Literature review for - Flourish Paediatrics

IV
Breastfeeding: common problems and their management
Hygiene
Nipple Pain and trauma
Search results
The initial search of the databases included 146 references on nipple pain/trauma during
breastfeeding. Data were extracted from 25 references, and 2 publications were used to form
the final body of evidence statements. Sufficient evidence was found to make statements on
the treatment of nipple pain in lactating women and on the prevention of nipple pain in
lactating women. Additional evidence was found on the incidence of nipple pain (2 narrative
reviews), but the evidence was not strong enough to develop a body of evidence statement.
TREATMENT FOR NIPPLE PAIN/TRAUMA DURING LACTATION
What are the best forms of treatment for women who experience nipple pain/trauma
during lactation?
Draft Evidence statement
Grade
Component Rating Notes
No single intervention offers a significant improvement
in the symptoms or duration of nipple pain/trauma
D
Evidence Base Satisfactory 2 Systematic reviews (overlap between studies, 16
RCTs and quasi-experimental studies in total) of high
quality.
Consistency
Satisfactory Both reviews concluded that no single pharmacological
or non-pharmacological method offered a significant
effect in terms of treating nipple pain/trauma in
breastfeeding women.
Clinical impact Poor No trial provides sufficient evidence on any intervention
to justify widespread uptake of that intervention.
Generalisability
Applicability
Satisfactory Majority of studies conducted in developed countries,
including Australia
Satisfactory Results are applicable to Australian women
The studies included in the body of evidence statement are shown in the Table below.
The systematic literature review on nipple pain management methods conducted in 2003
included 12 studies comparing education, water compress, breast milk, warm compress,
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