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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-two primigravida women who planned to breastfeed began conditioning their nipples six weeks before their expected delivery date by nipple rolling twice a day for two minutes each time; providing gentle friction against the nipple with a terry cloth towel for 15 seconds once a day; and nipple airing for two hours a day, allowing outer clothing to rub against the nipple. Each woman served as her own control, conditioning one nipple but not the other. No nipple ointments or soap were used on either nipple during the course of the study. Each woman was given instructions on breastfeeding techniques to be used after delivery. The women completed two checklists: One revealed how consistently they followed the nipple-conditioning regime; with the other, they rated nipple pain on each breast, for every nursing, during the first five days postdelivery. Ratings were: 1--negligible pain or no pain, 2--definite pain, 3--extreme pain. Seventeen women successfully completed the study. Effect of skin color on the amount of nipple pain was also investigated. The prenatal nipple-conditioning regime significantly reduced the amount of total nipple pain experienced during the first few days of breastfeeding. The amount of extreme pain experienced on the conditioned nipple was significantly (p less than .01) reduced compared to the control nipple. Fair-skinned women reported more nipple soreness on unconditioned nipples, and olive-complected women reported significantly (p less than .01) less nipple soreness on unconditioned nipples.
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PMID:Prenatal nipple conditioning for breastfeeding. 25

Increased mobility of families and shorter hospital stays have added to the adjustment difficulties of new mothers, and lack of an adequate support system may cause the mother to end breast feeding. The purpose of this study was to identify the postpartum concerns of breast feeding mothers from time of discharge through the 1st postpartum month. The sample consisted of 32 women, aged 20-38, who had uncomplicated vaginal deliveries, were released from hospital by the 3rd day, and were breast feeding for the 1st time. They were telephoned daily during the 1st 2 weeks and twice a week for the 3rd and 4th week. 78% were primigravidas. 97% of the women reported a total of 210 concerns about the infant; 81% reported 237 concerns about themselves; and 19% reported 15 concerns about interactions with family or friends. Feeding-related concerns were most frequent in the 1st and 2nd weeks and included frequency of feeding (64%), formula and/or water supplementation, and duration of nursing time. Concerns about the infants' sleeping and crying behavior were also most frequent (76%) during the 1st 2 weeks. Sleeping concerns included the effects of long periods of wakefulness and sleeping during the day rather than at night. Crying or fussy behavior following feeding and during family dinner was reported by 53% of the mothers during the 1st week and 41% during the 2nd week. Concerns about the physical state of the infant included wellness and growth, temperature, cord care, bilirubin level, infection, and bowel movements. 81% of the mothers expressed concerns about themselves. Physical concerns included breast soreness, nipple pain and blisters, uterine bleeding and cramps, episiotomy pain, muscle pain, and hemorrhoids. 18 mothers reported emotional concerns, particularly fatigue. Only 6 mothers reported concern over interactions with family and friends, including lack of help from the father and pressure from visits by friends and relatives. The greatest number of concerns expressed in this study were related to the infant, whereas other studies have reported more maternal concerns. However, these women were all breast feeding, which may imply that they were more infant-oriented to begin with.
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PMID:Postpartum concerns of breastfeeding mothers. 283 23

This study was designed to evaluate whether maintenance of a moist environment on the nipple skin during the first week of breast-feeding would improve damaged nipple skin condition, as indicated by the presence of eschar, erythema, and fissures, and reduce pain. Fifty White women applied a polyethylene film dressing with a perimeter adhesive system to a randomly determined nipple. The dressing was present at all times except during feeding. Subjects were assessed every 48 hours (four times) over 7 days. Serial photographic slides were obtained and assessed for skin characteristics. Nipple pain was self-rated with a verbal descriptor scale. Use of an occlusive film dressing on nipple skin during the first week of breast-feeding appeared to have limited influence on improvement in damaged skin condition. Summary scores indicated significant reduction in the amount of eschar on the surface of the nipple. There were no differences in erythema intensity or fissure severity. Use of a dressing significantly reduced nipple pain during the study period.
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PMID:Evaluation of a dressing to reduce nipple pain and improve nipple skin condition in breast-feeding women. 750 88

The authors conducted a study to evaluate the effects of various comfort measures in alleviating nipple soreness in 73 breastfeeding, postpartum, primiparous women in the postpartum unit of a community teaching hospital. The women were randomly assigned to four groups, with all receiving instructions about breastfeeding and using one of the following treatments: warm moist tea bag compress, warm water compress, expressed milk massaged into the nipple and areola and air dried, and instruction only for the control group. Each completed a questionnaire each morning for seven days on nipple soreness to assess the effect of treatments on postpartum nipple pain. Subjects in the warm water compress group experienced significantly less pain on Day 3 than the tea or breast milk group. The authors hold that obstetric nurses might anticipate the potential for women in such circumstances to experience nipple pain and recommend this nonpharmacological therapeutic approach.
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PMID:Comfort measures in breastfeeding, primiparous women. 817 27

