Nipple Pain in Breastfeeding Mothers: Incidence, Causes and Treatments

Abstract

Background: Persistent nipple pain is one of the most common reasons given by mothers for ceasing exclusive breastfeeding. We aimed to determine the frequency of nipple pain as a reason for consultation, the most common attributed aetiologies, and the effectiveness of the advice and treatment given. Methods: All consultations at the Breast Feeding Centre of Western Australia (WA) were audited over two six-month periods in 2011 (n = 469) and 2014 (n = 708). Attributed cause(s) of nipple pain, microbiology results, treatment(s) advised, and resolution of pain were recorded. Results: Nipple pain was one of the reasons for consultation in 36% of cases. The most common attributed cause of nipple pain was incorrect positioning and attachment, followed by tongue tie, infection, palatal anomaly, flat or inverted nipples, mastitis, and vasospasm. Advice included correction of positioning and attachment, use of a nipple shield, resting the nipples and expressing breastmilk, frenotomy, oral antibiotics, topical treatments, and cold or warm compresses. Pain was resolving or resolved in 57% of cases after 18 days (range 2–110). Conclusion: The multiple attributed causes of nipple pain, possibly as a result of a cascade of events, suggests that effective early lactation management for prevention of nipple pain and early diagnosis and effective treatment are crucial to avoid early weaning.

Acompanhamento fonoaudiológico do aleitamento materno em recém-nascidos nas primeiras horas de vida

“…Breastfeeding also prevents the installation of deleterious oral habits, such as the use of pacifiers and digital suction (10,28) , in addition to enabling the extension of the link (9) and the stimulation of the hearing and the language of the NB (17) .…”

“…Currently, there are numerous breastfeeding promotion campaigns that seek support for mothers and their families from the prenatal period. Direct interventions with the dyads at the beginning of lactation have been shown to be fundamental for a longer duration of this practice (1,8,9) . However, early weaning rates are still alarming in developing countries (10) .…”

“…The identification of the risk factors for failure to breastfeed contributes to the definition of behaviors to be used in the management, as well as to delimit which specific knowledge is important to be emphasized among the population (3) . The literature refers to studies carried out with the aim of identifying risk factors for breastfeeding, discussing aspects involving anatomy (3,9,14) , physiology (1,3,9,11,14) , social and cultural issues (1,3,10,14,15) . However, the effects of the speech-language interventions performed through the follow-up of the breastfeeding in the mother-RN dyads have not been discussed.…”

Mastitis. Puesta al día

“…9,14,28,47,48 Se ha documentado, fundamentalmente, en el campo de la veterinaria; de hecho, aparece citada en 1093 artículos, solo 32 referidos a mujeres (acceso PubMed el 21-03-2016) y, salvo un único artículo, 49 los restantes casos se han descrito en mujeres de países en desarrollo, con malas condiciones nutricionales y/o infectadas por virus de la inmunodeficiencia humana (VIH).…”

“…28,39,48 Se ha aislado esta bacteria en la leche del 20% de mujeres con dolor crónico de pecho frente al 2% en la leche de los controles y se ha constatado la mejoría clínica con antibióticos. 7 Varios autores no encontraron relación entre SCN y el dolor crónico de pecho.…”