Measurement tools and intensity of nipple pain among women with or without damaged nipples: A quantitative systematic review

Author(s)

Coca, Kelly Pereira ^{[1, 2]} ; Amir, Lisa H. ^{[1, 3]} ; da Silva Alves, Maria dos Remedios ^[4] ; Barbieri, Marcia ^[2] ; Marcacine, Karla Oliveira ^[2] ; Freitas de Vilhena Abrao, Ana Cristina ^[2]

Affiliation

^[1] La Trobe Univ, Judith Lumley Ctr, Melbourne, Vic - Australia

^[2] Univ Fed Sao Paulo, Dept Nursing Womans Hlth, Sao Paulo - Brazil

^[3] Royal Womens Hosp, Breastfeeding Serv, Melbourne, Vic - Australia

^[4] Vila Santa Catarina Municipal Hosp, Sao Paulo - Brazil

• Document type: Review article
• Source: JOURNAL OF ADVANCED NURSING; v. 75, n. 6, p. 1162-1172, JUN 2019.
• Web of Science Citations: 0

Abstract

Aims To describe and evaluate pain scales used to measure nipple pain in breastfeeding women and to identify nipple pain intensity in women with or without nipple damage. Background Nipple pain is one of the most common reasons given for premature cessation of breastfeeding. However, there are no agreed tools to measure pain and no previous reviews have provided summary estimates of pain scores. Design Systematic review. Data sources Medline, CINAHL, Scopus, Web of Science, SciELO, and LILACS. Review methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The guiding question was: How is nipple pain in breastfeeding women measured and how severe is it? We analysed articles published up to February 2018, excluded review articles and those that did not present the level of nipple pain or tools to estimate pain severity. Results A total of 1,023 articles were identified and 25 were included in the review after applying the exclusion criteria. The Numeric Rating Scale (nine studies) and Visual Analogue Scale (seven studies) were the most prevalent tools for measuring pain. Using a pain score between 0-10, women with nipple damage reported a weighted mean of 6.2 in the first week and 5.8 after that period; women without damage reported a weighted mean of 2.7. Conclusion Women with nipple damage consistently reported a higher level of pain than women without damage. To prevent premature cessation of breastfeeding, it is important to help new mothers avoid nipple damage. (AU)

• FAPESP's process: 17/07469-5 - Development of a randomized controlled trial to compare different strength/whatever low intensity laser irradiation in the management of nipple pain for breastfeeding women with nipple damage
• Grantee: Kelly Pereira Coca
• Support Opportunities: Scholarships abroad - Research