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Kazemi A, Iraji A, Esmaealzadeh N, Salehi M, Hashempur MH. Peppermint and menthol: a review on their biochemistry, pharmacological activities, clinical applications, and safety considerations. Crit Rev Food Sci Nutr 2024:1-26. [PMID: 38168664 DOI: 10.1080/10408398.2023.2296991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
In this manuscript, we conducted a comprehensive review of the diverse effects of peppermint on human health and explored the potential underlying mechanisms. Peppermint contains three main groups of phytochemical constituents, including essential oils (mainly menthol), flavonoids (such as hesperidin, eriodictyol, naringenin, quercetin, myricetin, and kaempferol), and nonflavonoid phenolcarboxylic acids. Peppermint exhibits antimicrobial, antioxidant, anti-inflammatory, immunomodulatory, anti-cancer, anti-aging, and analgesic properties and may be effective in treating various disorders, including gastrointestinal disorders (e.g., irritable bowel syndrome, dyspepsia, constipation, functional gastrointestinal disorders, nausea/vomiting, and gallbladder stones). In addition, peppermint has therapeutic benefits for psychological and cognitive health, dental health, urinary retention, skin and wound healing, as well as anti-depressant and anti-anxiety effects, and it may improve memory. However, peppermint has paradoxical effects on sleep quality and alertness, as it has been shown to improve sleep quality in patients with fatigue and anxiety, while also increasing alertness under conditions of monotonous work and relaxation. We also discuss its protective effects against toxic agents at recommended doses, as well as its safety and potential toxicity. Overall, this review provides the latest findings and insights into the properties and clinical effects of peppermint/menthol and highlights its potential as a natural therapeutic agent for various health conditions.
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Affiliation(s)
- Asma Kazemi
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aida Iraji
- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Niusha Esmaealzadeh
- Department of Traditional Pharmacy, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Traditional Persian Medicine and Complementary Medicine (PerCoMed) Student Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Salehi
- Traditional and Complementary Medicine Research Center (TCMRC), Department of Traditional Medicine, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Mohammad Hashem Hashempur
- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Can Gürkan Ö, Abbasoğlu D, Arslan Özkan H, Alioğullari A. Cacao Butter as Prophylaxis for Nipple Problems: A Pilot Randomized Controlled Study. Breastfeed Med 2022; 17:745-752. [PMID: 35881863 DOI: 10.1089/bfm.2021.0349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: Cacao butter is a type of oil extracted from the fruit of the Theobroma Cacao plant. This study was conducted to compare the use of breast milk and cacao butter for the prevention of nipple problems in the early postpartum period. Materials and Methods: This randomized controlled study involved 72 participants, who were randomized into the cacao and mother's milk groups. Data were collected using Descriptive questionnaire, Nipple assessment form, and IMDAT (Amount of Urine Output, Condition of Breasts, Amount of Stool, Weight Increase and Satisfaction Status). Results: On postpartum day 10, the rates of nipple pain (11.40% cacao group versus 40.50% mother's milk group), rashes (14.30% cacao group versus 35.10% mother's milk group), and cracks (14.30% cacao group versus 43.20% mother's milk group) significantly reduced in the cacao group when compared with the mother's milk group (p < 0.05). Conclusion: The application of cacao butter to the nipples is possibly a more effective method than the application of mother's milk for preventing nipple pain, rashes, or cracked nipples. Cacao butter can be used prophylactically to prevent nipple problems in the early postpartum period.
