Duffy et al.2323 Duffy ER, Percival P, Kershaw E. Positive effects of an antenatal group teaching session on postnatal nipple pain, nipple trauma and breast feeding rates. Midwifery. 1997; 13: 189-96.; Midwifery, 1997 |
Perth- Austrália, 1995 |
Intervention study: convenience sample with 70 primiparous (35 in the control group and 35 in the intervention group) |
To evaluate the effect of prenatal orientation in positioning and handling the breast in relation to duration of breastfeeding, pain and nipple trauma |
ANOVA, chisquare test |
Incidence in the experimental group= 53%; in the control group= 100% |
Guidance on the positioning and adequate handling to the mother’s breast |
____ |
Centouri et al.,3939 Centuori S, Burmaz T, Ronfani L, Fragiacomo M, Quintero S, Pavan C, Davanzo R, Cattaneo A. Nipple care, sore nipples, and breastfeeding: a randomized trial. J Hum Lact. 1999; 15 (2): 125-30. ; J Hum Lact, 1999 |
Trieste- Itália, 1996- 1997 |
Intervention study: 219 mothers (96 in the control group and 123 in the intervention group) |
Determine the incidence of nipple injury and duration of breastfeeding |
ANOVA and Kruskal-Wallis, Fisher test, the Chi-square test, Mantel-Haesnzel |
Incidence in the experi-mental group= 73%; in the control group= 76% |
The use of baby bottle; The use of pacifier |
Prevalence of exclusive maternal breastfeeding at 4 months |
Henderson et al.,5858 Henderson A, Stamp G, Pincombe J. Postpartum positioning and attachment education for increasing breastfeeding: a randomized trial. Birth. 2001; 8 (4): 236-42. ; Birth, 2001 |
Adelaide- Austrália, 1999 |
Intervention study: 160 mothers |
To evaluate the effect of educational program and placement for breastfeeding in primiparous women on the onset of nipple trauma |
Fisher test, Chisquare, student t test |
Incidence in the Experimental Group= 17%; in the control group= 16% |
____ |
Guidance on the correct positioning between mother-child in the postpartum |
Weigert et al.,3838 Weigert EML, Giugliani ERJ, França MCT, Oliveira LD, Bonilha ALL, Espiríto Santo LC, Köhler CV. The influence of breastfeeding technique on the frequencies of exclusive breastfeeding and nipple trauma in the first month of lactation. J Pediatr. 2005; 81 (4): 310-6.; J Pediatr. 2005 |
Porto Alegre- Brasil, 2003 |
Cohort study: 211 mothers and babies |
To investigate the influence of breastfeeding technique on nipple injuries on the first month of lactation |
Pearson's chisquare test or chi-square test with Yates correction, Student t test |
Incidence of 43.6% |
Handling the baby: mouth slightly open; Symmetrical handling |
Mother/baby positioning: mother with tense shoulders: baby’s head and trunk not aligned; baby’s body away from the mother; baby’s chin does not touch mother’s breast; baby is not supported correctly; Handling of the baby: inferior lip not inverted |
Shimoda et al.,3232 Shimoda GT, Silva IA, Santos JLF. Characteristics, frequency and factors present in nipples damage occurence in lactating women. Rev Bras Enferm. 2005; 58 (5): 529-34.; Rev Bras Enferm. 2005 |
São Paulo- Brasil, 2000 |
A cross-sectional study: 1,020 medical records of puerperal women and newborns |
Check the occurrence of the nipple according to the characteritics of the newborn and the puerperal |
Chi-square test and two measurement test |
Prevalence of 52.75% |
7 days incidence of 43.2% in the control group and 48.9% in the intervention group |
Type of nipple; Type of childbirth; Baby’s gender; Baby’s weight |
Abrão et al.,4040 Abrão ACFV, Gutierrez MGR, Marin HF. Diagnóstico de Enfermagem Amamentação Ineficaz - Estudo de identificação e validação clínica. Acta Paul Enferm. 2005; 18 (1): 46-55.; Acta Paul Enferm. 2005 |
São Paulo- Brasil, 1996 a 1997 |
A analytic descriptive study: 124 puerperal women and newborns in maternal breastfeeding |
Identify and Validate defining characteristics of diagnosis on ineffective breastfeeding |
