Literature review for - Flourish Paediatrics

Mothers were interviewed in
the immediate postpartum
period (usually in the first 48
h) in the maternity ward.
Mothers who were discharged
home early were interviewed
at home. Telephone
interviews were conducted
when the infants were 1, 2, 3,
6, 9 and 12 mo of age.
instructed to avoid any
physical (eg massage),
chemical (eg cream),
mechanical (eg shield) method
of nipple care.
Control group used an
ointment at onset of nipple
pain.
Interview at discharge,
telephone interview at 2 weeks
and 3 mo postpartum
structured one-to-one
postpartum positioning &
attachment education.
Control group received
usual postpartum care.
Nipple pain/trauma assessed
daily in hospital and
telephone interview follow
up at 6 weeks, 3 mo, 6 mo
postpartum.
Quality P P P P
Results
8/242 (2%) women stopped
breastfeeding by 12 months
due to sore nipples. (more
than one reason could have
been given)
No difference was found
between the intervention and
control group in the incidence
of sore and cracked nipples. At
two weeks postpartum
intervention group 73% vs.
control group 76%
None of the mothers who had
stopped breastfeeding by 3
months had done so because of
sore nipples.
Early infant care practices
associated with a higher
incidence of nipple soreness
(with the control and
intervention group analysed
together) were the use of a
Counselling on positioning
and attachment and
subsequent assessment of
breastfeeding decreased the
proportion of nipple pain in
first-time mothers during
the first few days in
hospital.
Day 2 postpartum:
intervention group 39% vs.
control group 62%
Day 3 postpartum:
intervention group 51% vs.
control group 68%.
No difference between
groups at 6 weeks, 3 mo and
6 mo.
Face-to-face interview at
first days postpartum.
Telephone interviews at
1,2,3,6,9 & 12 months
postpartum
Sore nipples in the first
month were associated
with an increased risk of
mastitis Adjusted OR
2.07 (1.17,3.66)
159