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

Time	Narration
00:01	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
00:11	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.
01:29	Note that we have discussed the correct latching technique in another tutorial of the same series.
01:37	Remember, sore or cracked nipples do 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.
01:56	If the mother has fungal or bacterial infection, she should consult the doctor.
02:03	Next, some mothers have a habit of cleaning the nipples before every feed.
02:09	This causes dryness of nipples.
02:13	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.
02:28	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.
03:22	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,
03:37	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.
04:42	Remember, not to use the following on sore and 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.
05:33	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.
05:56	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.
07:00	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.
07:19	This brings us to the end of this tutorial on nipple conditions in lactating mothers.
07:26	In this tutorial, we learnt about sore or cracked nipples and
07:31	flat or inverted nipples.
07:34	This tutorial has been contributed by Spoken Tutorial Project, IIT Bombay.
07:40	Spoken Tutorial Project is funded by NMEICT, MHRD, Government of India.
07:47	More information on this mission is available at this link.
07:52	This tutorial is partly funded by a generous contribution from WHEELS Global Foundation.
07:59	This tutorial is part of Maa aur Shishu Poshan project.
08:04	The domain reviewers for this tutorial are- Dr. Rupal Dalal, MD Pediatrics and Dr. Taru Jindal, MS Obstetrics and Gynecology. This is Nutritionist Rajani Sawant along with animator Arthi Anbalagan from IIT Bombay, signing off. Thanks for joining.

Contributors and Content Editors

Debosmita, Jyotisolanki, PoojaMoolya, Sandhya.np14