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Sore nipples are one of the most common complaints of
new mothers and are one of the most frequent reasons why
mothers stop breastfeeding sooner than they intend to (Riordan,
2005). Numerous methods of healing sore and cracked nipples
have been used, including the application of human milk, tea
bags, Masse cream, lanolin cream, and breast shells. A
common therapeutic approach to sore nipples presently
consists of application of human milk, modified lanolin
(medical grade), and the wearing of breast shells. In none of
the published studies, however, has any method been
completely efficacious, and sore nipples remain a frustrating
clinical dilemma. This prompted the investigation of alternative
treatment methods and to test their safety and efficacy
(Jennifer et al., 2009).
The present study aimed to evaluate the effect of
pharmacological & non pharmacological methods on traumatic
nipples for lactating mothers. The study was carried out at the
Postnatal Inpatient Maternity Unit at Ain Shams University
Hospital. The study started on 17-5 2011 and ended in 17-5-2012. Purposive sample technique was used to recruit 150
lactating mothers suffering from nipple trauma based on the
following criteria: breastfeeding with painful and damaged
nipples during first three month after childbirth, different types
of delivery, different parity, medically diagnosed for damaged
nipples, and healthy (free from medical disease) women, with
A pilot study was conducted on 15 women (10% of the
total sample) to evaluate the applicability and reliability of the
constructed tools. The results obtained from the pilot study
were then used as a guide for any necessary modification of
the study title, setting, subjects, resources or data collecting
Data were collected through three tools : a) a structured
interview sheet developed to collect the mothers’ data and
knowledge; b) Visual Analogue Scale conducted to assess the
degree of pre/post intervention nipple pain; c) Nipple Trauma
Score (NTS) conducted to assess the degree of pre/post
intervention traumatic nipple.Mothers were randomly divided into 2 groups. The first
group used pharmacological method lanolin ointment; the
second group used nonpharmacological methods and diveded
into group A&B.group A used Teabag Compress while group
B used breast milk after each feeding for 14 days to relieve
The Researcher asked the subjects to rate the nipple
pain they experienced during breastfeeding by marking their
pain intensity level on a visual analog scale (VAS) form given
to them ranging from 0 (no pain) to 10 (most intense pain
imaginable). Then an assessment of nipple trauma score was
made through the description of the scores given on VAS.
Follow-up telephone interviews were conducted during
7th &14th days of intervention to assess the improvement and
any problems arising.
The study arrived at the conclusion that most of mothers
didn’t have any reaction toward nipple trauma in the first days
of delivery. The majority of mothers have poor knowledge of breastfeeding and traumatic nipple. It was also concluded that
lanolin, tea bag compress, and breast milk had the same effect
of relieving traumatic nipple.
In the light of the results of the study the researcher
1- Developing a counseling program for women during
pregnancy and immediate postpartum period about
prevention and treatment of traumatic nipple.
2- Establishing education center at inpatient postnatal unit in
the hospital to facilitate the follow-up of cases .
3-Establishing of breast feeding support group.
4- Conducting further research to determine the factors
affecting the treatment of nipple trauma
5- Carrying out more studies to assess the effect of
breastfeeding position on the occurrence of nipple trauma .