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Affiliation(s)
- Özlem Can Gürkan
- Nursing Division, Department of Obstetrics and Gynaecology Nursing, Faculty of Health Sciences of Marmara University, Istanbul, Turkey
| | - Döne Abbasoğlu
- Zeynep Kamil Women and Children Diseases Training and Research Hospital, Ministry of Health, Istanbul, Turkey
| | - Hediye Arslan Özkan
- Nursing Division, Department of Obstetrics and Gynaecology Nursing, Faculty of Health Sciences of Yeditepe University, Istanbul, Turkey
| | - Ayşegül Alioğullari
- Research and Development Project Coordination Unit, Turkey Institutes of Health, Istanbul, Turkey
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Laageide L, Radke S, Santillan D, Ten Eyck P, Powers J. Postpartum Nipple Symptoms: Risk Factors and Dermatologic Characterization. Breastfeed Med 2021; 16:215-221. [PMID: 33337281 PMCID: PMC8418445 DOI: 10.1089/bfm.2020.0030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Nipple discomfort inhibits breastfeeding goals, particularly between 0 and 8 weeks postpartum (PP), and yet the specific dermatologic entities that contribute to nipple soreness have not been clearly delineated. Moreover, there remains a lack of evidence-based guidelines for nipple symptoms and skin diseases. Methods: A survey was distributed to 6-8-week PP women, 18-50 years of age, with an intent to exclusively or partially breastfeed ("at the breast" or "pump"). The study aimed to characterize nipple skin symptoms (pain and itching) and lesions (eczema, redness, cuts, or wounds) and any association between these nipple problems and past dermatologic history, breastfeeding outcomes, and the ability to meet her breastfeeding goals. Results: Findings paralleled Centers for Disease Control and Prevention (CDC) statistics with a 25% decline in breastfeeding rates between birth, 86.3% (189), and 6-8 weeks PP, 64.5% (145). By 6-8 weeks PP, exclusive "formula" and "exclusive feeding at the breast" showed the largest increase (+16.4%) and decrease (-22.9%), respectively. Although no significant difference was found in comparison of nipple problems to feeding methods or skin history, women who reported pumping or PP redness/eczema had higher odds ratios of a change in feeding practice, history of eczema, and sensitive skin. Strong pumping intentions were also associated with the highest risk of unmet breastfeeding goals. Conclusion: Regardless of feeding method, product, or provider use, PP nipple problems predominantly arose between 1 and 3 weeks PP. Clinical Trial Registration number 201901737.
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Affiliation(s)
- Leah Laageide
- Department of Internal Medicine, University of Iowa - Des Moines, Des Moines, Iowa, USA
| | - Stephanie Radke
- Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Donna Santillan
- Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Patrick Ten Eyck
- University of Iowa Institute for Clinical and Translational Science, Iowa City, Iowa, USA
| | - Jennifer Powers
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
- VA Medical Center, Iowa City, Iowa, USA
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Abstract
BACKGROUND The postpartum period is the most crucial but also the most fragile stage of most pregnancies. The health benefits of aromatherapy have recently become more widely accepted among medical experts. Although a number of studies have examined these health benefits, no systematic reviews have been conducted to assess the effects of aromatherapy on the psycho-physiological health of postpartum women. PURPOSE This systematic review was conducted to evaluate the effectiveness of aromatherapy interventions on the psycho-physiological health of postpartum women, to determine the methods that were used to measure intervention effectiveness, and to identify the types of interventions that were used. METHODS We searched for studies that evaluated the effects of aromatherapy on postpartum women published in the Chinese or English languages before March 2018. We used online databases such as the Taiwan Journal Index, Centre for European Policy Studies, Cumulative Index for Nursing and Allied Health Literature, Cochrane Library, PubMed, and Social Sciences Citation Index. The search keywords used were "women," AND "postpartum," OR "postnatal" AND "aromatherapy," OR "aroma," OR "essential oils." Only randomized controlled trials including humans as study participants were included. The methodological quality of the trials was assessed using the modified Jadad scale. The quality of the full-text studies was assessed by three reviewers. RESULTS The 15 studies that were included in this systematic review were performed in Iran, England, and the United States and included 2,131 participants in total. The numbers of participants in each study ranged between 35 and 635. The review found that the effective duration of aromatherapy varied according to the essential oils that were selected. The visual analog scale was the most frequently used measure of postpartum pain. Most of the studies found that the aromatherapy intervention improved postpartum physiological and psychological health, with positive effects shown on anxiety, depression, distress, fatigue, mood, nipple fissure pain, physical pain, post-cesarean-delivery pain, post-cesarean-delivery nausea, postepisiotomy pain, postepisiotomy recovery, sleep quality, and stress. Most of the studies reported no serious intervention-related side effects. CONCLUSIONS This systematic review may serve as a reference for healthcare workers in caring for postpartum women. Aromatherapy may be applied as a noninvasive complementary intervention to promote physio-psychological comfort in postpartum women.
