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Interventions to treat painful nipples in lactating women.

Interventions to treat painful nipples in breastfeeding women.

Although the health benefits of breastfeeding are clear, many women stop breastfeeding within the first few weeks after having a baby. One of the common reasons for stopping breastfeeding is painful nipples.

Research characteristics.

We searched the Cochrane Pregnancy and Childbirth Group clinical trial databases for clinical trials evaluating methods (interventions) to relieve nipple pain in lactating women in September 2014. We also looked at rates of nipple healing and infection, duration of breastfeeding, whether babies received only breast milk, and whether mothers were satisfied with the treatment of nipple problems and breastfeeding in general. Interventions included medication (against bacteria that can come from [child’s] mouth, spray and ointment; fungal infections), non-drug treatments (lanolin, petroleum jelly, peppermint oil, glycerin), dressings, nipple guards (pads), phototherapy, or applying expressed milk.

Interventions were compared with each other or with conventional assistance (control).

Main results.

We found four clinical trials of good methodological quality, involving 656 women, in which five different interventions were evaluated, including glycerin pads, lanolin with breast pads, lanolin only, expressed breast milk, and universal nipple ointment. All studies included teaching the correct position of the infant at the breast as part of routine care in both intervention and control groups.

There is currently insufficient evidence to recommend any particular type of treatment for breastfeeding women with painful nipples. These results suggest that avoiding or applying expressed milk may be equivalent to or more beneficial for short-term nipple pain than applying an ointment such as lanolin. One important finding from this review was that regardless of the treatment used, most women had moderate nipple pain around 7-10 days after birth (postpartum)..

Quality of evidence.

The quality of the evidence in this review did not allow for reliable conclusions

regarding the treatment of nipple pain. We found only four small clinical trials, and all four trials compared different interventions, different participants, different metrics, and standard of care routine. Although the methodological quality of the included studies was good, overall, the quality of the evidence for the primary outcome of nipple pain was low, mainly due to single studies with a small number of participants who were able to use the data for analysis..

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