Chi-square test, Cochran G test |
Prevalence of 30.6% |
____ |
Incorrect handling of the nipple-areola region; Parity; Malformed nipples |
Oliveira et al.,5757 Oliveira LD, Giugliani ER; Espírito Santo LC, França MC, Weigert EML, Kohler CV, Lourenzi Bonilha AL. Effect of Intervention to Improve Breastfeeding Technique on the Frequency of Exclusive Breastfeeding and Lactation-Related Problems. J Hum Lact. 2006; 22 (3): 315-21.; J Hum Lact. 2006 |
Porto Alegre- Brasil, 2003 |
An intervention study: 211 pairs (mother and child) at 7 and 30 days after postpartum (74 in the intervention group and 137 in the control group) |
Evaluate the impact of an intervention of breastfeeding technique about nipple problems during the first month after postpartum |
Pearson's chisquare test or the chi-square test with Yates correction, Student t -Test |
7 days incidence of 43.2% in the control group and 48.9% in the intervention group |
____ |
An intervention on adequate orientation on breastfeeding technique |
Coca et al.,77 Coca KP, Gamba MA, Silva RSE, Abrão ACFV. Factors associated with nipple trauma in the maternity unit. J Pediatr. 2009; 85 (4): 341-5.; Rev Esc Enferm USP. 2009 |
São Paulo- Brasil, 2004 a 2005 |
A case-control study: 146 binomials mother and child (73 cases and 73 controls) in the first week of postpartum in maternal breastfeeding |
Identify factors related to the position of the child during breastfeeding and apprehension of the nipple |
Chi-square, student t -test, univariate analysis and correspondence analysis |
____ |
Mother/baby positioning: Position of the child not alignment. Handling of the baby: Chin away from the breast; Lip facing inward |
Mother/baby positioning: Mother with shoulders ten-se and/or perched on the child; Child positioned away from the mother. Handling of the baby: Baby’s mouth slightly open; Tongue not visible; Absence of the asymmetric handling; Quick suction; Non audible swallowing |
Coca et al.,3434 Coca KP, Gamba MA, Silva RSE, Abrão ACFV. Does breast feeding position influence the onset of nipple trauma? Rev Escola Enferm USP. 2009; 43 (2): 446-52.; J Pediatr. 2009 |
São Paulo- Brasil, 2004 a 2005 |
A case-control study: 146 puerperal women (73 cases and 73 controls) with a single pregnancy and exclusive breastfeeding |
Identify the factors associated to nipple trauma in women in exclusive maternal breastfeeding |
Chi-square test , Student t test and non-conditional logistic regression |
____ |
Does not live with a partner; Breasts turgid and engorged; Semiprotruding and/or malformed nipples; Pre-sence of breastfeeding in the first hour after birth; Primiparity |
Maternal age; Maternal schooling; Maternal Race/color; Preparation of the nipples during pregnancy; The baby’s gender; Birth weight |
Kronborg et al.,3636 Kronborg H, Vaeth M. How Are Effective Breastfeeding Techniqueand Pacifier Use Related to Breastfeeding Problems and BreastfeedingDuration? Birth. 2009; 36: 34-42.; Birth. 2009 |
Aarhus- Dinamarca, 2004 |
An intervention study: 579 pairs mother-child |
Investigate the relationship of breastfeeding technique and the use of pacifier with problems in breastfeeding and in the duration of maternal breastfeeding |
Chi-square test, logistic regression, using Cox regression method, Kaplan Meier and Log Rank Testing |
____ |
Ineffective Breastfeeding techniqu |
Use of a pacifier |
Moraes et al.,3535 Moraes M, Silva L, Faliú B, Sosa C. Técnica de alimentación a pecho y aparición de trauma del pezón previo al alta hospitalaria. Arch Pediatr Urug. 2011; 82 (1): 10-17.; Arch Pediatr Urug. 2011 |
Montevideo- Uruguai, 2009 a 2010 |
A cross-sectional study: 204 mothers and infants |
Evaluate the relationship between breastfeeding technique and the presence of nipple trauma before hospital discharge |
Chi-square test, logistic regression |
Prevalence of 40.1% |
