Saline Compresses to Reduce Nipple Pain and Nipple Injury in Breastfeeding Mothers

Abstract

Purpose: Between 80-100% of breastfeeding mothers experience nipple pain starting in the first week after birth, and as many as 35-50% of mothers will go on to develop macroscopic tissue injury to the nipple-areolar complex (NAC). This morbidity can lead to premature breastfeeding cessation in the first six weeks after birth. Current standard of care lacks routine nursing assessment and treatment of NAC pain and tissue injury. Methods: An Interventional Pilot Study for a Randomized Controlled Trial was conducted with 40 breastfeeding mothers to evaluate whether application of a 0.9% sterile saline compress applied to the NAC after breastfeeding reduces maternal pain scores and/or macroscopic tissue injury during the first week postpartum. Results: Saline compresses reduced acute nipple pain scores at 1 minute after breastfeeding by 0.8 points, a statistically significant improvement with a p-value of 0.0011. The saline treatment group also had gross reductions in signs of NAC inflammation and tissue injury, but results trended only toward significance. Conclusion: Application of a 0.9% saline compress to the nipple-areolar complex within 30 seconds after de-latching reduces acute nippleareolar complex pain scores and increases maternal comfort during breastfeeding initiation, but more research is needed to understand its potential impacts on reducing tissue inflammation and macroscopic tissue injury.