Nonpharmacological Interventions for Treating Breastfeeding Nipple Pain: Systematic Review and Meta-Analysis

To evaluate the efficacy and safety of nonpharmacological topical interventions for treating breastfeeding nipple pain. Randomized clinical trials (RCTs) assessing lactating women suffering from breastfeeding painful nipples were included. Primary outcomes were pain, healing process, and adverse eve...

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Bibliographic Details
Published in:	Breastfeeding medicine Vol. 19; no. 8; p. 599
Main Authors:	Nozimoto, Ingrid Naomi Pires, da Silva, Beatriz Aparecida, Bandeira, Melissa Diniz, da Silva, Ana Paula, Bussadori, Sandra Kalil, Santos, Elaine Marcílio, Martimbianco, Ana Luiza Cabrera
Format:	Journal Article
Language:	English
Published:	United States 01-08-2024
Subjects:	Breast Feeding Female Humans Lactation Lanolin - therapeutic use Low-Level Light Therapy Nipples Pain Pain Management - methods Randomized Controlled Trials as Topic nipple pain treatment breastfeeding systematic review evidence-based medicine
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Summary:	To evaluate the efficacy and safety of nonpharmacological topical interventions for treating breastfeeding nipple pain. Randomized clinical trials (RCTs) assessing lactating women suffering from breastfeeding painful nipples were included. Primary outcomes were pain, healing process, and adverse events. A comprehensive search was conducted on June 02, 2023, without date or language restrictions. Methodological quality was assessed using the Cochrane risk of bias tool and the certainty of the evidence, the GRADE approach. Nineteen RCTs with unclear to high risk of bias were included. There was uncertain evidence regarding the effects of photobiomodulation versus placebo on pain reduction (mean difference [MD] -0.15; 95% confidence interval [95% CI] -1 0.49 to 1.19; 139 participants, 2 RCTs). There are uncertainties concerning the effects of lanolin versus 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 any adverse events (zero events in both groups). Similar effects were observed by the other interventions assessed. The evidence of nonpharmacological topical interventions for painful nipples is imprecise, and future RCTs with higher methodological quality are needed to support recommendations. Considering the accessibility and low cost of these alternative treatments, the findings of this evidence synthesis could support clinical decision-making and guide future research. PROSPERO CRD42020170320.
ISSN:	1556-8342
DOI:	10.1089/bfm.2024.0043