http://www.ama-assn.org/sci-pubs/journals/archive/ajdc/vol_152/no_11/poa8161a.htm

<a
href="http://www.ama-assn.org/sci-pubs/journals/archive/ajdc/vol_152/no_11/poa8161a.htm">Sore
Nipples in Breastfeeding Women</a> from Arch of Ped.

Abstracts - November 1998

                  Sore Nipples in Breast-feeding Women

                  A Clinical Trial of Wound Dressings vs Conventional
Care

                  Nancy Brent, MD, IBCLC; Sherrill J. Rudy, MSN, RN,
CPNP; Beverly
                  Redd, IBCLC; Thomas E. Rudy, PhD; Lillian A. Roth,
RN, BSN, FACCE,
                  IBCLC

                  Background: Sore nipples in breast-feeding mothers
are a common cause of premature weaning, and are difficult to treat
owing
to recurrent trauma and  exposure to the infant's oral flora.

                  Objective: To compare the safety and efficacy of a
hydrogel moist wound dressing (Elasto-gel, Southwest Technologies Inc,
Baltimore, Md) with the use of breast shells and lanolin cream in the
treatment
of maternal sore nipples associated with breast-feeding.

                  Design: Randomized controlled trial comparing the
above treatments for sore nipples. Patients were seen for a maximum of
3
follow-up visits within 10 days, or until the resolution of symptoms.

                  Setting: The Maternal-Infant Lactation Center at the
Mercy Hospital of Pittsburgh, Pittsburgh, Pa, a tertiary care teaching
hospital in inner-city Pittsburgh.

                  Patients: A referred sample of 42 breast-feeding
women who presented to the Maternal-Infant Lactation Center for the
treatment of sore nipples. All patients with breast infection or
chronic unrelated
pain conditions were excluded from the study.

                  Intervention: After informed consent, patients were
randomized to receive either a hydrogel wound dressing or breast
shells
and lanolin. All patients underwent a history, physical examination of
the
infant and the mother's breasts, assessment of breast-feeding
technique, and
breast-feeding instruction.

                  Main Outcome Measures: The degree of pain on
self-report questionnaires and the change in scores for physical
examination,
breast-feeding technique, and pain behaviors during breast-feeding.

                  Results: Although both treatments, in association
with instruction in breast-feeding technique, were effective, greater
improvement was seen in the group using breast shells and lanolin.
This
reached statistical significance for physician-rated healing (P<.01)
and
self-reported pain (P<.05). There were significantly more infections
in the dressing
group (P<.05), which resulted in early discontinuation of the study.

                  Conclusions: Prevention of sore nipples by teaching
proper technique on the initiation of breast-feeding should be
instituted.
For those cases in which sore nipples do develop, breast shells and
lanolin in
association with instruction in breast-feeding technique are more
effective than
moist wound dressings.  Lanolin and shells should remain first-line
therapy.

                  Arch Pediatr Adolesc Med. 1998;152:1077-1082


*********

Cable, B, et.al.  Nipple wound care: a new approach to an old
problem.  J Hum Lact 13(4), 1997: 313-318.

*****

~Andrea

--
--
Andrea Eastman, MA, CCE, IBCLC
Granville, Ohio
mailto:[log in to unmask]

Gentle Birth Alternatives
http://www.geocities.com/HotSprings/8978
http://www.breastfeeding.com/andrea_eastman.html