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Nipple Soreness in Lactation

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21. Corticosteroids - topical (skin), nose, and eyes

. Solutions Solutions are low viscosity, alcohol- or water-based liquids. They are easy to apply and are non-greasy. They are very drying if alcohol is the base, and can sting sore skin. Lotions Lotions are similar to solutions, but thicker. They are useful for treating large or hairy areas, and for treating exudative lesions. Creams Creams are thicker than lotions and are suitable for moist or weepy lesions. They are moisturizing without being greasy. Many people prefer them, especially for use (...) . The risk of systemic absorption can be minimized by using the weakest potency possible, for the shortest period of time. Only the lower potency topical corticosteroids (such as hydrocortisone and triamcinolone) should be used on the nipple or areola. Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking. If the topical corticosteroid is applied to the breasts, it should be washed off before

2018 NICE Clinical Knowledge Summaries

22. The Use of and Experiences With Telelactation Among Rural Breastfeeding Mothers: Secondary Analysis of a Randomized Controlled Trial. (PubMed)

discussed included: breast pain, soreness, and infection (25/83, 30%), use of nipple shields (21/83, 25%), and latch or positioning (17/83, 24%). Most telelactation users (43/47, 91%) expressed satisfaction with the help received.Telelactation is an innovation in the delivery of professional breastfeeding support. This research documents both demand for and positive experiences with telelactation in an underserved population.ClinicalTrials.gov NCT02870413; https://clinicaltrials.gov/ct2/show/NCT02870413 (...) The Use of and Experiences With Telelactation Among Rural Breastfeeding Mothers: Secondary Analysis of a Randomized Controlled Trial. Telelactation services connect breastfeeding mothers to remotely located lactation consultants through audio-visual technology and can increase access to professional breastfeeding support in rural areas.The objective of this study was to identify maternal characteristics associated with the demand for and use of telelactation and to describe visit

2019 Journal of medical Internet research Controlled trial quality: uncertain

23. Mammary candidiasis: A medical condition without scientific evidence? (PubMed)

Mammary candidiasis: A medical condition without scientific evidence? Many physicians, midwives and lactation consultants still believe that yeasts (particularly Candida spp.) play an important role as an agent of nipple and breast pain despite the absolute absence of scientific proofs to establish such association. In this context, the objective of this study was to investigate the microorganisms involved in sore nipples and/or painful "shooting" breastfeeding by using a variety of microscopy (...) ". Nipple swabs and nipple biopsy samples were also collected from the participating women. Results showed that the role played by yeasts in breast and nipple pain is, if any, marginal. In contrast, our results strongly support that coagulase-negative staphylococci and streptococci (mainly from the mitis and salivarius groups) are the agents responsible for such cases. As a consequence, and following the recommendations of the US Library of Medicine for the nomenclature of infectious diseases, the term

Full Text available with Trip Pro

2017 PLoS ONE

24. Acute Pain Management: Scientific Evidence

Nonpharmacological therapies 484 References 485 10. OTHER SPECIFIC PATIENT GROUPS 515 10.1 The pregnant patient 515 10.1.1 Management of acute pain during pregnancy 515 10.1.2 Pain syndromes in pregnancy 517 10.1.3 Management of acute pain during labour and birth 522 10.1.4 Pain management during lactation 533 10.1.5 Pain in the puerperium 538 10.2 The older patient 540 10.2.1 Physiology and perception of pain 540 10.2.2 Assessment of pain 542 10.2.3 Pharmacokinetic and pharmacodynamic changes 544 10.2.4 Drugs

2015 Clinical Practice Guidelines Portal

25. Mastitis

; 232:904–909. 33. ChristensenAF,Al-SulimanN,NielsonKR,etal.Ultrasound- guided drainage of breast abscesses: Results in 151 patients. Br J Radiol 2005;78:186–188. 34. Kataria K,Srivastava A,DharA.Management oflactational mastitis and breast abscesses: review of current knowledge and practice. Indian J Surg 2013;75:430–435. 242 ABM PROTOCOL 35. Livingstone V, Stringer LJ. The treatment of Staphylo- coccus aureus infected sore nipples: A randomized com- parative study. J Hum Lact 1999;15:241–246. 36 (...) . Amir LH, Garland SM, Dennerstein L, et al. Candida albicans: Is it associated with nipple pain in lactating women? Gynecol Obstet Invest 1996;41:30–34. 37. Saenz RB. Bacterial pathogens isolated from nipple wounds: A four-year prospective study. Breastfeed Med 2007;2:190. 38. Hale TW, Bateman TL, Finkelman MA, et al. The absence of Candida albicans in milk samples of women with clinical symptoms of ductal candidiasis. Breastfeed Med 2009;4: 57–61. 39. Andrews JI, Fleener DK, Messer SA, et al

