Mariani Neto Corintio, de Albuquerque Rosemeire Sartori, de Souza Sonia Cristina, Giesta Renata Oliveira, Fernandes Andrea Penha Spinola, Mondin Bárbara
Women's Health Area, Medicine Course, Universidade Cidade de São Paulo, São Paulo, SP, Brazil.
Hospital Maternidade Leonor Mendes de Barros, São Paulo, SP, Brazil.
Rev Bras Ginecol Obstet. 2018 Nov;40(11):664-672. doi: 10.1055/s-0038-1675180. Epub 2018 Oct 29.
To compare two different treatments-the use of highly purified anhydrous (HPA) lanolin and expressed breast milk-for women with pain and nipple trauma during the breastfeeding process.
A total of 180 puerperal women were randomly assigned to 2 groups: one was treated with HPA lanolin and the other with their own expressed breast milk. All of the participants received the same breastfeeding technique instructions and therapeutic care standard. Three assessments were performed: at the time of inclusion in the study (after randomization); after 48 hours; and after 7 days. At each interval, data was collected in relation to pain and trauma. A numerical/verbal category scale was used for the pain variable, and the nipple trauma score for the trauma variable. The results were subjected to statistical analysis using the chi-squared test, the Fisher exact test, the student -test, and the Kolmogorov-Smirnov test. Generalized estimating equations were calculated using the STATA 12 statistical software package (StataCorp LLC, College Station, TX, USA) and IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp, Armonk, NY, USA).
There was pain improvement from the second to the third assessment in the group that used HPA lanolin, while the pain remained unchanged between these two periods ( < 0.001) in the breast milk group. In terms of trauma, improvement was identified in its extension and depth from the first to the third assessment, and it was higher in the HPA lanolin group than in the breast milk group ( = 0.025).
The treatment of pain and nipple trauma with HPA lanolin achieved better results than the one with breast milk, based on a 7-day treatment period.
比较两种不同的治疗方法——使用高度纯化无水(HPA)羊毛脂和挤出的母乳——对母乳喂养过程中出现疼痛和乳头损伤的女性的疗效。
总共180名产后妇女被随机分为两组:一组用HPA羊毛脂治疗,另一组用自身挤出的母乳治疗。所有参与者都接受相同的母乳喂养技术指导和治疗护理标准。进行了三次评估:在纳入研究时(随机分组后);48小时后;以及7天后。在每个时间间隔,收集有关疼痛和损伤的数据。疼痛变量使用数字/文字分类量表,损伤变量使用乳头损伤评分。结果采用卡方检验、Fisher精确检验、学生t检验和Kolmogorov-Smirnov检验进行统计分析。使用STATA 12统计软件包(美国德克萨斯州大学城StataCorp有限责任公司)和IBM SPSS Statistics for Windows 20.0版(美国纽约州阿蒙克IBM公司)计算广义估计方程。
使用HPA羊毛脂的组从第二次评估到第三次评估疼痛有所改善,而母乳组在这两个时期之间疼痛保持不变(<0.001)。在损伤方面,从第一次评估到第三次评估,损伤在范围和深度上有所改善,且HPA羊毛脂组比母乳组改善程度更高(=0.025)。
基于7天的治疗期,用HPA羊毛脂治疗疼痛和乳头损伤比用母乳治疗取得了更好的效果。