A comparison of topical agents to relieve nipple pain and enhance breastfeeding.

BACKGROUND: Nipple soreness is one reason why breastfeeding women wean their infants. This study examined the effectiveness of three topical agents--USP-modified lanolin, warm water compresses, and expressed breast milk with air drying--in alleviating nipple pain, and if early predictors of breastfeeding at six weeks could be determined. METHODS: One hundred seventy-seven breastfeeding, primiparous women were randomly assigned to one of four groups. All women received education about breastfeeding technique. Numeric rating scales were used to discriminate levels of pain intensity, pain affect, and strength of sucking on day 1. Participants were interviewed by telephone on postpartum days 4, 7, and 14, and during week 6 using the same scales. RESULTS: No significant differences were found among groups for pain intensity, pain affect, or duration of breastfeeding. Results of a logistic regression indicated that older mothers and those who were exclusively breastfeeding (no supplemental feeding) were most likely to be breastfeeding six weeks postpartum. Raw scores supported the use of warm compresses. CONCLUSION: Further investigation is required into ways of supporting young mothers and how caregivers provide support to breastfeeding mothers in the early weeks after childbirth.

Comfort measures in breastfeeding, primiparous women.

OBJECTIVE: To examine various comfort measures and evaluate their effects in alleviating nipple soreness. DESIGN: Prospectively randomized, experimental study. SETTING: Postpartum unit of a community teaching hospital. PATIENTS: Seventy-three primiparous, postpartum, breastfeeding women. INTERVENTIONS: Subjects were randomly assigned to four groups, with all women receiving instruction about breastfeeding and using one of the following treatments: warm moist tea bag compress, warm water compress, expressed milk massaged into the nipple and areola and air dried, instruction only (control group). The subjects completed a questionnaire each morning for 7 days regarding nipple soreness. MAIN OUTCOME MEASURE: Effect of treatments on postpartum nipple pain. RESULTS: Subjects in the warm water compress group demonstrated significantly less pain on Day 3 than did the tea or breast milk group. CONCLUSIONS: Anticipatory guidance by obstetric nurses may assist breastfeeding women in treating their pain nonpharmacologically.

PIP: The authors conducted a study to evaluate the effects of various comfort measures in alleviating nipple soreness in 73 breastfeeding, postpartum, primiparous women in the postpartum unit of a community teaching hospital. The women were randomly assigned to four groups, with all receiving instructions about breastfeeding and using one of the following treatments: warm moist tea bag compress, warm water compress, expressed milk massaged into the nipple and areola and air dried, and instruction only for the control group. Each completed a questionnaire each morning for seven days on nipple soreness to assess the effect of treatments on postpartum nipple pain. Subjects in the warm water compress group experienced significantly less pain on Day 3 than the tea or breast milk group. The authors hold that obstetric nurses might anticipate the potential for women in such circumstances to experience nipple pain and recommend this nonpharmacological therapeutic approach.