2014 Academy of Breastfeeding Medicine

26. Guidelines for Hospital Discharge of the Breastfeeding Term Newborn and Mother: The Going Home Protocol,

, Number 1, 2014 ª Mary Ann Liebert, Inc. DOI: 10.1089/bfm.2014.9996 3 Table 1. Maternal Risk Factors for Lactation Problems Factors History/social Primiparity Intention to both breastfeed and bottle or formula feed at less than 6 weeks Intention to use paci?ers/dummies and/or arti?cial nipples/teats at less than 6 weeks Early intention/necessity to return to school or work History of previous breastfeeding problems or breastfed infant with slow weight gain History of infertility Conception (...) surgery, including cosmetic procedures (important to ask—not always obvious on exam) Previous breast abscess Maternal obesity (body mass index ‡ 30 kg/m 2 ) Extremely or persistently sore nipples Failure of ‘‘secretory activation’’ lactogenesis II. (Milk did not noticeably ‘‘come in’’ by 72 hours postpartum. This may be dif?cult to evaluate if mother and infant are discharged from the hospital in the ?rst 24–48 hours postpartum.) Mother unable to hand-express colostrum Need for breastfeeding

2014 Academy of Breastfeeding Medicine

27. Guidelines for identification and management of substance use and substance use disorders in pregnancy

Psychosocial interventions 30 15 Detoxification 0 0 Dependence management 36 4 Lactation 0 0 Management of the infant 5 4 Unclassified 5 n/a Total 93 33 FIGURE 1: SCREENING OF RECORDS FROM THE LITERATURE SEARCH TO ELIGIBLE ARTICLES FULL TEXT OBTAINED 172 ELIGIBLE ARTICLES 93 SCREENED 5632 conducted using Cochrane methods, including meta-analysis, where appropriate, to generate results that were then evaluated using GRADE. To supplement gaps in the RCT literature, the other studies identified

2014 World Health Organisation Guidelines

28. Clinical practice guideline for care in pregnancy and puerperium

activities on the position of the mother and baby during breastfeeding, signs of proper latch and effective signs of milk transfer. Weak We suggest using warm compresses after breastfeeding for those women who breastfeed with pain or nipple lesions. v At least one observation of breastfeeding should be done before hospital discharge to check it is done properly, and if there are any complications such as engorgement, sore and cracked nipple to help correct the difficulties in latching of the baby . CPG (...) . What are the tools with better performance in the detection of mental disorders during the puerperium? 80. Does the contact of the mother with other mother networks and support groups reduce the risk of mental problems and postpartum depression? Breastfeeding 81. What practices favour the establishment of breastfeeding during the puerperium? 82. What practices help to maintain breastfeeding during the puerperium? 83. What is the most appropriate treatment for the cracks in the nipple, breast

2014 GuiaSalud

29. Community pharmacists' services for women during pregnancy and breast feeding in Kuwait: a cross-sectional study. (PubMed)

feeding.The top services provided to pregnant and lactating women were recommending vitamins and food supplements (89.8%) and contraception advice (83.4%), respectively. More than half of participants indicated that they would recommend medications for headache, constipation, cough, runny nose, sore throat, nausea/vomiting, indigestion, sore or cracked nipple and insufficient milk. Diarrhoea, haemorrhoids, insomnia, varicose vein, swelling of the feet and legs, vaginal itching, back pain, fever, mastitis (...) Community pharmacists' services for women during pregnancy and breast feeding in Kuwait: a cross-sectional study. This study was designed to identify the services provided by community pharmacists in Kuwait and their views regarding self-care in pregnancy and lactation. In addition, it determined the pharmacists' recommendations for treatment of pregnancy-related and breast feeding-related ailments.Cross-sectional questionnaire-based survey.Community pharmacies in Kuwait.207 pharmacies were

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2018 BMJ open

30. The Effect of Chinese Herbal Medicine for Reducing the Application of Antibiotics in the Treatment of Acute Mastitis

the application of antibiotics for women with acute mastitis. Condition or disease Intervention/treatment Phase Mastitis Acute Female Drug: CHPM (Chinese Herbal Patent Medicine ) Drug: Antibiotics Cefdinir Capsules Behavioral: Education Phase 2 Phase 3 Detailed Description: Acute mastitis affects the health and quality of life of the infants and mothers during the lactation. Increasing studies indicate that bacterial infections and/or dysbacteriosis are essential to the mechanisms of the disease. Thus (...) . To evaluate the effect of drug action time and the temperature changing from the baseline to the end of 3-day treatment. Change of the sores of breast pain [ Time Frame: Measured from the beginning to the end of the treatment, every 8 hours for 3 days, total 10 times including the baseline measured, specifically measured on 6:00 am, 14:00 pm, 22:00 pm. ] Pain of breast will be self-reported by participants and recorded. A visual analog scale (VAS) is used to assess breast pain. The scale was tested

