Until the 1930’s, breastfeeding was almost universally practiced. At that time, infant formula, made from modified cow milk, was developed and became a symbol of an affluent society. This led to a dramatic decline in breastfeeding.
Now breastfeeding is again strongly promoted because since the 1960’s, studies have repeatedly proven the benefits of breastfeeding and the superiority of human milk. Breastfed infants appear to have fewer incidences of illnesses such as colds, diarrhea or ear infections. Additionally, breastfed babies are less likely to have allergies. Moreover breastfeeding is important for the psychological well being of mother and child.
However, breastfeeding is often an unpleasant challenge for the mother because of retracted nipples, painful nipples, infection of the breast (mastitis), thrush in the baby’s mouth and on the nipple, constant leakage of milk and its social implication, or simply insufficient milk production, leading to a feeling of guilt and inadequacy.
Normal neonatal sucking induces visible changes in nipple skin, especially swelling and eschar (scab). Blisters, inflamed areas and peeling are also frequently observed (Ziemer 1993). Statistics reveal that 80-95 % of breastfeeding women will experience some degree of soreness with 26 % reporting extreme nipple pain (Newton 1952, Walker 1989). It is evident that a nipple trauma is still very common (Cable 1997).
Painful nipples can inhibit the let-down (milk ejection) reflex. As the mother becomes more tense, a vicious circle has begun that often leads to early weaning.
Nipple damage may create a predisposing factor for infection with micro-organisms such as Candida albicans or Staphylococcus aureus and increase the risk of developing mastitis due to the infection of the ascending lactiferous duct (Amir 1991, Livingstone 1999).
Most important in the prevention of damaged, painful nipples is the correct positioning and latch-on of the baby. (Klaus 1987).
Some other factors are also contributing to cracked/fissured nipples, such as products which remove the natural lubrication from the nipple area (soaps, shampoos), thrush and eczema or a tendency to have dry skin. Proper hygiene with proper products is imperative.
The old methodology in case of cracked/fissured nipples was to keep the damaged nipples dry. However as wounds heal in a moist environment, they heal without scab or crust formation. Hence, the new approach is to create a moisture barrier on the injured area as this slows down the evaporation of moisture naturally present in the skin.
It is fortunate that nowadays the knowledge of the importance of breastfeeding is accompanied by more knowledge on how to prevent and treat the problems of breast feeding mothers.
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