A systematic review of clinical trials in the treatment of sore nipple and nipple pain in breastfeeding women

Document Type : Review Article

Authors

1 M.Sc. student of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Assistant professor, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: Nipple fissure is one of the most common problems in breastfeeding women and the main reason for the early discontinuation of breastfeeding. Due to the importance of breastfeeding, the present study was performed with aim to review the clinical trials conducted on the treatment of sore nipple and nipple pain in breastfeeding women.
Methods: In this systematic review, all local databases were searched with the keywords of “sore nipple” and “clinical trial” and databases of Google Scholar, PubMed, ProQuest, Scopus, Science Direct and Medline with the keywords of “sore nipple” and “clinical trial” were searched to November 2015 with no time and language limitations. All the articles were reviewed based on the Jadad scale and those scoring ≥3 were selected. The results were reported qualitatively.
Results: A total of 14 articles meeting the inclusion criteria were ultimately examined. Among the treatments examined in these studies, Lanolin along with a nipple shield, Aloevera gel, menthol essence and warm compress led to more decrease in severity of pain and the fastest recovery of sore nipples.
Conclusion: Lanolin along with a nipple shield, Aloevera gel, menthol essence and warm compress are the most effective treatments for sore nipples. Nevertheless, a definitive judgment about the effectiveness of these interventions requires more accurate studies with adequate sample sizes. Studies conducted on sore nipples and their treatment are scattered and drawing conclusions about the interventions is not possible due to the limited number of studies.