2018 Clinical Trials

31. The Effect of (PubMed)

The Effect of Nipple fissure is a common problem during breastfeeding. Zizyphus Jujube Fruits is one of the oldest medicinal plants which can heal wounds through its antimicrobial and anti-inflammatory properties. This study aimed to determine the effect of jujube lotion on the recovery of breast fissure. This double-blind clinical trial recruited 100 primiparous lactating women who were randomly divided into two groups. In Jujube group, mothers used 0.5 mL of Fruit Lotion, and in control group (...) ). No significant difference was observed in sore nipple discharge between the two groups before the study and on the 7th day, while a statistically significant difference was observed between the two groups on the 14th day (P = 0/1, P = 0/01). The finding of this study revealed that the Zizyphus jujube fruits lotion heals nipple fissure faster and better than breast milk.

2018 Iranian journal of pharmaceutical research : IJPR Controlled trial quality: uncertain

32. Postpartum Nursing Care Pathway

eakdown) Intervention – nipple trauma Assess infant feeding • Ask mother to rate her nipple pain • (using V AS-see Pain) Encourage mother to look at nipple • as baby r eleases it, if nipple looks rounded rather than creased or flattened the pain is pr obably r elated to pr evious damage. This ‘reference feeding’ can help determine latch effectiveness Refer to individual knowledgeable • in current breastfeeding practices or lactation consultant (LC) After 24 hours use a combination • of hand and pump (...) and beyond bReASt S (Continued) Variance – nipple Candida (fungus Infection) Yeast Sore burning nipplesSore all the time but worse when feeding • Deep burning/shooting pain • Itchy , flaky nipples • Tiny blisters • Deep pink/bright red nipples/areola • Mother may have recently been on antibiotics or has a yeast infection • (infant may have signs of Candida in mouth or perineal ar ea) 34 Intervention – nipple Candida (fungus Infection) Yeast Differentiate from poor latch • Frequent hand washing

2011 British Columbia Perinatal Health Program

33. Delphinus SoftVue Prospective Case Collection

Female Any race or ethnicity Age 18 or older Asymptomatic Complete screening FFDM and DBT views BI‐RADS density composition category c or d Willing to comply with protocol and follow‐up recommendations as described in consent form, including the next annual screening exam in 12 months Exclusion Criteria Weight exceeds 350lbs Currently pregnant or lactating by patient self‐report Weeping rash, open wounds, or unhealed sores on the breast Bilateral mastectomy Unable to lay prone on the scan table (...) the chest wall to the nipple. Not only does SoftVue capture data from the reflection of the sound waves off of tissue boundaries and structures within the breast, but because the transducer surrounds the whole breast, SoftVue also captures signals that are transmitted through the breast. This additional transmission data enhances the visualization of the anatomic structure of the breast tissue and is not currently available in any other commercially marketed breast ultrasound device. This prospective

2017 Clinical Trials

34. Breastfeeding-Friendly Physician?s Office: Optimizing Care for Infants and Children

for this child. Provide educational material that highlights the many ways in which breastfeeding is superior to formula feeding. Encourage attendance of both parents at prenatal breastfeeding classes. Direct education and educa- tional material to all family members involved in childcare (father, grandparents, etc.). 1,13,26 The father of the infant is particularly important in support of the mother. 26 Identify patients with lactation risk fac- tors (such as ?at or inverted nipples, history of breast (...) activity, and output. Provide medical help for women with sore nipples or other maternal health problems that may impact breastfeeding. Provide close follow- up until the parents feel con?dent and the infant is doing well with adequate weight gain by the World Health Organization Child Growth Standards. 35 (III) 7. Ensure availability of appropriate educational resources for parents. In accordance with the World Health Organization International Code of MarketingofBreast- milk Substitutes, 36

2013 Academy of Breastfeeding Medicine

35. Common Breast Problems

as listed previously in the guideline can also be utilized. Persistent breast pain requires further evaluation (see breast pain). Nipple discharge. Nipple discharge is another common symptom in pregnancy and is often related to hormonal changes in preparation for lactation. Galactorrhea is the most common form of nipple discharge in pregnancy and can be managed conservatively. Galactorrhea that persists longer than 6-12 months following completion of pregnancy/lactation requires investigation for other (...) of Palpable Breast Masses. Am Fam Physician 2005;71:1731-38. Overview and recommendations for evaluation of breast masses, including summary of the strength of the evidence behind the recommendations. Jardines L. Management of nipple discharge. Am Surg, 1996; 62(2:119-122. Recommendations for evaluation and management of nipple discharge. Sabate, J, et al. Radiologic evaluation of breast disorders related to pregnancy and lactation. Radiographics 2007;27:S101-124. 12 UMHS Breast Problems Guideline, June

