哺乳期母亲的乳头疼痛：发生率、病因及治疗方法
Nipple Pain in Breastfeeding Mothers: Incidence, Causes and Treatments.
作者信息
Kent Jacqueline C, Ashton Elizabeth, Hardwick Catherine M, Rowan Marnie K, Chia Elisa S, Fairclough Kyle A, Menon Lalitha L, Scott Courtney, Mather-McCaw Georgia, Navarro Katherine, Geddes Donna T
机构信息
School of Chemistry & Biochemistry, The University of Western Australia, 35 Stirling Highway, Crawley WA 6009, Australia.
Breast Feeding Centre of WA, King Edward Memorial Hospital for Women, 374 Bagot Rd, Subiaco WA 6008, Australia.
出版信息
Int J Environ Res Public Health. 2015 Sep 29;12(10):12247-63. doi: 10.3390/ijerph121012247.
BACKGROUND
Persistent nipple pain is one of the most common reasons given by mothers for ceasing exclusive breastfeeding. We aimed to determine the frequency of nipple pain as a reason for consultation, the most common attributed aetiologies, and the effectiveness of the advice and treatment given.
METHODS
All consultations at the Breast Feeding Centre of Western Australia (WA) were audited over two six-month periods in 2011 (n = 469) and 2014 (n = 708). Attributed cause(s) of nipple pain, microbiology results, treatment(s) advised, and resolution of pain were recorded.
RESULTS
Nipple pain was one of the reasons for consultation in 36% of cases. The most common attributed cause of nipple pain was incorrect positioning and attachment, followed by tongue tie, infection, palatal anomaly, flat or inverted nipples, mastitis, and vasospasm. Advice included correction of positioning and attachment, use of a nipple shield, resting the nipples and expressing breastmilk, frenotomy, oral antibiotics, topical treatments, and cold or warm compresses. Pain was resolving or resolved in 57% of cases after 18 days (range 2-110).
CONCLUSION
The multiple attributed causes of nipple pain, possibly as a result of a cascade of events, suggests that effective early lactation management for prevention of nipple pain and early diagnosis and effective treatment are crucial to avoid early weaning.
背景
持续性乳头疼痛是母亲停止纯母乳喂养的最常见原因之一。我们旨在确定因乳头疼痛前来咨询的频率、最常见的病因，以及所提供建议和治疗的效果。
方法
对西澳大利亚州母乳喂养中心在2011年（n = 469）和2014年（n = 708）两个为期六个月的时间段内的所有咨询进行了审核。记录乳头疼痛的归因原因、微生物学结果、建议的治疗方法以及疼痛的缓解情况。
结果
乳头疼痛是36%病例的咨询原因之一。乳头疼痛最常见的归因原因是姿势和衔乳不正确，其次是舌系带过短、感染、腭裂畸形、乳头扁平或内陷、乳腺炎和血管痉挛。建议包括纠正姿势和衔乳、使用乳头保护罩、让乳头休息并挤出母乳、舌系带切开术、口服抗生素、局部治疗以及冷敷或热敷。18天后（范围为2 - 110天），57%的病例疼痛正在缓解或已缓解。
结论
乳头疼痛的多种归因原因，可能是一系列事件导致的，这表明有效的早期泌乳管理以预防乳头疼痛以及早期诊断和有效治疗对于避免过早断奶至关重要。
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