Nipple pain during breastfeeding with or without visible trauma.
BACKGROUND
Nipple pain is a major cause of early weaning. The causes of nipple pain are diverse, and most treatments involve experience-based assessment. There is little knowledge of the intensity or variation in pain experienced by breastfeeding women. Given the high breastfeeding initiation rates, it is important to evaluate pain experienced by lactating women in detail.


OBJECTIVE
To investigate and compare the pain experienced by breastfeeding women using objective measures.


METHODS
The type, effect, and severity of pain were measured using the McGill Pain Questionnaire, Brief Pain Inventory, and Visual Analogue Scale, respectively, for 2 groups of breastfeeding women. One group were experiencing persistent nipple pain despite treatment, and the other had obvious signs of nipple trauma.


RESULTS
Pain intensity and interference scores were highly variable for both groups. Mothers with nipple trauma reported significantly higher mean pain intensity and breastfeeding interference. Higher pain intensity scores were related to higher interference scores. After accounting for pain intensity, higher interference with general activity, mood, and sleep interference was related to longer duration of pain. There was no difference in MPQ class scores.


CONCLUSIONS
The ramifications of nipple pain extend far beyond the act of breastfeeding, particularly for women whose pain lasts several months. Given the lack of evidence-based treatments, it is not surprising that pain is a major contributor to premature weaning. Further research into the causes of nipple pain is necessary to enable the implementation of effective interventions, thus reducing further complications such as infection and postnatal depression. Detailed pain analysis may assist in assessing the success of these interventions.
Chemistry and Biochemistry, University of Western Australia.
Holly L
HL
McClellan
Anna R
AR
Hepworth
Catherine P
CP
Garbin
Marnie K
MK
Rowan
Jane
J
Deacon
Peter E
PE
Hartmann
Donna T
DT
Geddes
D000328:Adult; D001941:Breast Diseases / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D001942:Breast Feeding / Q000009:adverse effects* / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D009558:Nipples / Q000293:injuries / Q000473:pathology; D010146:Pain / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D010147:Pain Measurement; D057566:Self Report; D012720:Severity of Illness Index; D014886:Weaning