Dodd Victoria, Chalmers Catherine
University of Alabama Medical Center, Birmingham, USA.
J Obstet Gynecol Neonatal Nurs. 2003 Jul-Aug;32(4):486-94. doi: 10.1177/0884217503255098.
To evaluate the use of hydrogel dressings for the prevention and treatment of nipple soreness in lactating women as compared with the common intervention of lanolin ointment. The hypothesis was as follows: Participants using hydrogel dressings as a preventive measure for nipple soreness will experience greater pain relief and a lower rate of nipple wounds as compared with the control group. The secondary hypothesis was that the reduction of nipple soreness in the treatment group would produce a longer duration of breastfeeding as compared with the control group.
A multicentered, prospective, randomized controlled clinical trial evaluating a sample of 106 lactating mothers.
Study sites were the University of Alabama Medical Center at Birmingham (an inner-city teaching hospital) and Northeast Health System (a community hospital in Beverly, Massachusetts).
Participants were older than age 18, fluent in English, and had an operational telephone in the residence. Other inclusion criteria were singleton, vaginal deliveries; no prior breastfeeding experience; and written informed consent.
Participants were randomized to either the lanolin ointment or the hydrogel dressings group and received instructions specific to their assignment. All participants received breastfeeding education provided by a board-certified lactation consultant.
During the initial 12 study days, participants identified pain intensity using a numeric pain intensity scale and verbal descriptor scale. Subjective data were collected via self-reported skin assessments of the bilateral breasts, nipples, and areolae. Breastfeeding duration was established by a follow-up telephone call at 2 months.
The hydrogel dressings group had significantly greater reduction in pain score mean values at baseline, on study Day 10, and on study Day 12 in comparison to the control group. Participants using the hydrogel dressings discontinued treatment sooner than participants in the lanolin ointment group. The lanolin ointment group had eight breast infections, whereas the hydrogel dressings group had none.
Hydrogel dressings are a safe, available treatment that provided more effective pain management for nipple soreness than the common intervention of lanolin ointment.
与羊毛脂软膏这一常用干预措施相比,评估水凝胶敷料用于预防和治疗哺乳期妇女乳头疼痛的效果。假设如下:与对照组相比,使用水凝胶敷料作为乳头疼痛预防措施的参与者疼痛缓解程度更高,乳头伤口发生率更低。次要假设是,与对照组相比,治疗组乳头疼痛减轻会使母乳喂养持续时间更长。
一项多中心、前瞻性、随机对照临床试验,对106名哺乳期母亲进行了抽样评估。
研究地点为位于伯明翰的阿拉巴马大学医学中心(一家市中心教学医院)和东北卫生系统(马萨诸塞州贝弗利的一家社区医院)。
参与者年龄超过18岁,英语流利,家中有可用电话。其他纳入标准为单胎、经阴道分娩;无母乳喂养经验;签署书面知情同意书。
参与者被随机分为羊毛脂软膏组或水凝胶敷料组,并接受与其分组对应的具体指导。所有参与者均接受了由获得委员会认证的泌乳顾问提供的母乳喂养教育。
在最初的12个研究日期间,参与者使用数字疼痛强度量表和语言描述量表确定疼痛强度。通过自我报告对双侧乳房、乳头和乳晕进行皮肤评估来收集主观数据。通过2个月时的随访电话确定母乳喂养持续时间。
与对照组相比,水凝胶敷料组在基线、研究第10天和研究第12天的疼痛评分平均值显著降低。使用水凝胶敷料的参与者比羊毛脂软膏组的参与者更早停止治疗。羊毛脂软膏组有8例乳房感染,而水凝胶敷料组无感染病例。
水凝胶敷料是一种安全、可用的治疗方法,与羊毛脂软膏这一常用干预措施相比,能更有效地管理乳头疼痛。