title: Effect of peppermint water on prevention of nipple cracks in lactating primiparous women: a randomized controlled trial.
abstract: BACKGROUND
  Nipple pain and damage in breastfeeding mothers are common causes of premature breastfeeding cessation. Peppermint water is popularly used for the prevention of nipple cracks in the North West of Iran. The aim of this study was to determine the effectiveness of peppermint water in the prevention of nipple cracks during breastfeeding in comparison with the application of expressed breast milk (EBM).
  
  
  METHODS
  One hundred and ninety-six primiparous breastfeeding women who gave birth between February and May 2005 in a teaching hospital in Tabriz, Iran, were randomized to receive either peppermint water or EBM. Each woman was followed for up to three visits or telephone calls within 14 days and then by telephone call at week six postpartum.
  
  
  RESULTS
  Women who were randomized to receive peppermint water were less likely to experience nipple and areola cracks (9%) compared to women using EBM (27%; p < 0.01). Women who used the peppermint water on a daily basis were less likely to have a cracked nipple than women who did not use peppermint water (relative risk 3.6, 95%CI: 2.9, 4.3). Nipple pain in the peppermint water group was lower than the expressed breast milk group (OR 5.6, 95% CI: 2.2, 14.6; p < 0.005).
  
  
  CONCLUSIONS
  This study suggests that peppermint water is effective in the prevention of nipple pain and damage. Further studies are needed to assess the usefulness of peppermint water in conjunction with correct breastfeeding techniques.
authors: Department of Obstetrics & Gynecology, Alzahra Teaching Hospital, South Artesh Avenue, Tabriz University of Medical Sciences, Tabriz, Iran. manizheh_610@yahoo.com
authors: Manizheh
authors: M
authors: Sayyah Melli
authors: Mohammad Reza
authors: MR
authors: Rashidi
authors: Abbas
authors: A
authors: Delazar
authors: Elaheh
authors: E
authors: Madarek
authors: Mohammad Hassan
authors: MH
authors: Kargar Maher
authors: Alieh
authors: A
authors: Ghasemzadeh
authors: Kamran
authors: K
authors: Sadaghat
authors: Zohreh
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authors: Tahmasebi