The discomfort and challenges posed by nipple pain during breastfeeding can significantly affect a mother’s ability to continue nursing. Nonpharmacological topical treatments, often considered due to their accessibility and low cost, may offer a solution. This study investigates the efficacy and safety of these interventions, aiming to provide clarity in clinical decision-making and guide future research.
A recent study aimed to evaluate the effectiveness and safety of nonpharmacological topical interventions for treating nipple pain in breastfeeding women. The research involved randomized clinical trials (RCTs) focusing on lactating women experiencing painful nipples. The primary outcomes assessed were pain reduction, the healing process, and the occurrence of adverse events.
Methodology and Quality Assessment
The study included a comprehensive search conducted on June 02, 2023, without any date or language restrictions. The methodological quality of the included RCTs was evaluated using the Cochrane risk of bias tool, while the certainty of the evidence was assessed using the GRADE approach. Nineteen RCTs with varying levels of bias were included in the analysis.
Findings and Uncertainties
The results indicated uncertain evidence regarding the effectiveness of photobiomodulation compared to placebo in pain reduction (mean difference [MD] -0.15; 95% confidence interval [CI] -1.49 to 1.19; 139 participants, 2 RCTs). Additionally, there were uncertainties about the effects of lanolin compared to breast milk on pain (MD -1.80; 95% CI -2.43 to -1.17; 1 RCT; 180 participants), wound healing (MD 0.10; 95% CI -0.26 to -0.46; 1 RCT; 180 participants), and adverse events, with zero events reported in both groups.
Other nonpharmacological interventions assessed showed similar uncertain effects. Due to the imprecision in the evidence, the study concludes that further RCTs with higher methodological quality are necessary to support concrete recommendations.
Practical Inferences
For clinicians and researchers, the study offers several practical insights:
- Photobiomodulation may not significantly reduce pain compared to placebo.
- The comparison between lanolin and breast milk remains inconclusive for both pain relief and wound healing.
- Adverse events were rare, suggesting that these interventions are generally safe.
- Future research should focus on improving the methodological quality of RCTs in this area.
Considering the accessibility and affordability of nonpharmacological topical treatments, their potential benefits warrant further investigation. This study highlights the need for more robust evidence to inform clinical practice and guide future research directions.
Original Article: Breastfeed Med. 2024 Jun 5. doi: 10.1089/bfm.2024.0043. Online ahead of print.
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