Abstract
Background
Australian breastfeeding rates fall significantly in the months following birth, often
as a result of breastfeeding complications.
Aim
To explore the potential risk factors for nipple trauma and breast engorgement in
a group of women who were referred to the in home breastfeeding service in Melbourne,
Australia.
Method
A retrospective, cross-sectional analyses of the maternal–infant records (n = 653) from 2003 to 2007 including demographic characteristics; pregnancy, labour and
birth data; the presenting complications and observational and diagnostic results.
Bivariate and logistic regression analyses were conducted to explore the predictors
of nipple trauma and engorgement.
Results
Nipple trauma was the most common presenting complication (62.9%). Logistic regression
analyses identified four statistically significant predictors: facio-mandibular asymmetry
(AOR 4.21, 95% CI [1.25–14.20]), inflammatory mastitis (AOR 2.99, 95% CI [1.57–5.68],
nipple malignment (AOR 2.51, 95% CI [1.13–5.55]) and the cross-cradle technique (AOR
1.90, 95% CI [1.03–3.50]). Engorgement was associated with the first postpartum breastfeed
being less than one-hour duration (AOR 2.01, 95% CI [1.07–3.79]).
Conclusion
Nipple trauma was associated with commonly taught techniques that involved the cross-cradle
hold and manoeuvres of the breast, nipple and baby that resulted in nipple malalignment
and facio-mandibular asymmetry. This practice, appeared to interfere with the baby's
intra-oral function by restricting movement of the cranio-cervical spine and nuchal
ligament. The combination appeared to limit the baby's instinctive ability to activate
neuro-sensory mammalian behaviours to freely locate and effectively draw the nipple
and breast tissue without causing trauma. Changes to the first and early breastfeeding
techniques are recommended.
Keywords
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Article info
Publication history
Published online: February 16, 2016
Accepted:
January 12,
2016
Received in revised form:
January 12,
2016
Received:
November 4,
2015
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
