible reasons for problems should be a priority. A review of the literature was conducted concerning the diagnosis of ankyloglossia, possible methods of treatment and their efficacy in improving breastfeeding quality. The authors of the research cited claim that any surgica/ intervention should be performed only in cases of symptomatic ankylog/ossia interfering with sucking mechanisms. The most frequent surgical procedure performed in newborns with symptomatic ankyloglossia is frenulotomy. ft is a simple procedure with a low risk of complications. The literature gives a great number of studies confirming both the short and long-term efficacy of tongue-tie release in improving breastfeeding quality with emphasis on decreasing mothers' discomfort, nipple pain and trauma.

Pharmacological management of common lactation problems

AbstractThe importance of breastfeeding is well recognised with benefits for both the mother and infant. Despite these benefits, women often cease breastfeeding prematurely after experiencing common problems such as breast and nipple pain or low breast milk supply in the early weeks of breastfeeding. Some mothers stop breastfeeding while taking medications to treat these conditions because of unfounded concern or inappropriate advice from healthcare providers. Most of these conditions can be managed without the need to stop breastfeeding. This review provides pharmacists with an understanding of common breastfeeding problems and outlines evidence‐based pharmacological management strategies for women experiencing these complications. All health professionals need to support mothers to continue breastfeeding for as long as they desire, and pharmacists have a unique role and a clear responsibility to provide up‐to‐date, evidence‐based information to empower breastfeeding mothers in their decision making to ensure breastfeeding is not stopped without good reason.

Promoting self-management of breast and nipple pain in breastfeeding women: Protocol of a pilot randomized controlled trial.

The majority of women experience pain during breastfeeding initiation with few strategies to manage breast and nipple pain. In fact, women cite breast and nipple pain as among the most common reasons for breastfeeding cessation. To address this important issue, we developed a breastfeeding self-management (BSM) intervention, based on the Individual and Family Self-Management Theory Framework. In this framework, self-management is conceptualized as a process in which women use knowledge, beliefs, and social facilitation to achieve breastfeeding goals. The purpose of this longitudinal pilot randomized controlled trial was to test the feasibility, acceptability, and preliminary efficacy of the BSM intervention with women initiating breastfeeding. Recruitment of 60 women intending to breastfeed occurred within 48 hr of delivery and women were randomized to either the intervention or usual care group. The BSM intervention group received BSM education modules that included information of how to manage breast and nipple pain and self-management support through biweekly texting from the study nurse, and were asked to complete a daily breastfeeding journal. Primary outcomes measured at baseline, 1, 2, and 6 weeks will be used to (a) evaluate feasibility, acceptability, and preliminary efficacy of the BSM intervention, and (b) assess the influence of protective and risk factors of breastfeeding pain (including individual genetic polymorphisms related to pain sensitivity) on process variables for self-management of breastfeeding and breastfeeding pain, and on proximal (breastfeeding pain severity and interference, breastfeeding frequency) and distal outcomes (breastfeeding exclusivity and duration and general well-being).

A combination of mupirocin and acidic fibroblast growth factor for nipple fissure and nipple pain in breastfeeding women: protocol for a randomised, double-blind, controlled trial

IntroductionNipple fissure and nipple pain are common complaints among breastfeeding mothers. Studies found that mupirocin was effective in preventing and treating infections of damaged nipple and nipple pain. Acidic fibroblast...

Efficacy of a Breastfeeding Pain Self-Management Intervention: A Pilot Randomized Controlled Trial.

Over 90% of women experience pain during breastfeeding initiation and lack strategies to self-manage breast and nipple pain. Guided by the Individual and Family Self-Management Theory, a breastfeeding self-management (BSM) intervention targeted women's knowledge, beliefs, and social facilitation to manage their breast and nipple pain and achieve their breastfeeding goals. The purpose of this longitudinal pilot randomized control trial (RCT) was to test the preliminary efficacy of the BSM intervention on general and specific pain related to breastfeeding. Sixty women intending to breastfeed were approached within 48 hours of delivery to participate in this pilot RCT (30 randomized to the BSM intervention and 30 randomized to the control group). All participants provided baseline data before discharge and pain and breastfeeding measures at 1, 2, and 6 weeks. Participants in the BSM intervention group received educational modules addressing breast and nipple pain and biweekly, text-based nurse coaching and completed a daily breastfeeding journal. Women in the BSM intervention group reported significantly less breast and nipple pain at 1 and 2 weeks using a visual analog scale (p < .014 and p < .006) and at 2 weeks using the Brief Pain Inventory intensity scale (p < .029), but no difference in breastfeeding duration. The BSM intervention pilot demonstrates a positive effect on breastfeeding specific and overall generalized pain. Future investigation is needed to identify at-risk women of ongoing breastfeeding pain and develop precision interventions to sustain this beneficial health behavior for mothers and infants.