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Sağlık DK, Kısacık ÖG. Comparison of the effects of olive oil and breast milk on the prevention of nipple problems in primiparous breastfeeding women: a randomized controlled trial. Health Care Women Int 2020; 42:877-894. [PMID: 33290192 DOI: 10.1080/07399332.2020.1840570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We aimed to determine the effects of olive oil and breast milk on the prevention of nipple problems in this study. This study was conducted on 120 primiparous breastfeeding mothers. The mean scores for nipple pain demonstrated a statistically significant difference between the olive oil group and the control group (p = .006) and nipple damage was significantly less in the olive oil group (p = .003) on the 7th day of the follow-up. Our results illustrated that olive oil was effective in reducing pain severity and preventing the formation of nipple crack compared control group.
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Affiliation(s)
| | - Öznur Gürlek Kısacık
- Assistant Professor, Faculty of Health Science, Fundamentals of Nursing Department, Afyonkarahisar Health Science University, Afyonkarahisar, Turkey
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Babamohamadi H, Ansari Z, Nobahar M, Mirmohammadkhani M. The effects of peppermint gel on prevention of pressure injury in hospitalized patients with head trauma in neurosurgical ICU: A double-blind randomized controlled trial. Complement Ther Med 2019; 47:102223. [PMID: 31780037 DOI: 10.1016/j.ctim.2019.102223] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 10/14/2019] [Accepted: 10/17/2019] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the effect of peppermint gel on the prevention of pressure injuries in patients with head trauma admitted to neurosurgical intensive care units. DESIGN This double blind, randomized, controlled clinical trial study was conducted on 150 patients with head trauma admitted to the ICU. Using sealed envelopes, patients were assigned randomly into two intervention (n = 75) and control (n = 75) groups. SETTING The study was conducted in the ICUs of a university hospital and a general hospital in Shiraz, Iran. INTERVENTION The intervention group received peppermint gel three times a day up to 14 days during the skin care as a layer on the skin areas exposed to the risk of pressure injuries. The control group used a placebo gel. PRIMARY OUTCOMES The expected outcome in this study was the incidence of pressure injuries stage I, which once daily was evaluated by pairs of observers with the National Pressure Ulcer Advisory Panel. RESULTS The incidence rate of pressure injuries was 22.8% and 77% in the intervention and the control groups, respectively. The chi-square test result showed a significant deference between two groups (P < 0.001). Sacrum was the most common site for incidence of the pressure injuries. CONCLUSION The findings showed that the peppermint gel has a positive effect in the prevention of pressure injuries in the patients with head trauma admitted to ICUs. So, the use of this gel is suggested as an easy and low-cost method for prevention of pressure injuries in the patients admitted to ICUs.
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Affiliation(s)
- Hassan Babamohamadi
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran; Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran.
| | - Zahra Ansari
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran, Iran.
| | - Monir Nobahar
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran; Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran; Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.
