Literature review for - Flourish Paediatrics

lanolin, aerosol spray, ointment, firm dressing, tea-bag compress, hydrogel dressing, breast
shells or oral cloxacillin/erythromycin use in the treatment on nipple pain/trauma. After
reviewing the literature the authors summarized the evidence for the treatment of nipple
pain/trauma; water compresses reduced nipple pain (one level II study), expressed breastmilk
reduced duration of cracked nipples (one level II study), hydrogen dressings were associated
with a high incidence of infection (one level II study), systemic antibiotics are recommended
if a positive culture for Staphylococcus is obtained (one level II study), tea bags may change
the smell of the nipple (one level IV study), film dressings reduced eschar and nipple pain
and a low level of satisfaction were reported with film dressing (one level IV study). In
conclusion there was limited evidence to identify a single intervention that would offer a
significant improvement in the treatment of nipple pain/trauma however there is a potential
for some intervention to reduce pain and increase comfort and thereby increase breastfeeding
duration (Page, Lockwood et al. 2003).
The systematic literature review on prevention and therapies for nipple pain conducted in
2006 included 7 trials comparing water compress, breast milk, lanolin, collagenase, glycerin
gel, dexpanthenol, vitamin A, tea-bag compress, glycerin gel therapy and breast shells use in
the treatment of nipple pain/trauma. From the findings, the authors deduced that no one
topical agent showed superior results in the relief of nipple discomfort. The authors highlight
the most important factor in decreasing the incidence of nipple pain is the provision of
education for proper breastfeeding technique and latch-on as well as anticipatory guidance
with regard to the high incidence of early postpartum nipple pain (Morland-Schultz and Hill
2005).
Neifert’s review on the clinical aspects of lactation provides further recommendation for the
routine treatment of sore nipples suggesting mothers remove surface moisture after feeding
and avoid excessive drying that can crack or damage the skin (Neifert 1999).
PREVENTION OF NIPPLE PAIN/TRAUMA IN LACTATING WOMEN
What interventions are recommended for the prevention of nipple pain/trauma during
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