Persistent nipple pain in lactating women, burning in nature, and associated with radiating breast pain, has been claimed by some authorities to be due to 'thrush' (candida) infection. Yet, scientific proof has been lacking. This study compared microbiological assessment of 61 women with nipple pain, 64 women without nipple pain, and 31 non-lactating women. Swabs of the nipple and baby's mouth, and expressed breast milk were collected for culture. Growth of Candida albicans (nipple and milk) was found more often in the women with nipple pain (19%) than in the control group (3%, p < 0.01). In addition, Staphylococcus aureus was also associated with nipple pain (p < 0.0001), and independently associated with nipple fissures (p < 0.0001). Neither C. albicans nor S. aureus was found on the nipples of the non-lactating group.
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PMID:Candida albicans: is it associated with nipple pain in lactating women? 882 81

The aim of the study was to assess the psychological impact of nipple pain in lactating women. Forty-eight lactating women with nipple pain completed mood scales at their first visit and following resolution of their pain, and 65 lactating women without nipple pain completed one set of mood scales. At the first visit, the mean score on the Edinburgh Postnatal Depression Scale (EPDS) in the nipple pain group was 12.4 and the control group was 7.6 (p < 0.0001). Eighteen women (38%) scored above the threshold for depression (> 12), compared to nine in the control group (14%): p < 0.01. Following pain resolution, the mean score on the EPDS decreased to 7.3 (p < 0.001); and six women (16%) scored 13 or over on the EPDS, significantly less than initially (p < 0.05). Similarly, on the Profile of Mood States (POMS), the nipple pain group scored significantly higher than control group on all mood factors (Tension, Depression, Fatigue, Confusion, Vigor [lower]), except Anger which did not reach a level of significance. After pain resolution, POMS scores returned to similar levels as the control group. In conclusion, both the EPDS and POMS indicated women with nipple pain were experiencing high levels of emotional distress. However, once the pain had resolved their distress also resolved.
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PMID:Psychological aspects of nipple pain in lactating women. 886 Aug 87

This case report describes a situation in which a mother who experienced prolonged nipple pain with her first child sought help from a lactation consultant at the birth of her second child. Despite being very attentive to positioning and latch, similar pain was experienced from the first feeding with the second baby. The mother's history and symptoms were explored, and nipple vasospasms related to Raynaud's syndrome were suspected. After reviewing the literature and consulting with her personal obstetrician, the mother (a pediatrician) chose to treat with nifedipine. The mother was pain free after a 2-week course and nursing without difficulty at 4 months postpartum.
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PMID:Nipple vasospasms, Raynaud's syndrome, and nifedipine. 1244 56

A cringe response, born of fear of anticipated nipple pain, creates behaviours that undermine comfortable latch of baby at breast, resulting in the pain th women feared. Fear is an important response in human survival but sometimes the behaviours resulting from the fear are inappropriate. This case study discusses the psychological processes and specific physical responses observed in a woman who is experiencing nipple pain during breastfeeding. It describes steps that can be taken to assist the mother in identifying what she is doing, educating her about the processes involved, and providing her with strategies to override the inappropriate response.
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PMID:Latch and the fear response: overcoming an obstacle to successful breastfeeding. 1598 49

Leiomyoma is a rare, benign neoplasm of the nipple. We report the case of a patient with a leiomyoma arising from her left nipple who presented with persistent nipple pain and tenderness which led to the eventual complete excision of her left nipple and areola complex. The clinical characteristics, gross and microscopic pathologic findings, and management of this lesion are discussed. Surgical management should be tailored primarily to the control of symptoms. Clinicians should be aware that this is a rare, but potential cause of chronic persistent pain and swelling in the region of the nipple-areola complex of the breast.
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PMID:Leiomyoma of the nipple. 1684 53

This chart review study describes the history, physical and laboratory findings, and clinical outcomes in patients who presented to a lactation specialist between 1997 and 2002 and were treated with antibiotics for their chronic breast and/or nipple pain. A total of 69 charts were reviewed. Five were excluded because of loss of follow-up. Eighty-two percent of patients described postpartum breast tenderness, 74% had nipple sores postpartum, and 79% were tender on physical examination. Nipple lesions were present among 73% of the women. Breast milk or nipple cultures were performed for 60 of 64 patients and were positive for pathogenic bacteria among 50% of the patients cultured. The average duration of antibiotic treatment was 5.7 weeks, and 94% of the women had pain resolution. Symptoms of deep breast aching, breast tenderness on palpation, and nipple lesions may be suggestive of a bacterial lactiferous duct infection. Treatment with antibiotics for 4 to 6 weeks may be appropriate.
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PMID:History, physical and laboratory findings, and clinical outcomes of lactating women treated with antibiotics for chronic breast and/or nipple pain. 1706 89


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