| | - Majid Mirmohammadkhani
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran; Department of Epidemiology and Statistics, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
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Lv X, Feng R, Zhai J. A combination of mupirocin and acidic fibroblast growth factor for nipple fissure and nipple pain in breastfeeding women: protocol for a randomised, double-blind, controlled trial. BMJ Open 2019; 9:e025526. [PMID: 30918032 PMCID: PMC6475339 DOI: 10.1136/bmjopen-2018-025526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 02/17/2019] [Accepted: 02/21/2019] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Nipple fissure and nipple pain are common complaints among breastfeeding mothers. Studies found that mupirocin was effective in preventing and treating infections of damaged nipple and nipple pain. Acidic fibroblast growth factor (aFGF) plays an important role in wound healing. However, current evidence on the efficacy and safety of mupirocin plus aFGF for nipple fissure and nipple pain in breastfeeding women is inconclusive due to the lack of well-designed randomised controlled trials on this topic. The purpose of this study is to test the hypothesis that mupirocin plus aFGF is more effective than mupirocin alone for nipple fissure and nipple pain in breastfeeding women. METHODS AND ANALYSIS This study is a randomised, double-blind, single-centre, parallel-group clinical trial. A total of 120 breastfeeding women with nipple fissure and nipple pain will be randomly assigned to either mupirocin plus aFGF group or mupirocin plus placebo group according to a computer-generated random allocation sequence. The treatment period lasts 14 days. The primary outcome is nipple pain intensity measured by the Visual Analogue Scale on day 14 during the treatment period. Secondary outcome measures include time to complete nipple pain relief, changes in the Nipple Trauma Score, time to complete healing of nipple trauma, quality of life measured by the Maternal Postpartum Quality of Life (MAPP-QOL) Questionnaire, the frequency of breast feeding, the rate of breastfeeding discontinuation, weight change in infants and adverse events. ETHICS AND DISSEMINATION The study has gained approval from the Ethics Review Committee of Tianjin Central Hospital of Gynaecology Obstetrics on 22 January 2018 (approval no. 2018KY001). We plan to publish our research findings in a peer-reviewed academic journal and disseminate these findings in international conferences. This study has been registered with the Chinese Clinical Trial Registry. TRIAL REGISTRATION NUMBER ChiCTR1800017248.
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Affiliation(s)
- Xiaofang Lv
- Galactophore Department, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, China
| | - Rui Feng
- Galactophore Department, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, China
| | - Jingbo Zhai
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Campos TM, dos Santos Traverzim MA, Sobral APT, Bussadori SK, Fernandes KSP, Motta LJ, Makabe S. Effect of LED therapy for the treatment nipple fissures: Study protocol for a randomized controlled trial. Medicine (Baltimore) 2018; 97:e12322. [PMID: 30313028 PMCID: PMC6203513 DOI: 10.1097/md.0000000000012322] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 08/21/2018] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Poor positioning of the child in relation to the breast and improper suckling are the main causes of nipple fissure. Treatment options for nipple fissures include drug therapy with antifungal and antibiotics, topical applications of lanolin, glycerin gel, creams and lotions, the milk itself, hot compresses, and silicone nipple shields. Studies involving light-emitting diode (LED) therapy have demonstrated anti-inflammatory properties, the enhancement of the wound repair process, and the control of pain. As it does not cause discomfort, is relatively inexpensive and may impede the discontinuation of breastfeeding, phototherapy could be a viable option for the treatment of nipple fissures. AIM The principal objective of the proposed study is to evaluate the effectiveness of LED therapy for the treatment of nipple fissures in postpartum mothers. MATERIALS AND METHODS One hundred patients treated with a medical diagnosis of bilateral nipple trauma classified as nipple fissures or cracks will participate in the study, randomized into 2 groups: The control group will receive orientation regarding breast care and adequate breastfeeding techniques. The experimental group will receive the same orientation and phototherapy sessions using a device developed especially for the treatment of nipple trauma. Both groups will be followed up for 6 consecutive weeks.
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Affiliation(s)
- Thalita Molinos Campos
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE
| | | | - Ana Paula Taboada Sobral
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE
| | - Sandra Kalil Bussadori
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE
| | | | - Lara Jansiski Motta
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE
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Shanazi M, Farshbaf Khalili A, Kamalifard M, Asghari Jafarabadi M, Masoudin K, Esmaeli F. Comparison of the Effects of Lanolin, Peppermint, and Dexpanthenol Creams on Treatment of Traumatic Nipples in Breastfeeding Mothers. J Caring Sci 2015; 4:297-307. [PMID: 26744729 PMCID: PMC4699508 DOI: 10.15171/jcs.2015.030] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 09/27/2015] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Traumatic nipple is among the most common problems of the breastfeeding period which leads to early cessation of breastfeeding. The study aimed to compare the effects of the lanolin, peppermint, and dexpanthenol creams on the treatment of traumatic nipples. METHODS This double-blind randomized controlled trial was carried out on 126 breastfeeding mothers. The mothers had visited at the health centers and children's hospitals in Sanandaj City. The selected participants were randomly divided into the following three groups of lanolin, peppermint, and dexpanthenol cream groups. Nipple pain was measured using the Store scale while trauma was measured with the Champion scale. Analyses were carried out through the Kruskal-Wallis test, Chi-square, ANOVA, and repeated measures ANOVA by using SPSS software ver. 13. RESULTS The result showed that the mean score of nipple pain and nipple trauma at the prior to intervention stage, third, seventh, and fourteenth days of intervention was not significantly different between three groups. But, repeated measures ANOVA showed a significant difference in comparison of the four time periods of intervention in each group. CONCLUSION RESULTS of this study revealed that the lanolin, peppermint, and dexpanthenol medicines had similar therapeutic effects on traumatic nipple.
