Difference between revisions of "Health-and-Nutrition/C2/Nipple-conditions/English"

Welcome to this spoken tutorial on Nipple conditions in lactating mothers.

Image: Sore and cracked nipples.

Image: Flat and inverted nipples.

• Sore or cracked nipples and
• Flat or inverted nipples.

Image: Bleeding and cracked nipple.

Image: Dry nipples.

The first nipple condition is-

Sore or cracked nipples

• It is a condition where mother develops cracked and bleeding nipples.

• This causes the nipples to become itchy and dry.

Image: Symbol of cause.

Image: Nipple feeding.

Image: Fungal infection of breast.

Image: A mother is cleaning her nipple.

Now let’s discuss the various causes of sore or cracked nipples which are-

• Nipple feeding,
• Fungal or Bacterial infection,
• Habit of cleaning the nipples after every feed and
• Baby with tongue tie.

Image: Nipple feeding.

Image: Sore or cracked nipples.

Image: Incorrect latching.

GIF of incorrect latching

Nipple feeding is the first and foremost cause of sore or cracked nipples.

• During nipple feeding-
  • nipple gets rubbed onto the hard palate of the baby’s mouth.
  • baby pinches this nipple between the hard palate and the tongue.
  • this pinching makes the breastfeeding painful.
  • and results into sore or cracked nipple.

Image: Nipple feeding.

GIF of correct latching.

Image: Correct latching technique.

• Nipple feeding is the result of improper latching.
  • therefore correct latching plays an important role to avoid sore or cracked nipples due to nipple feeding.

• Note that,

We have discussed the correct latching technique in another tutorial of the same series.

Image: Sore or cracked nipple. Image: Symbol of pain. Image: A mother is breastfeeding a baby.

Remember

• Sore or cracked nipples does hurt during correct latching,

• If the mother continues with the correct latching technique then slowly and gradually it stops hurting.

Image: Fungal infection.

Image: A mother is talking to a doctor.

• Next is fungal or bacterial infection,
  • If the mother has a fungal or bacterial infection she should consult the doctor.

Image: Mother is cleaning her nipples.

Image: A mother is breastfeeding to a baby.

Image: Dry nipples.

Image: Cracked nipples.

• Some mothers have a habit of cleaning the nipples before every feed.
• This causes dryness of nipples.
• Thus, this routine should be avoided.

Image: A mother is taking a shower.

Image: Cracked nipples.

Image: A mother is applying the hindmilk on her breast.

Image: Mouth organisms.

• Mother can clean the nipples once during bath.
• However, once cracked nipple has developed mother should clean it after every feed.
• After cleaning, mother should apply her hindmilk on the wound.
• As hind milk contain substances that aids in healing and fighting infection.
• Thus, preventing the organisms from baby's mouth to leak into the crack of the nipple.

Image: Tongue tie. Image: Nipple feeding.

Next is the baby with tongue tie-

• Tongue tie is a condition-
  • in which the tip of the baby’s tongue is attached to the inner bottom part of the mouth.
• It is a very rare condition.
• Nipple feeding is commonly observed in baby with tongue tie.

Image: Correct latching.

Image: Surgery.

Image: The mother and the doctor.

• In case the baby has tongue tie then-
  • mere correct latching is not enough and
  • surgery is required.
  • thus in such cases, mother should always consult the doctor.

Image: A health worker is examining the mother’s breast.

Image: A mother is expressing the breast milk.

Image: Soften breasts.

Image: Nipple fissure.

Image: Mastitis breast.

Now let’s discuss the treatment for sore or cracked nipples

• If a mother has sore or cracked nipples, then, the health worker should-
  • examine the mother’s breast and nipple,
  • tell the mother to express some breastmilk with her hand before breastfeeding.
  • it will soften the breast and baby will easily attach.
  • apart from these expressing will reduce the risk of infections, nipple fissure and mastitis.
  • then, guide the mother to attach her baby correctly to her breast.

Image: A mother is breastfeeding to a baby.