2013 University of Michigan Health System

36. CPG for the Management of Invasive Meningococcal Disease

– Fever – Headache – Neck Stiffness – Photophobia D One must remain alert to the possibility of IMD when evaluating patients with acute febrile disease because in the ? rst 4-6 hours of onset of the clinical IMD nonspeci? c symptoms such as fever, lethargy, refusal of food, nausea, vomiting, irritability, signs and / or symptoms of upper respiratory tract infection (runny nose, sore throat, etc.), diarrhoea, or abdominal pain may appear. D In the initial clinical evaluation (primary care), it should

2013 GuiaSalud

37. Delphinus SoftVue Prospective Case Collection

the case useful for the lesion atlas or teaching library Weight exceeds 350lbs Currently pregnant or lactating by patient self‐report Weeping rash, open wounds, or unhealed sores on the breast Bilateral mastectomy Unable to lay prone on the scan table for up to 15 minutes Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer (...) the chest wall to the nipple. Not only does SoftVue capture data from the reflection of the sound waves off of tissue boundaries and structures within the breast, but because the transducer surrounds the whole breast, SoftVue also captures signals that are transmitted through the breast. This additional transmission data enhances the visualization of the anatomic structure of the breast tissue and is not currently available in any other commercially marketed breast ultrasound device. This prospective

2016 Clinical Trials

38. Mastitis

Mastitis From Related Chapters II. Epidemiology : 9-33% of lactating women Most common in first few weeks and nearly all cases within first 3 months III. Pathophysiology rally occurs in several weeks postpartum enter through a cracked nipple IV. Etiology e V. Symptoms Malaise Myalgias VI. Signs Unilateral inflammation Warmth Tenderness Erythema Observe for signs of Breast abscess Requires needle aspiration VII. Labs: Milk Culture Indications (not routine) Severe Mastitis Refractory despite optimal (...) refractory) Indicated in refractory cases (after 3 attempted needle aspirations) Also first-line measure in very superficial lesions, with skin thinning over the abscess References Sacchetti in Herbert (2016) EM:Rap 16(5): 1 XII. Follow-up Early antibiotics prevent abscess formation If not better in 48 hours examine for abscess Consider XIII. Prevention Optimal with good latch-on by infant Address predisposing factors early Sore nipples suggest problems Correct latch-on problems Address dry nipples

2018 FP Notebook

39. Breast Feeding Technique

-on Infants positioned under nipple Do not block infant's nares with Infant's chin should be pressed into the mother's Use finger to break infant's suction should not be painful after the first 30-60 seconds of latching on Infant should have a rhythmic suck and swallow feeding pattern Ensure that infant latches on to entire areola Use C-Hold to support and direct latch-on Avoid baby latching onto only nipple Results in nipple soreness and fissures Infant should latch on to as much of areola as possible (...) Feeding Technique Aka: Breast Feeding Technique , Lactation Technique , Breast Feeding Pearls , Effective Breast Feeding Signs From Related Chapters II. Technique: Breast Feeding positions Cradle hold Use arm on side of Mother's antecubital space supports baby's head Mother's hand supports baby's bottom Cross-cradle hold Use arm on opposite side of Mother's antecubital space supports baby's bottom Mother's hand supports baby's head Baby cradled like football inside arm Similar to football hold (except

2018 FP Notebook

40. Breast Feeding Problems for the Mother

Feeding Problems for the Mother Breast Feeding Problems for the Mother Aka: Breast Feeding Problems for the Mother , Lactation Problems for the Mother From Related Chapters II. Approach: Nipple Conditions Inverted Nipples Identify problem well before delivery Recommend nipple shells to help evert nipples Sore Nipples See Milk Blebs (milk-filled s on nipple) Soak in warm water for 5-10 minutes, then gently rub nipple with washcloth to unroof may be unroofed with sterile 18 gauge needle III. Approach (...) . Approach: Inhibited Milk let down Warm shower Privacy for Comfortable environment Private Soft music Low light intensity Local heat to s VII. Approach: Medications See VIII. Approach: Work-Related Lactation problems Educate regarding various s and devices Support and encourage using at work IX. Approach: Vasospasm (Raynauds phenomenon of nipple) Decrease nipple cold exposure and warm nipple as needed Reduce nipple Avoid s (e.g. ) Consider 30 mg daily for 2 weeks (safe in ) X. References (2016) Presc

2018 FP Notebook

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