Multiparous women; Nipple fissure in previous pregnancies; Technique of feeding with one or two negative parameters; Technique on feeding with three or more negative parameters |
____ |
Goyal et al.,3737 Goyal RC, Banginwar AS, Ziyo F, Toweir AA. Breastfeeding practices: Positioning, attachment (latch-on) and effective suckling - A hospital-based study in Libya. J Fam Comm Med. 2011; 18 (2): 74-9.; J Fam Comm Med. 2011 |
Benghazi- Líbia, 2009 a 2010 |
A cross-sectional study: 192 mothers and children |
Assess the positioning, the handle and the suction of Children in breastfeeding admitted to hospitals in Benghazi- Lybia |
Chi-square test |
____ |
Positioning; Handling |
____ |
Prieto- Goméz et al.,4747 Prieto-Gómez R, Baeza-Weinmann B. Lactancia materna: Prevalencia de grietas y dolor en mujeres que amamantan, región de la araucanía, Temuco, Chile. 2010-2011. Rev Colombiana Obstetr Ginecol. 2013; 64 (3): 229-33.; Rev Colombiana Obstetr Ginecol. 2013 |
Temuco- Chile, 2010 a 2011 |
A cross-sectional study: 343 postpartum women for convenience sampling |
To determine the prevalence of nipple fissure in mothers in the early puerperium, and practices of health professionals in relation to breastfeeding |
Descriptive analysis with prevalence calculation |
Prevalence of 46.1% |
____ |
Maternal age; Type of childbirth; Parity; Classification of the newborn according to weight/ gestational age; Previous experience with breastfeeding; Presence of pain |
Buck et al.,5555 Buck ML, Amir LH, Cullinane M, Donath SM. Nipple pain, damage, and vasospasm in the first 8 weeks postpartum. Breastfeed Med. 2014; 9 (2): 56-62.; Breastfeed Med. 2014 |
Melbourne- Australia, 2009 a 2011 |
A cohort study: 340 primiparous women |
To describe the nipple pain/ injury and its rela-tion to the type of childbirth |
Chi-square test |
Incidence of 58% |
____ |
Type of childbirth |
Shimoda et al.,3333 Shimoda GT, Aragaki IMM, Sousa CA, Silva IA. Associação entre persistência de lesão de mamilos e condições de aleitamento materno. Rev Mineira Enferm. 2014; 18 (1): 68-74.; Rev Min Enferm. 2014 |
São Paulo- Brasil, 2000 |
A cross-sectional study: 60 women |
Check the association between the persistence of nipples injuries and breastfeeding conditions |
Fisher test |
Prevalence of 26.7% |
Color of the nipple-areola region little pigmentation; Nipple pain; Improper handling of the newborn to the mother's breast |
Type of breast feeding; Breast engorgement. Nipple type |
Shimoda et al.,99 Shimoda GT, Soares AV, Aragaki IMM, Mcarthur A. Preventing nipple trauma in lactating women in the University Hospital of the University of Sao Paulo: a best practice implementation project. JBI Database System Rev Implement Rep. 2015; 12 (13): 212-32.; JBI Database System Rev Implement Rep. 2015 |
São Paulo- Brasil, 2013 |
An intervention study: 196 women and newborns |
Evaluate the implementation impact of the Assessment Form on breastfeeding, to observe and guide the mother in the postnatal period, on the rates of nipple trauma |
Descriptive analysis with incidence calculation |
Incidence of 67.3% |
____ |
Guidance on maternal breastfeeding and breastfeeding technique during the postpartum period |
Thompson et al.,1212 Thompson R, Kruske S, Barclay L, Linden K, Gao Y, Kildea S. Potential predictors of nipple trauma from an in-home breastfeeding programme: a cross-sectional study. Women Birth. 2016; 29 (4): 336-44.; Women Birth. 2016 |
Melbourne- Australia, 2001 a 2007 |
A cohort study: 653 women |
Describe the characteristics of women who participated in the service of breastfeeding and explore the potential risk factors for nipple trauma and breast engorgement |
Chi-square test, logistic regression |
Incidence of 62.9% |
Asymmetric handling infants’ facialmandibular in relation to the breast; Positioning: technique cross-cradle; hand in "scissors" to hold the breast; Lactational mastitis |
Breast engorgement |