Hi all!
I'm coming up for air (am in the midst of 2nd term of grad school in a nurse
practitioner program) to comment on an article that was assigned reading in
our research class.It is in the Nov/Dec. '95 issue of Nursing Research. We
are to read it not because of content but to look at variables, extraneous,
indepdent, dependent, etc, etc.

I think it is bizarre. The article reported on research which was to explore
whether the use of a polyethylene film dressing might improve nipple skin
condition and reduce nipple pain during the first week of breastfeeding. (It
didn't work, by the way but the authors still think this medical approach is
important.) One assumption is that 65% of women develop visible eschar and
the same author wrote in 1993 on this "fact". No, I am not a tissue expert.
 And maybe we can get some help from one for our serious nipple problem
patients, but to assume that nipple pain is to be expected is not what most
of us are preaching. They cite Marmet, Minchin, Walker, but the authors say
there are no studies to support proper positioning as means of prevention of
pain.

Are there really no studies to support the fact that better positioning of
mother and infant and correct latch-on prevent painful breastfeeding?

 I find thisis disturbing because those who read it are nurses and it only
reinforces what I consider incorrect information among a group that is
already lacking in info much of the time. (Not those of you who like me have
updated ourselves.)

 We have not discussed this yet in class and I will do my bit by mentioning
the extraneous variables that are not considered,  like incorrect latch-on,
improper positioning, tongue action of infant, separation of mother and baby,
use of pacifiers, and (do epidurals cause swelling of the nipple?) etc.

I don't have time to search my files for  research studies to support our
position.
Is part of our problem that nursing schools are still not teaching about
lactation? Maybe I need to change my research proposal. Any feedback? Please
read it if you can get ahold of it.

If so, please e-mail me privately too, because I cannot stay on Lactnet.
Physical assessment class, and two papers are calling!

Cindy of Lansing, MI--  MSU grad student