Keywords

References

  1. Nazari R, Hossein Alipour S, Rashidae M, Sharifnia SH, Saatsaz S. Assay of suppressing factor of nutrition of newborn with mother milk in families referring to Amol city health centers. J Nurs Midwifery 2011; 28:33-8. (Persian).
  2. Boskabadi H, Ramazanzadeh M, Zakerihamidi M, Rezagholizade Omran F. Risk factors of breast problems in mothers and its effects on newborns. Iran Red Crescent Med J 2014; 16(6):e8582.
  3. de Jong C, Kikkert HK, Fidler V, Hadders‐Algra M. Effects of long‐chain polyunsaturated fatty acid supplementation of infant formula on cognition and behaviour at 9 years of age. Dev Med Child Neurol 2012; 54(12):1102-8.
  4. Cunningham FG. Williams obstetrics. New York: McGraw Hill Professional; 2014. P. 674.
  5. Tafazoli M, Saeedi R, Gholami Robatsangi M, Mazloom R. Aloevera gel Vs. Lanolin ointment in the treatment of nipple sore: a randomized clinical trial. Tehran Univ Med J 2010; 67(10):699-704. (Persian).
  6. Gungor AN, Oguz S, Vurur G, Gencer M, Uysal A, Hacivelioglu S, et al. Comparison of olive oil and lanolin in the prevention of sore nipplesin nursing mothers. Breastfeed Med 2013; 8(3):334-5.
  7. Melli MS, Rashidi MR, Delazar A, Madarek E, Maher MH, Ghasemzadeh A, et al. Effect of peppermint water on prevention of nipple cracks in lactating primiparous women: a randomized controlled trial. Int Breastfeed J 2007; 2(1):1-7. (Persian).
  8. Coca KP, Abrão AC. An evaluation of the effect of lanolin in healing nipple injuries. Acta Paul Enferm 2008; 21(1):11-6.
  9. Kazemirad M, Khodakarami N, Salamzadeh J, Nasiri N, Kazemi M, Moattar F. Comparison of calendit-e cream versus expressed breast milk. J Shahid Beheshti Nurs Midwifery 2013; 23(80):5380. (Persian).
  10. Tafazoli M, Ebrahimi A, Mohammad zadeh A, Esmaili H. Effect of breastfeeding technique modification on prevention of nipple sore. Iran J Obstet Gynecol Infertil 2015; 17(138):10-17. (Persian).
  11. Abou-Dakn M, Fluhr J, Gensch M, Wöckel A. Positive effect of HPA lanolin versus expressed breastmilk on painful and damaged nipples during lactation. Skin Pharmacol Physiol 2011; 24(1):27-35.
  12. Cadwell K, Turner-Maffei C, Blair A, Brimdyr K, Maja McInerney Z. Pain reduction and treatment of sore nipples in nursing mothers. J Perinatal Educ 2004; 13(1):29-35.
  13. Abd-Elsalam S, Hamido S, Abd el Hameed HS. Effect of using pharmacological versus alternative therapy on traumatic nipples for lactating mothers. J Am Sci 2011; 7(11):485-96.
  14. Cervellini MP, Gamba MA, Coca KP, de Vilhena Abrão AC. Injuries resulted from breastfeeding: a new approach to a known problem. Rev Esc Enferm USP 2014; 48(2):346-56.
  15. Marrazzu A, Sanna MG, Dessole F, Capobianco G, Piga MD, Dessole S. Evaluation of the effectiveness of a silver-impregnated medical cap for topical treatment of nipple fissure of breastfeeding mothers. Breastfeed Med 2015; 10(5):232-8.
  16. Buck ML, Amir LH, Donath SM. Topical treatments used by breastfeeding women to treat sore and damaged nipples. Clin Lactat 2015; 6(1):16-23.
  17. Amir LH, Donath SM, Garland SM, Tabrizi SN, Bennett CM, Cullinane M, et al. Does Candida and/or Staphylococcus play a role in nipple and breast pain in lactation? A cohort study in Melbourne, Australia. BMJ Open 2013; 3(3):1-8.
  18. Fraser DM, Cooper MA. Myles tex book for midwifery. Midwifery 2003; 33(3):11-7.
  19. Barakati SH, Sadonian S, Alaei S, Farivar M, Homayounfar N. Guide for breastfeeding, mothers' answers to common questions. Tehran: Ministry of Health and Medical Education; 2011. P. 1-67. (Persian).
  20. Spencer JP. Management of mastitis in breastfeeding women. Am Fam Physician 2008; 78(6):727-31.
  21. Branch-Elliman W, Golen TH, Gold HS, Yassa DS, Baldini LM, Wright SB. Risk factors for Staphylococcus aureus postpartum breast abscess. Clin Infect Dis 2012; 54(1):71-7.
  22. McClellan HL, Hepworth AR, Kent JC, Garbin CP, Williams TM, Hartmann PE, et al. Breastfeeding frequency, milk volume, and duration in mother–infant dyads with persistent nipple pain. Breastfeed Med 2012; 7(4):275-81.
  23. McClellan HL, Hepworth AR, Garbin CP, Rowan MK, Deacon J, Hartmann PE, et al. Nipple pain during breastfeeding with or without visible trauma. J Hum Lact 2012; 28(4):511-21.
  24. Mohammadzadeh A, Farhat A, Esmaeily H. The effect of breast milk and lanolin on sore nipples. Saudi Med J 2005; 26(8):1231-4.
  25. 25.Alamolhoda SH, Aliakbari SA, Akbarzadeh Baghban A, Esmaeili S. Effect of aloe vera gel on breast fissures in breastfeeding women. Pajoohandeh J 2014; 19(1):13-7. (Persian).
  26. Jadad AR, Moore R, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996; 1(17):1-12.
  27. Ganji G, Keramat A, Ahmad Shirvani M. Effect of acupressure on labor pain relife: a systematic review of clinical trials. Iran J Obstet Gynecol Infertil 2014; 17(119):8-17. (Persian).
  28. Chaves ME, Araújo AR, Santos SF, Pinotti M, Oliveira LS. LED phototherapy improves healing of nipple trauma: a pilot study. Photomed Laser Surg 2012; 30(3):172-8.
  29. Ziemer MM, Cooper DM, Pigeon JG. Evaluation of a dressing to reduce nipple pain and improve nipple skin condition in breastfeeding women. Nurs Res 1995; 44(6):347-51.
  30. Gosha JL, Tichy AM. Effect of a breast shell on postpartum nipple pain: an exploratory study. J Nurse Midwifery 1988; 33(2):74-7.
  31. Brent N, Rudy SJ, Redd B, Rudy TE, Roth LA. Sore nipples in breast-feeding women: a clinical trial of wound dressings vs conventional care. Arch Pediatr Adolesc Med 1998; 152(11):1077-82.
  32. Lavergne NA. Does application of tea bags to sore nipples while breastfeeding provide effective relief? J Obstet Gynecol Neonatal Nurs 1995; 26(1):53-8.
  33. Centuori S, Burmaz T, Ronfani L, Fragiacomo M, Quintero S, Pavan C, et al. Nipple care, sore nipples, and breastfeeding: a randomized trial. J Hum Lact 1999; 15(2):125-30.
  34. Hewat RJ, Ellis DJ. A comparison of the effectiveness of two methods of nipple care. Birth 1987; 14(1):41-5.
  35. Pugh LC, Buchko BL, Bishop BA, Cochran JF, Smith LR, Lerew DJ. A comparison of topical agents to relieve nipple pain and enhance breastfeeding. Birth 1996; 23(2):88-93.
  36. Dennis CL, Schottle N, Hodnett E, McQueen K. An all-purpose nipple ointment versus lanolin in treating painful damaged nipples in breastfeeding women: a randomized controlled trial. Breastfeed Med 2012; 7(6):473-9.
  37. Riordan J. The effectiveness of topical agents in reducing nipple soreness of breastfeeding mothers. J Hum Lact 1985; 1(3):36-41.
  38. Akbari SA, Alamolhoda SH, Baghban AA, Mirabi P. Effects of menthol essence and breast milk on the improvement of nipple fissures in breastfeeding women. J Res Med Sci 2014; 19(7):629-33.
  39. Vieira F, Bachion MM, Mota DDC, Munari DB. A systematic review of the interventions for nipple trauma in breastfeeding mothers. J Nurs Scholarsh 2013; 45(2):116-25.
  40. Duffy EP, Percival P, Kershaw E. Positive effects of an antenatal group teaching session on postnatal nipple pain, nipple trauma and breastfeeding rates. Midwifery 1997; 13(4):189-96.
  41. Jacobs A, Abou-Dakn M, Becker K, Both D, Gatermann S, Gresens R, et al. S3-Guidelines for the Treatment of Inflammatory Breast Disease during the Lactation Period: AWMF Guidelines, Registry No. 015/071 (short version) AWMF Leitlinien-Register Nr. 015/071 (Kurzfassung). Geburtshilfe Frauenheilkd 2013; 73(12):1202-8.
  42. Api M, Siviri D, Api O, Gorgen H, Cetin A, Yayla M. Prevention of nipple cracks with guaiazulene versus breast milk in nursing mother: a randomized, controlled, double-blind trial. J Turkish German Gynecol Assoc 2005; 6(4):279-84.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 19, Issue 6
April 2016
Pages 22-33

Files

Share

How to cite

Statistics