Remember,

• Breastfeeding frequency is one of the factors which determines the breastmilk supply.

• Therefore, mother should not stop breastfeeding.

Image: A Mother is expressing her breast milk.

Image: A spoon.

Image: A cup.

Image: A mother is applying hindmilk on her breast.

• During breastfeeding-

She should begin to breastfeed on the side that hurts less.

• If breastfeeding is still painful then-
  • she can express the breast milk using her hand and
  • feed it to the baby with a spoon or a cup.

Also,

• Apply few drops of hind milk onto the affected area after each feed, as discussed earlier.

Image: Soaps, lotions and perfumes.

Image: Sore or cracked nipples.

Remember, not to use the following on sore and cracked nipples and even on healthy nipples-

• Soap, oils, lotions, balms and perfumes.
• They may contain irritants.
• It will worsen the condition if a mother has sore or cracked nipples.

Image: A mother is talking to a doctor.

Image: A health worker is guiding the mother.

• In severe conditions, mother should consult the doctor or the health worker.

Image: A baby is initiating the process of breastfeeding in breast crawl position

• Start breastfeeding immediately after birth.

Image: Correct latching technique.

• Always make sure that baby is latched on deeply while breastfeeding.

Image: Flat and inverted nipples

flat or inverted nipples,

Image: Normal nipple and flat nipple.

Image: Normal nipple and inverted nipple.

• Flat nipples are not protruded from the level of the areola.

Whereas,

• Inverted nipples are usually pointed in the inward direction.

Image: Flat or inverted nipples.

Image: Mother is breastfeeding a baby.

Image: Correct latching.

• It is very important for the mother to understand the fact that-
  • flat or inverted nipple is not a hindrance to breastfeeding.
  • since, during correct latching baby latches on to the areola and not on the nipple.

Image: Calendar.

Image: Natural delivery.

Image: A health worker is guiding the mother.

• Note that,

incase of flat or inverted nipples- mother requires help in first week of delivery.

• During this period-
  • health worker should guide the mother about correct latching.
  • this will build her confidence.

Image: Cross-cradle hold.

Image: Football hold.

Image: Semi-reclining position.

Remember,

In case a mother has flat or inverted nipples then the best holds for effective attachment are-

• Cross cradle hold
• Football hold and
• Semi-reclining position.

Image: Groped image of holds.

Image: Position of baby’s lips and mother’s fingers.

• In any hold, it is of utmost importance that-
  • mother should hold the breast in the correct manner,
  • where baby’s lips and mother’s fingers will be in the same direction.

Image: Incorrect latching.

Image: Sore nipples.

incorrect latching will result into sore nipples.

Image: Nipple shields with the red cross mark.

Image: Feeding bottles.

• Do not use feeding bottles or nipple shields.

• It will make it difficult for a baby to breastfeed from breasts having flat or inverted nipples.

Image: A mother carrying a baby with the green check mark.

Image: Oxytocin reflex.

• Mother should provide plenty of skin to skin contact to the baby.
  • it helps stimulate oxytocin reflex in the mother and
  • breast milk easily comes out.

Image: Correct latching technique.

Always remember,

Correct latching is the key to deal with most of these nipple conditions.

Image: Sore or cracked nipples.

Image: Flat or inverted nipples.

In this tutorial, we learnt about-

• Sore or cracked nipples and
• Flat or inverted nipples

Image: The Spoken Tutorial Project logo.

• Spoken Tutorial Project, IIT Bombay

Link to spoken tutorial project or NMEICT

More information on this mission is available at this link.

Image: WHEELS Global Foundation logo.

Image: Maa aur Shishu Poshan Project logo.

• This tutorial is part of Maa aur Shishu Poshan project.
• The domain reviewers for this tutorial are-
  • Dr. Rupal Dalal, MD Pediatrics.
  • Dr. Taru Jindal, MS Obstetrics and Gynaecology.

This is Nutritionist Rajani Sawant along with animator Arthi Anbalagan from IIT Bombay signing off.

Thanks for joining.