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

Visual cue	Narration
Title slide	Welcome to this Spoken Tutorial on Nipple conditions in lactating mothers.
Image: Sore and cracked nipples. Image: Flat and inverted nipples.	In this tutorial, we will learn about- 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.	Let us begin with the 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.	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.
Image: Correct latching technique.	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.	Next, 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.	Remember, 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 hindmilk 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- Soaps, 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	For preventing sore or cracked nipples, 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	The nipple condition that we will discuss next is- 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: A groped image of holds. Image: Position of baby’s lips and mother’s fingers.	As explained in an earlier tutorial, 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.	Note that, incorrect latching will result into sore nipples.
Image: Nipple shields with the red cross mark. Image: Feeding bottles.	Remember- 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.	This brings us to the end of this tutorial on nipple conditions in lactating mothers. In this tutorial, we learnt about- Sore or cracked nipples and Flat or inverted nipples
Image: The Spoken Tutorial Project logo.	This tutorial has been contributed by Spoken Tutorial Project, IIT Bombay
Link to spoken tutorial project or NMEICT	Spoken Tutorial Project is funded by NMEICT, MHRD, Government of India. More information on this mission is available at this link.
Image: WHEELS Global Foundation logo.	This tutorial is partly funded by a generous contribution from WHEELS Global Foundation.
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.

Contributors and Content Editors

Bellatony911, Rajani st