Factors associated to nipple trauma in lactation period: a systematic review

Abstract

Objectives: To identify the characteristics associated to nipple trauma in nursing mothers

Prevalence of nipple traumas and related factors among post-partum women assisted in a teaching hospital

“…More than half of the postpartum women did not exercise paid activities, similar to the percentage found in other studies, ranging from 56 to 75%. 9,[17][18] The fact of working outside home is still a controversial issue in literature. Working outside home behaved as a protective factor for breast problems.…”

“…6,7 Nipple trauma occurs most often in the maternity ward or even in the first seven days postpartum, and, according to the literature, the prevalence varies from 11 to 96%, with a mean frequency of 43.6 to 46.9%. 8,9 It is noted that 80 to 96% of women report breast pain or discomfort in the first weeks after delivery and 26% report extreme or unbearable pain, and trauma-related pain may be one of the precipitating weaning factors. 7,10 In addition to the pain caused and the risk of weaning, nipple trauma is also associated with maternal depression and anxiety, and is a determinant factor for the occurrence of puerperal mastitis.…”

“…11 Statistical significance was observed when investigating the risk factors for trauma: primiparity; mothers of race/white or yellow color; absence of a fixed partner; presence of trauma in previous breastfeeding; anesthesia during labor; gestational age between 37 and 40 weeks; do not breastfeed in the first hour of life; presenting semi-protruding and/or malformed (inverted or pseudo-inverted) and/or depigmented nipples; breast engorgement and/or turgid breasts; breast pain; mastitis; use of pumps to extract milk; use of oils, creams and ointments applied on the nipple; use of intermediaries and pacifiers (pacifiers and bottle) and wet linings, in addition to the grip and erroneous positioning of the neonate. [8][9][10]12 The literature points out that inadequate positioning of the infant during breastfeeding (twisted neck, a child far from the mother's breast and the inward-facing lip during sucking) may determine the occurrence of nipple trauma. The follow-up/ supervision of breastfeeding is a protective factor, as well as having received guidelines on breastfeeding during prenatal care.…”

“…Furthermore, breastfeeding in the newborn's first hour of life and a partner's presence are described as protective factors for trauma. 9 The early identification of nipple traumas and their prompt treatment, the verification of possible risk factors associated with this occurrence, and the implementation of care and educational measures during the hospitalization of the mother and the newborn in the rooming-in (before discharge) are paramount for the prevention of nipple trauma and early weaning. Given the relevance and negative impacts of early weaning on the health of children and mothers, and the influence of nipple trauma in this occurrence, it is justified to carry out this study.…”

Herbal prevention and treatment of nipple trauma and/or pain in Iranian studies: a systematic review

“…Nipple traumas are characterized by the presence of pain sensation in suction lesions of nipple which includes edema, erythema, fissures, cracks, blisters, abrasions and ecchymosis associated with breast feeding (5)(6)(7). It is located around the base of the nipple and frequently found at the top part of the nipple which involves dermis and epidermis (8). Nipple trauma confronts breastfeeding women 3-6 days postpartum and in some mothers may persist to 6 weeks after delivery (9,10).…”