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      Positive Effect of HPA Lanolin versus Expressed Breastmilk on Painful and Damaged Nipples during Lactation

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          Abstract

          Painful and/or damaged nipples associated with breastfeeding are common and represent a challenge for both the persons experiencing nipple pain and/or trauma and for those providing treatment. However, evidence-based data has been insufficient to demonstrably minimize these common reasons for failure to initiate or continue successful breastfeeding. The aim of this study was to evaluate the efficacy of specific-grade highly purified anhydrous (HPA) lanolin versus expressed breastmilk (EBM) for the treatment of painful and damaged nipples associated with breastfeeding in a prospective controlled clinical trial evaluating 84 lactating mothers. Nipple trauma and healing rates were rated by the Nipple Trauma Score. Nipple pain intensity was assessed on a visual analog scale. Outcome parameters were in favor of the HPA lanolin group, reaching statistical significance for healing rates, nipple trauma and nipple pain. In our study, we found HPA lanolin more effective than EBM, inducing faster healing of nipple trauma (absolute risk reduction of 0.43) and reducing nipple pain (absolute risk reduction of 0.61 on day 3). We concluded that HPA lanolin, combined with breastfeeding education, was more effective than EBM, combined with breastfeeding education, in reducing nipple pain and promoting healing of nipple trauma.

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          Breastfeeding and the use of human milk.

          Lawrence Gartner, Jane I. Morton, Ruth Lawrence … (2005)
          Considerable advances have occurred in recent years in the scientific knowledge of the benefits of breastfeeding, the mechanisms underlying these benefits, and in the clinical management of breastfeeding. This policy statement on breastfeeding replaces the 1997 policy statement of the American Academy of Pediatrics and reflects this newer knowledge and the supporting publications. The benefits of breastfeeding for the infant, the mother, and the community are summarized, and recommendations to guide the pediatrician and other health care professionals in assisting mothers in the initiation and maintenance of breastfeeding for healthy term infants and high-risk infants are presented. The policy statement delineates various ways in which pediatricians can promote, protect, and support breastfeeding not only in their individual practices but also in the hospital, medical school, community, and nation.
          Article 0 comments Cited 530 times – based on 0 reviews     Review now
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            The Perceived Stress Questionnaire (PSQ) reconsidered: validation and reference values from different clinical and healthy adult samples.

            Herbert Fliege, Matthias Rose, Petra Arck … (2015)
            The aim was to translate, revise, and standardize the Perceived Stress Questionnaire (PSQ) by Levenstein et al. (1993) in German. The instrument assesses subjectively experienced stress independent of a specific and objective occasion. Exploratory factor analyses and a revision of the scale content were carried out on a sample of 650 subjects (Psychosomatic Medicine patients, women after delivery, women after miscarriage, and students). Confirmatory analyses and examination of structural stability across subgroups were carried out on a second sample of 1,808 subjects (psychosomatic, tinnitus, inflammatory bowel disease patients, pregnant women, healthy adults) using linear structural equation modeling and multisample analyses. External validation included immunological measures in women who had suffered a miscarriage. Four factors (worries, tension, joy, demands) emerged, with 5 items each, as compared with the 30 items of the original PSQ. The factor structure was confirmed on the second sample. Multisample analyses yielded a fair structural stability across groups. Reliability values were satisfactory. Findings suggest that three scales represent internal stress reactions, whereas the scale "demands" relates to perceived external stressors. Significant and meaningful differences between groups indicate differential validity. A higher degree of certain immunological imbalances after miscarriage (presumably linked to pregnancy loss) was found in those women who had a higher stress score. Sensitivity to change was demonstrated in two different treatment samples. We propose the revised PSQ as a valid and economic tool for stress research. The overall score permits comparison with results from earlier studies using the original instrument.
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              Lactation mastitis: occurrence and medical management among 946 breastfeeding women in the United States.

              Kendra Schwartz, Brenda Gillespie, Hannah d'Arcy … (2002)
              In 1994-1998, the authors followed 946 breastfeeding women from Michigan and Nebraska for the first 3 months postpartum or until they stopped breastfeeding to describe mastitis incidence, mastitis treatment, and any associations between mastitis occurrence and hypothesized host characteristics and behaviors. Participants were interviewed by telephone at 3, 6, 9, and 12 weeks postpartum or until they ceased breastfeeding. A total of 9.5% reported provider-diagnosed lactation mastitis at least once during the 12-week period, with 64% diagnosed via telephone. After adjustment in a logistic regression model, history of mastitis with a previous child (odds ratio (OR) = 4.0, 95% confidence interval (CI): 2.64, 6.11), cracks and nipple sores in the same week as mastitis (OR = 3.4, 95% CI: 2.04, 5.51), using an antifungal nipple cream (presumably for nipple thrush) in the same 3-week interval as mastitis (OR = 3.4, 95% CI: 1.37, 8.54), and (for women with no prior mastitis history) using a manual breast pump (OR = 3.3, 95% CI: 1.92, 5.62) strongly predicted mastitis. Feeding fewer than 10 times per day was protective regardless of whether or not feeding frequency in the same week or the week before mastitis was included in the model (for the same week: 7-9 times: OR = 0.6, 95% CI: 0.41, 1.01; < or =6 times: OR = 0.4, 95% CI: 0.19, 0.82). Duration of feeding was not associated with mastitis risk.
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                Author and article information

                Journal
                Journal ID (publisher-id): SPP
                Journal ID (nlm-ta): Skin Pharmacol Physiol
                Journal ID (doi): 10.1159/issn.1660-5527
                Title: Skin Pharmacology and Physiology
                Publisher: S. Karger AG
                ISSN (Print): 1660-5527
                ISSN (Electronic): 1660-5535
                Publication date Subscription-year: 2011
                Publication date (Print): December 2010
                Publication date (Electronic): 18 August 2010
                Volume: 24
                Issue: 1
                Pages: 27-35
                Affiliations
                aDepartment of Obstetrics and Gynaecology, St. Joseph Hospital, Academic Hospital of the Charité, University Medicine Berlin, bBioskin and cDepartment of Dermatology, Charité University Clinic, Berlin, and dDepartment of Obstetrics and Gynaecology, University Hospital Ulm, Ulm, Germany
                Author notes
                *Joachim W. Fluhr, MD, Bioskin, Bergmannstrasse 5, DE–10961 Berlin (Germany), Tel. +49 30 2804 3950, E-Mail joachim.fluhr@gmx.net
                Article
                Publisher ID: 318228 Other ID: Skin Pharmacol Physiol 2011;24:27–35
                DOI: 10.1159/000318228
                PubMed ID: 20720454
                SO-VID: 4e4535a9-4f4c-4429-903f-4160501508c1
                Copyright © © 2010 S. Karger AG, Basel
                License:

                Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) ( http://www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 19 March 2010
                Date accepted : 28 June 2010
                Page count
                Figures: 5, Tables: 2, References: 39, Pages: 9
                Categories
                Subject: Original Paper

                ScienceOpen disciplines: Oncology & Radiotherapy,Pathology,Surgery,Dermatology,Pharmacology & Pharmaceutical medicine
                Keywords: Breastfeeding,Breastmilk,Topical treatment,Lactation,Nipple trauma,Nipple pain,Highly purified anhydrous lanolin
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy, Pathology, Surgery, Dermatology, Pharmacology & Pharmaceutical medicine
                Keywords: Breastfeeding, Breastmilk, Topical treatment, Lactation, Nipple trauma, Nipple pain, Highly purified anhydrous lanolin

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