Potential predictors of nipple trauma from an in-home breastfeeding programme: a cross-sectional study

Thompson, Robyn, Kruske, Sue, Barclay, Lesley, Linden, Karin, Gao, Yu and Kildea, Sue (2016) Potential predictors of nipple trauma from an in-home breastfeeding programme: a cross-sectional study. Women and Birth, 29 4: 336-344. doi:10.1016/j.wombi.2016.01.002

Author Thompson, Robyn
Kruske, Sue
Barclay, Lesley
Linden, Karin
Gao, Yu
Kildea, Sue
Title Potential predictors of nipple trauma from an in-home breastfeeding programme: a cross-sectional study
Journal name Women and Birth   Check publisher's open access policy
ISSN 1878-1799
Publication date 2016-02-16
Year available 2016
Sub-type Article (original research)
DOI 10.1016/j.wombi.2016.01.002
Open Access Status Not Open Access
Volume 29
Issue 4
Start page 336
End page 344
Total pages 9
Place of publication Amsterdam, Netherlands
Publisher Elsevier
Language eng
Formatted abstract
Background:  Australian breastfeeding rates fall significantly in the months following birth, often as a result of breastfeeding complications.

Aim:  To explore the potential risk factors for nipple trauma and breast engorgement in a group of women who were referred to the in home breastfeeding service in Melbourne, Australia.

Method:  A retrospective, cross-sectional analyses of the maternal–infant records (n = 653) from 2003 to 2007 including demographic characteristics; pregnancy, labour and birth data; the presenting complications and observational and diagnostic results. Bivariate and logistic regression analyses were conducted to explore the predictors of nipple trauma and engorgement.

Nipple trauma was the most common presenting complication (62.9%). Logistic regression analyses identified four statistically significant predictors: facio-mandibular asymmetry (AOR 4.21, 95% CI [1.25–14.20]), inflammatory mastitis (AOR 2.99, 95% CI [1.57–5.68], nipple malignment (AOR 2.51, 95% CI [1.13–5.55]) and the cross-cradle technique (AOR 1.90, 95% CI [1.03–3.50]). Engorgement was associated with the first postpartum breastfeed being less than one-hour duration (AOR 2.01, 95% CI [1.07–3.79]).

Conclusion:  Nipple trauma was associated with commonly taught techniques that involved the cross-cradle hold and manoeuvres of the breast, nipple and baby that resulted in nipple malalignment and facio-mandibular asymmetry. This practice, appeared to interfere with the baby's intra-oral function by restricting movement of the cranio-cervical spine and nuchal ligament. The combination appeared to limit the baby's instinctive ability to activate neuro-sensory mammalian behaviours to freely locate and effectively draw the nipple and breast tissue without causing trauma. Changes to the first and early breastfeeding techniques are recommended.
Keyword Breastfeeding
Nipple trauma
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
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School of Nursing, Midwifery and Social Work Publications
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Citation counts: TR Web of Science Citation Count  Cited 3 times in Thomson Reuters Web of Science Article | Citations
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