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Affiliation(s)
- Mahnaz Shanazi
- Department of Midwifery, Nursing and Midwifery Faculty, Tabriz University of
Medical Sciences, Tabriz, Iran
| | - Azizeh Farshbaf Khalili
- Department of Midwifery, Tabriz Health Services Management Research Centre,
Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahin Kamalifard
- Department of Midwifery, Nursing and Midwifery Faculty, Tabriz University of
Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Department of Biostatistics & Epidemiology, Road Traffic Injury Research
Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kazhal Masoudin
- Department of Midwifery, Nursing and Midwifery Faculty, Tabriz University of
Medical Sciences, Tabriz, Iran
| | - Fariba Esmaeli
- Information Technology, Faculty of Nursing and Midwifery, Tabriz University of
Medical Sciences, Tabriz, Iran
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Marrazzu A, Sanna MG, Dessole F, Capobianco G, Piga MD, Dessole S. Evaluation of the effectiveness of a silver-impregnated medical cap for topical treatment of nipple fissure of breastfeeding mothers. Breastfeed Med 2015; 10:232-8. [PMID: 25989381 DOI: 10.1089/bfm.2014.0177] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study evaluated the effectiveness of a medical topical treatment device named Silver Cap(®) (Depofarma S.P.A., Mogliano Veneto, Treviso, Italy) for the treatment of nipple fissure in lactating women and its local tolerability, compared with the standard of care for nipple fissure treatment during breastfeeding. SUBJECTS AND METHODS From December 2013 to September 2014, we recruited 40 women for symptomatic nipple fissures during lactation. Participants were randomized into two groups: the Silver Cap group (20 women; group A) or the control group (20 women; Group B, standard of breastfeeding care). All participants received breastfeeding education provided by a board-certified lactation consultant. Group A was instructed to use the Silver Cap. Group B had a handbook with the standard of care for nipple treatment after each breastfeeding. Both groups received a questionnaire for a daily assessment. The duration of both treatments was 15 days. We performed a clinical evaluation on Days 0 and 2 and a follow-up by telephone on Day 7, and all participants underwent final evaluation face to face on Day 15. We performed photographic recording of the nipple on Day 0 and Day 15. RESULTS There were no statistical differences in follow-up between the two treatments at Day 2. There was a significant and a more rapid resolution of painful symptoms in the Silver Cap group compared with the control group (p<0.05) at Days 7 and 15. Treatment with Silver Cap was more appreciated by the participants than standard care (p<0.05). Four participants in the Silver Cap group and six in the control group dropped out of the study. No local or systemic reactions were reported following Silver Cap application. CONCLUSIONS Results of treatment with Silver Cap were more effective than standard care of nipple fissure treatment in term of resolution of painful symptoms. It promoted the healing process of lesions, and it was well tolerated and accepted by participants.
