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How effective are interventions for treating painful nipples among breastfeeding women?
There was insufficient evidence that glycerine gel dressings, breast shells with lanolin, lanolin alone or the all-purpose nipple ointment significantly improved maternal perceptions of nipple pain. Applying nothing or just expressed breast milk may be equally or more beneficial in the short-term experience of nipple pain than the application of an ointment such as lanolin. Regardless of the treatment used, for most women nipple pain reduced to mild levels by approximately 7 to 10 days' postpartum. There was a lack of clarity regarding the effect of breastfeeding education and corrective instruction in the treatment of damaged nipples or as a control condition.
All 4 trials compared varying interventions, participants, study outcome measures and standards of usual care. The methodological quality of the included studies was good, but the overall quality of the evidence for the primary outcome of nipple pain was of low quality, mainly because single studies with few participants contributed data for analysis.
Although the health benefits of breastfeeding are well established, many women discontinue breastfeeding within the first few weeks of giving birth. One common reason is painful nipples.
Dennis CL et al. Interventions for treating painful nipples among breastfeeding women. Cochrane Reviews, 2014, Issue 12. Art. No.: CD007366.DOI: 10.1002/14651858. CD007366.pub2. This review contains 4 studies involving 656 participants.
Cochrane Systematic Reviews for primary care practitioners
Developed by the Cochrane Primary Care Field, New Zealand Branch of the Australasian Cochrane Centre at the Department of General Practice and Primary Health Care, University of Auckland and funded by the Ministry of Health and New Zealand Doctor. PEARLS are meant for educational use and not to guide clinical care. New Zealanders can access the Cochrane Library free via www.cochrane.org.nz
Pharmacist prescribers Linda Bryant and Leanne Te Karu discuss positive polypharmacy for heart failure. Current evidence shows the intensive implementation of four medications offers the greatest benefit to most patients with heart failure, with significant reductions in cardiovascular mortality, heart failure hospitalisations and all-cause mortality
