title: Nipple Pain Incidence, the Predisposing Factors, the Recovery Period After Care Management, and the Exclusive Breastfeeding Outcome.
abstract: Nipple pain is the most common complaint of breastfeeding mothers during the immediate postpartum period. Persistent nipple pain is associated with low breastfeeding rate at 6 months postpartum.
  
  
  
  To further explore the incidence of nipple pain, associated predisposing factors, time for recovery after management, and the impact on exclusive breastfeeding rates.
  
  
  
  Included in this study were 1,649 singleton, pregnant women who delivered and had their 1-week follow-up at the breastfeeding clinic during the period of January 2013 to December 2015. The mothers who experienced nipple pain were analyzed for the incidence, the predisposing factors, and the recovery period after care management. The breastfeeding outcome comparison of both, mothers with and without pain, was measured by the exclusive breastfeeding rate at the sixth week postpartum.
  
  
  
  The incidence of nipple pain was at 9.6% by day 7. A predisposing factor of nipple pain was primiparity (relative risk = 1.8, 95% confidence interval 1.3-2.5). The reasons for nipple pain were inappropriate positioning and latching (72.3%), tongue-tie (23.2%), and oversupply (4.4%). The recovery period after care management was 1-2 weeks. There were no statistically significant differences between the 6-week exclusive breastfeeding rates of the mothers with nipple pain with treatment and the mothers without nipple pain.
  
  
  
  Persistent nipple pain was a common problem. The active management, including early detection and treatment, would help the mothers recover within a 2-week period and there was no significant difference of exclusive breastfeeding rates between the mothers who had early care management and the mothers without nipple pain.
authors.affiliation: 1 Department of Obstetrics and Gynecology, Faculty of Medicine, Srinakharinwirot University , Nakhon Nayok, Thailand .
authors.forename: Pawin
authors.initials: P
authors.lastname: Puapornpong
authors.affiliation: 1 Department of Obstetrics and Gynecology, Faculty of Medicine, Srinakharinwirot University , Nakhon Nayok, Thailand .
authors.forename: Panwara
authors.initials: P
authors.lastname: Paritakul
authors.affiliation: 1 Department of Obstetrics and Gynecology, Faculty of Medicine, Srinakharinwirot University , Nakhon Nayok, Thailand .
authors.forename: Maysita
authors.initials: M
authors.lastname: Suksamarnwong
authors.affiliation: 1 Department of Obstetrics and Gynecology, Faculty of Medicine, Srinakharinwirot University , Nakhon Nayok, Thailand .
authors.forename: Siriwan
authors.initials: S
authors.lastname: Srisuwan
authors.affiliation: 2 Department of Obstetric and Gynecology Nursing, HRH Princess Maha Chakri Sirindhorn Medical Center , Nakhon Nayok, Thailand .
authors.forename: Sukwadee
authors.initials: S
authors.lastname: Ketsuwan
mesh_terms: D000328:Adult; D000072676:Ankyloglossia / Q000150:complications*; D001941:Breast Diseases / Q000209:etiology / Q000517:prevention & control*; D001942:Breast Feeding / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008297:Male; D009035:Mothers / Q000523:psychology*; D009558:Nipples / Q000293:injuries* / Q000503:physiopathology; D009824:Ointments; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D059408:Pain Management / Q000379:methods*; D049590:Postpartum Period; D011446:Prospective Studies; D011482:Protective Devices / Q000706:statistics & numerical data; D013391:Sucking Behavior / Q000502:physiology*; D013785:Thailand
chemical_list: D009824:Ointments
keywords: exclusive breastfeeding; nipple pain; recovery period; the predisposing factors