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Affiliation(s)
- Adriano Marrazzu
- 1 Gynecologic and Obstetric Clinic, Department of Surgical, Microsurgical, and Medical Sciences, Sassari University , Sassari, Italy
| | | | - Francesco Dessole
- 1 Gynecologic and Obstetric Clinic, Department of Surgical, Microsurgical, and Medical Sciences, Sassari University , Sassari, Italy
| | - Giampiero Capobianco
- 1 Gynecologic and Obstetric Clinic, Department of Surgical, Microsurgical, and Medical Sciences, Sassari University , Sassari, Italy
| | - Maria Domenica Piga
- 1 Gynecologic and Obstetric Clinic, Department of Surgical, Microsurgical, and Medical Sciences, Sassari University , Sassari, Italy
| | - Salvatore Dessole
- 1 Gynecologic and Obstetric Clinic, Department of Surgical, Microsurgical, and Medical Sciences, Sassari University , Sassari, Italy
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Abstract
BACKGROUND Leading health authorities all recommend exclusive breastfeeding to six months' postpartum. While most women initiate breastfeeding, many discontinue due to difficulties encountered rather than maternal choice. One common breastfeeding difficulty is painful nipples. Research has identified poor infant positioning or latch as a common cause of painful nipples. While many different interventions designed to reduce nipple pain in breastfeeding women have been evaluated, it is unclear which intervention is the most effective treatment. An understanding of nipple pain and treatment options are needed to improve breastfeeding duration and exclusivity rates and to address systematically one of the most frequent difficulties encountered by breastfeeding women. OBJECTIVES To assess the effects of all interventions in the resolution or reduction of nipple pain and the impact of the interventions on other outcomes such as nipple trauma, nipple infections, breast mastitis, breastfeeding duration, breastfeeding exclusivity, and maternal satisfaction. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2014) and scanned secondary references. SELECTION CRITERIA All randomised or quasi-randomised controlled trials designed to evaluate any intervention for treating nipple pain among breastfeeding women. Trials using a cluster-randomised design were eligible for inclusion. Cross-over trials were not eligible for inclusion. The following interventions were eligible for inclusion compared with each other or usual care (i.e. education only): pharmacological (e.g. antifungal creams); non-pharmacological topical treatments (e.g. lanolin); dressings (e.g. hydrogel dressings); nipple protection devices (e.g. breast shells), phototherapy, and expressed breast milk. Nipple pain in women who are feeding with expressed breast milk (i.e. women of infants in neonatal units) is associated with other methods of removing milk from the mother's breast such as manual expression and various types of breast pumps. Nipple pain and subsequent treatment is different in this unique maternal population and thus we excluded women solely feeding with expressed breast milk from this review. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion, extracted data, evaluated methodological quality, and checked data for accuracy. We sought additional information from several trial researchers. MAIN RESULTS We included four trials of good methodological quality involving 656 women in the review. The four included trials evaluated five different interventions including glycerine pads, lanolin with breast shells, lanolin alone, expressed breast milk, and an all-purpose nipple ointment. All studies included education to position the infant at the breast correctly as part of routine postpartum care to both treatment and control groups.Pooled data existed only for the comparison of lanolin versus usual care. We did not pool data for other outcomes due to either heterogeneity in outcome measures or differing interventions.There was no evidence that glycerine gel dressings or breast shells with lanolin significantly improved nipple pain. One trial found no clear differences in nipple pain (at one to three days, four to five days, or six to seven days' post-treatment) between women who applied lanolin or nothing to their nipples. In contrast, the same trial found that women who applied expressed breast milk had significantly lower perceptions of nipple pain following four to five days of treatment than women who applied lanolin. However, this beneficial effect was not maintained after six to seven days of treatment. There were no group differences in nipple pain perceptions at any assessment between women who applied expressed breast milk and women who applied nothing. Women who applied an "all-purpose nipple ointment", in comparison to women who applied lanolin, had no improvement in nipple pain after seven days of treatment. There was insufficient evidence that glycerine gel dressings, lanolin with breast shells, lanolin alone, expressed breast milk, or all-purpose nipple ointment improved maternal perceptions of nipple pain.Overall, there was insufficient evidence to recommend any intervention for the treatment of nipple pain. However, one important finding was that regardless of the treatment used, for most women nipple pain reduced to mild levels after approximately seven to 10 days' postpartum. The provision of anticipatory guidance regarding usual time to pain reduction may be a useful strategy in assisting women to continue to breastfeed and to do so exclusively. The overall quality of the evidence for the primary outcome of nipple pain as assessed using GRADE was of low quality, mainly because single studies with few participants contributed data for analysis. AUTHORS' CONCLUSIONS There was insufficient evidence that glycerine gel dressings, breast shells with lanolin, lanolin alone, or the all-purpose nipple ointment significantly improved maternal perceptions of nipple pain. The results from these four trials of good methodological quality suggested that applying nothing or just expressed breast milk may be equally or more beneficial in the short-term experience of nipple pain than the application of an ointment such as lanolin.The quality of the evidence for this review did not lead to robust conclusions regarding the objectives assessed. We included only four trials, incorporating 656 women, in the review and all four trials compared varying interventions, participants, study outcome measures, and standards of usual care. The methodological quality of the included studies was good but the overall quality of the evidence for the primary outcome of nipple pain was of low quality, mainly because single studies with few participants contributed data for analysis.
