471 No specific treatment beneficial for painful nipples among breastfeeding women

January 01, 2016

written by Brian R McAvoy

Clinical question
How effective are interventions for treating painful nipples among breastfeeding women?

Bottom line
There was insufficient evidence that glycerine gel dressings, breast shells with lanolin, lanolin alone or the all-purpose nipple ointment significantly improved maternal perceptions of nipple pain. Applying nothing or just expressed breast milk may be equally or more beneficial in the short-term experience of nipple pain than the application of an ointment such as lanolin. Regardless of the treatment used, for most women nipple pain reduced to mild levels by approximately 7 to 10 days' postpartum. There was a lack of clarity regarding the effect of breastfeeding education and corrective instruction in the treatment of damaged nipples or as a control condition.

Caveat
All 4 trials compared varying interventions, participants, study outcome measures and standards of usual care. The methodological quality of the included studies was good, but the overall quality of the evidence for the primary outcome of nipple pain was of low quality, mainly because single studies with few participants contributed data for analysis.

Context
Although the health benefits of breastfeeding are well established, many women discontinue breastfeeding within the first few weeks of giving birth. One common reason is painful nipples.

Cochrane Systematic Review
Dennis CL et al. Interventions for treating painful nipples among breastfeeding women. Cochrane Reviews, 2014, Issue 12. Art. No.: CD007366.DOI: 10.1002/14651858. CD007366.pub2. This review contains 4 studies involving 656 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.