Initial nipple damages in breastfeeding women: analysis of photographic images and clinical associations.
Bárbara Tideman Sartorio Camargo, Adriana Sañudo, Denise Miyuki Kusahara and 1 others
PMID 38088688WHAT IT FOUND
Breastfeeding women in the early postpartum period had moderate nipple pain during feeding.
Bigger nipple damage was associated with a higher tissue-damage score, but pain was not significantly associated with damage degree.
Key findings
01Moderate nipple pain was reported during breastfeeding: median score 5, where 0 means no pain and 10 means worst pain imaginable.
02Larger nipple damage size was significantly associated with higher tissue-damage score: median 5 mm for NTS 2 and 9 mm for NTS 3 (p<0.001).
03Nipple pain was not significantly associated with tissue-damage degree: median pain 7 for NTS 2 and 5 for NTS 3 (p=0.055).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a secondary analysis of photographs and clinical data from two earlier randomized trials, not a treatment trial, so it cannot show that any intervention changed nipple damage or pain. The final sample was convenience-based and limited to the first two postpartum days; 30 women and 66 images were excluded for unclear photographs, so it may not represent all breastfeeding women or later postpartum periods. The analysis did not know the day nipple damage started, only the postpartum day of inclusion, which could affect how damage and pain are interpreted. Tissue-damage classification was done from photographs by two lactation consultants using a translated score, not by direct live examination at the bedside.
The easy way to misread this
Do not conclude that treating nipple damage size or tissue-damage score will reduce pain or early breastfeeding cessation. This was an observational image analysis, not a treatment trial, and pain was not significantly associated with damage degree.