Health-and-Nutrition/C2/Nipple-conditions/English-timed

Time	Narration
00:00	Welcome to this Spoken Tutorial on Nipple conditions in lactating mothers.
00:06	In this tutorial, we will learn about- sore or cracked nipples and
00:12	flat or inverted nipples.
00:15	The first nipple condition is- sore or cracked nipples.
00:20	It is a condition where mother develops cracked and bleeding nipples.
00:26	This causes the nipples to become itchy and dry.
00:30	Now, let’s discuss the various causes of sore or cracked nipples which are-
00:36	nipple feeding,
00:38	fungal or bacterial infection,
00:41	habit of cleaning the nipples after every feed and
00:45	baby with tongue tie.
00:47	Let us begin with the nipple feeding.
00:50	Nipple feeding is the first and foremost cause of sore or cracked nipples.
00:56	During nipple feeding, nipple gets rubbed on to the hard palate of the baby’s mouth.
01:03	Baby pinches this nipple between the hard palate and the tongue.
01:08	This pinching makes the breastfeeding painful and results into sore or cracked nipple.
01:17	Nipple feeding is the result of improper latching.
01:20	Therefore correct latching plays an important role to avoid sore or cracked nipples due to nipple feeding.
01:28	Note that we have discussed the correct latching technique in another tutorial of the same series.
01:36	Remember, sore or cracked nipples does hurt during correct latching.
01:43	If the mother continues with the correct latching technique then slowly and gradually it stops hurting.
01:51	Next is fungal or bacterial infection.
01:55	If the mother has fungal or bacterial infection, she should consult the doctor.
02:02	Next, some mothers have a habit of cleaning the nipples before every feed.
02:09	This causes dryness of nipples.
02:12	Thus, this routine should be avoided.
02:16	Remember, mother can clean the nipples once during bath.
02:21	However, once a cracked nipple has developed, mother should clean it after every feed.
02:27	After cleaning, mother should apply her hind-milk on the wound
02:32	as hind-milk contains substances that aid in healing and fighting infection.
02:39	Thus, preventing the organisms from baby's mouth to leak into the crack of the nipple.
02:46	Next is the baby with tongue tie.
02:50	Tongue tie is a condition in which the tip of the baby’s tongue is attached to the inner bottom part of the mouth.
02:58	It is a very rare condition.
03:01	Nipple feeding is commonly observed in baby with tongue tie.
03:06	In case, the baby has tongue tie then mere correct latching is not enough and surgery is required.
03:16	Thus, in such cases, mother should always consult the doctor.
03:21	Now, let’s discuss the treatment for sore or cracked nipples.
03:27	If a mother has sore or cracked nipples, then the health worker should- examine the mother’s breast and nipple,
03:36	tell the mother to express some breast milk with her hand before breastfeeding.
03:42	It will soften the breast and baby will easily attach.
03:47	Apart from these, expressing will reduce the risk of infections, nipple fissure and mastitis.
03:55	Then guide the mother to attach her baby correctly to her breast.
04:01	Remember, breastfeeding frequency is one of the factors which determines the breast milk supply.
04:09	Therefore, mother should not stop breastfeeding.
04:13	During breastfeeding- she should begin to breastfeed on the side that hurts less.
04:20	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.
04:32	Also, apply few drops of hind-milk onto the affected area after each feed as discussed earlier.
04:41	Remember, not to use the following on sore or cracked nipples and even on healthy nipples-
04:49	soaps, oils, lotions, balms and perfumes.
04:54	They may contain irritants.
04:57	It will worsen the condition if a mother has sore or cracked nipples.
05:03	In severe conditions, mother should consult the doctor or the health worker.
05:09	For preventing sore or cracked nipples, start breastfeeding immediately after birth.
05:15	Always make sure that baby is latched on deeply while breastfeeding.
05:22	The nipple condition that we will discuss next is, flat or inverted nipples.
05:28	Flat nipples are not protruded from the level of the areola.
05:32	Whereas, inverted nipples are usually pointed in the inward direction.
05:38	It is very important for the mother to understand the fact that flat or inverted nipple is not a hindrance to breastfeeding.
05:48	Since, during correct latching, baby latches on to the areola and not on the nipple.
05:55	Note that in case of flat or inverted nipples, mother requires help in first week of delivery.
06:03	During this period, health worker should guide the mother about correct latching.
06:08	This will build her confidence.
06:11	Remember, in case a mother has flat or inverted nipples then the best holds for effective attachment are- cross cradle hold,
06:22	football hold and semi-reclining position.
06:26	As explained in an earlier tutorial, in any hold, it is of utmost importance that mother should hold the breast in the correct manner
06:37	where baby’s lips and mother’s fingers will be in the same direction.
06:42	Note that incorrect latching will result into sore nipples.
06:47	Remember, do not use feeding bottles or nipple shields.
06:52	It will make it difficult for a baby to breastfeed from breasts having flat or inverted nipples.
06:59	Mother should provide plenty of skin to skin contact to the baby.
07:04	It helps stimulate oxytocin reflex in the mother and breast milk easily comes out.
07:12	Always remember, correct latching is the key to deal with most of these nipple conditions.
07:20	This brings us to the end of this tutorial. Thanks for joining

Contributors and Content Editors

Debosmita, Jyotisolanki, PoojaMoolya, Sandhya.np14