Assessment of the Efficacy of An Osteopathic Treatment in Infants with Biomechanical Impairments to Suckling.

Breastfeeding can be challenging for mother-infant dyads experiencing biomechanical suckling difficulties. Although lactation consultants (LCs) all over the world have increased their skills in this field and can provide support to help position the infant at the breast, the impact of their intervention might be limited in the presence of stiff structures in the infants. Here we present a protocol for a randomized controlled trial to assess the efficacy of osteopathic treatment, coupled with lactation consultation, for infants' biomechanical suckling difficulties. It proposes a set-up and a sequence of actions to ensure an optimal context for treatment, as well as a blinding of parents and LCs to the intervention. Data such as the infant's latch ability measured with the LATCH Assessment Tool, the mother's nipple pain with a visual analog scale (VAS), and the mother's perceptions are collected by LCs four times over a 10-day period. Osteopathic lesions are documented by the osteopath, using a standardized assessment grid. Structures of interest are coherent with the anatomical zones involved in latching onto the breast. This protocol also proposes a strategy to document systematically an osteopathic profile of infants with biomechanical suckling difficulties in their first weeks of life. The implementation of this protocol confirms its feasibility for osteopathic assessment and treatment and paves the way for future trials to further explore the efficacy of osteopathic techniques for infants with biomechanical suckling difficulties.

Natural latex-glycerol dressing to reduce nipple pain and healing the skin in breastfeeding women.

Nipple pain is the second most common reason for early weaning, exceeded only by the insufficient milk supply. Nipple fissures can bring other problems, acting also as a portal for bacteria and leading to mastitis. This work proposes the breast protector composite development using materials with tissue repair and moisturizing properties, aligned with a low-cost procedure, aiming not only to relieve pain, but also to heal the nipple fissures caused by breastfeeding. For the dressings, production was used Natural Latex extracted from the rubber tree and glycerol. The Samples were evaluated chemically and physically by the techniques of Scanning Electron Microscopy, Fourier transform infrared spectroscopy, mechanical traction, and contact angle. The samples were also biologically evaluated by the hemolytic and cytotoxic activity assays. From the physical-chemical assays, the matrix with glycerol has high pore density; the natural latex and glycerol do not covalently interact, indicating that the glycerol can be released; the glycerol addition makes the matrix more elastic but fragile, and increase the wettability. From the biological assays, both materials showed no hemolytic effects; and the cytotoxicity results showed that glycerol did not present cytotoxicity in the fibroblasts, but show a dose-dependent influence in the keratinocytes. The material developed for application in breast fissures has mechanical properties similar to those found for materials for dermal applications, present high wettability and pore density. Furthermore, the material showed no cytolytic activity and the tests with skin cell cultures demonstrated the biocompatibility.

Measurement tools and intensity of nipple pain among women with or without damaged nipples: A quantitative systematic review.

To describe and evaluate pain scales used to measure nipple pain in breastfeeding women and to identify nipple pain intensity in women with or without nipple damage. Nipple pain is one of the most common reasons given for premature cessation of breastfeeding. However, there are no agreed tools to measure pain and no previous reviews have provided summary estimates of pain scores. Systematic review. Medline, CINAHL, Scopus, Web of Science, SciELO, and LILACS. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The guiding question was: How is nipple pain in breastfeeding women measured and how severe is it? We analysed articles published up to February 2018, excluded review articles and those that did not present the level of nipple pain or tools to estimate pain severity. A total of 1,023 articles were identified and 25 were included in the review after applying the exclusion criteria. The Numeric Rating Scale (nine studies) and Visual Analogue Scale (seven studies) were the most prevalent tools for measuring pain. Using a pain score between 0-10, women with nipple damage reported a weighted mean of 6.2 in the first week and 5.8 after that period; women without damage reported a weighted mean of 2.7. Women with nipple damage consistently reported a higher level of pain than women without damage. To prevent premature cessation of breastfeeding, it is important to help new mothers avoid nipple damage.