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Affiliation(s)
- Cindy-Lee Dennis
- University of Toronto andWomen’s College Research Institute, 155 College Street, Toronto, ON, M5T 1P8, Canada.
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Chin EG, Vincent C, Wilkie D. A Comprehensive Description of Postpartum Pain after Cesarean Delivery. J Obstet Gynecol Neonatal Nurs 2014; 43:729-41. [DOI: 10.1111/1552-6909.12483] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Akbari SAA, Alamolhoda SH, Baghban AA, Mirabi P. Effects of menthol essence and breast milk on the improvement of nipple fissures in breastfeeding women. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2014; 19:629-33. [PMID: 25364362 PMCID: PMC4214021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 08/28/2013] [Accepted: 05/11/2014] [Indexed: 11/13/2022]
Abstract
BACKGROUND Nipple fissure is a common disorder during breastfeeding. With high prevalence of nipple fissures and its impacts on breastfeeding, as well as the existence of evidence in favor of the application of peppermint as an antiinflammatory and antiinfection herb, the purpose of this study is to determine the effect of Menthol essence on improving nipple fissures in the primiparous breastfeeding women. MATERIALS AND METHODS This study was conducted using a clinical trial method. Samples were divided randomly into two groups of 55 women. The women in the peppermint group applied four drops of Menthol essence on their nipple and areola after each feeding. The control group applied four drops of their own milk on the nipple and areola after each feeding. Then, the two groups were studied on days 10 and 14 postpartum. For intensity of pain, the visual analog scale (0-10 cm) and to measure the severity of damage, Amir scale (1-10 cm) were applied and the existence or lack of nipple discharge was also recorded. The data were analyzed using SPSS 17 software. RESULTS The mean intensity of pain and nipple fissure before treatment (8.55 ± 1.74) and day 10 after delivery (4.26 ± 1.57) and before treatment and day 14 after delivery in the case group (1.32 ± 1.02) had a significant difference (P < 0.001). Nipple discharge between the two groups, before treatment (%75.2) and day 10 after delivery (%31.6) and before treatment and day 14 after delivery (%15.7), the case group had a significant difference (P < 0.001). CONCLUSION Menthol essence can improve nipple fissures in the primiparous breastfeeding women.
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Affiliation(s)
- Sedigheh Amir Ali Akbari
- Department of Reproductive Health and Midwifery, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seideh Hanieh Alamolhoda
- Department of Reproductive Health and Midwifery, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Akbarzadeh Baghban
- Department of Basic Sciences, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvaneh Mirabi
- Department of Midwifery, Zanjan Branch, Islamic Azad University, Zanjan, Iran
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Cizmeci MN, Kanburoglu MK, Akelma AZ, Tatli MM. Rusty-pipe syndrome: a rare cause of change in the color of breastmilk. Breastfeed Med 2013; 8:340-1. [PMID: 23414230 DOI: 10.1089/bfm.2012.0143] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Mehmet Nevzat Cizmeci
- Division of Neonatology, Department of Pediatrics, Fatih University Medical School, Ankara, Turkey
| | - Mehmet Kenan Kanburoglu
- Division of Neonatology, Department of Pediatrics, Fatih University Medical School, Ankara, Turkey
| | - Ahmet Zulfikar Akelma
- Division of Neonatology, Department of Pediatrics, Fatih University Medical School, Ankara, Turkey
| | - Mustafa Mansur Tatli
- Division of Neonatology, Department of Pediatrics, Fatih University Medical School, Ankara, Turkey
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