title: Nipple pain, damage, and vasospasm in the first 8 weeks postpartum.
abstract: BACKGROUND
  Nipple pain and damage are common in the early postpartum period and are associated with early cessation of breastfeeding and comorbidities such as depression, anxiety, and mastitis. The incidence of nipple vasospasm has not been reported previously. This article describes nipple pain and damage prospectively in first-time mothers and explores the relationship between method of birth and nipple pain and/or damage.
  
  
  METHODS
  A prospective cohort of 360 primiparous women was recruited in Melbourne, Australia, in the interval 2009-2011, and after birth participants were followed up six times. The women completed a questionnaire about breastfeeding practices and problems at each time point. Pain scores were graphically represented using spaghetti plots to display each woman's experience of pain over the 8 weeks of the study.
  
  
  RESULTS
  After birth, before they were discharged home from hospital, 79% (250/317) of the women in this study reported nipple pain. Over the 8 weeks of the study 58% (198/336) of women reported nipple damage, and 23% (73/323) reported vasospasm. At 8 weeks postpartum 8% (27/340) of women continued to report nipple damage, and 20% (68/340) were still experiencing nipple pain. Ninety-four percent (320/340) of the women were breastfeeding at the end of the study, and there was no correlation between method of birth and nipple pain and/or damage.
  
  
  CONCLUSIONS
  Nipple pain is a common problem for new mothers in Australia and often persists for several weeks. Further studies are needed to establish the most effective means of preventing and treating breastfeeding problems in the postnatal period.
authors.affiliation: 1 Mother and Child Health Research, La Trobe University , Melbourne, Victoria, Australia .
authors.forename: Miranda L
authors.initials: ML
authors.lastname: Buck
authors.forename: Lisa H
authors.initials: LH
authors.lastname: Amir
authors.forename: Meabh
authors.initials: M
authors.lastname: Cullinane
authors.forename: Susan M
authors.initials: SM
authors.lastname: Donath
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001315:Australia; D001941:Breast Diseases / Q000209:etiology / Q000382:microbiology / Q000523:psychology*; D001942:Breast Feeding / Q000009:adverse effects / Q000523:psychology*; D002179:Candidiasis, Cutaneous / Q000188:drug therapy / Q000382:microbiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008895:Milk, Human; D009035:Mothers / Q000523:psychology*; D009558:Nipples / Q000293:injuries / Q000382:microbiology*; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D012944:Social Support; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology / Q000523:psychology*; D013391:Sucking Behavior; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents