Comparative Study of the Use of HPA Lanolin and Breast Milk for Treating Pain Associated with Nipple Trauma

Abstract

Objective To compare two different treatments—the use of highly purified anhydrous (HPA) lanolin and expressed breast milk—for women with pain and nipple trauma during the breastfeeding process.

Method A total of 180 puerperal women were randomly assigned to 2 groups: one was treated with HPA lanolin and the other with their own expressed breast milk. All of the participants received the same breastfeeding technique instructions and therapeutic care standard. Three assessments were performed: at the time of inclusion in the study (after randomization); after 48 hours; and after 7 days. At each interval, data was collected in relation to pain and trauma. A numerical/verbal category scale was used for the pain variable, and the nipple trauma score for the trauma variable. The results were subjected to statistical analysis using the chi-squared test, the Fisher exact test, the student t-test, and the Kolmogorov-Smirnov test. Generalized estimating equations were calculated using the STATA 12 statistical software package (StataCorp LLC, College Station, TX, USA) and IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp, Armonk, NY, USA).

Results There was pain improvement from the second to the third assessment in the group that used HPA lanolin, while the pain remained unchanged between these two periods (p < 0.001) in the breast milk group. In terms of trauma, improvement was identified in its extension and depth from the first to the third assessment, and it was higher in the HPA lanolin group than in the breast milk group (p = 0.025).

Conclusion The treatment of pain and nipple trauma with HPA lanolin achieved better results than the one with breast milk, based on a 7-day treatment period.

Resumo

Objetivo Comparar dois tratamentos distintos—o uso de lanolina anidra altamente purificada (HPA, na sigla em inglês) e o próprio leite materno—para mulheres com dor e trauma mamilar durante o processo de amamentação.

Métodos Participaram do estudo 180 puérperas randomizadas para 2 grupos: um utilizou tratamento com lanolina HPA e o outro o próprio leite materno. Todas receberam a mesma orientação quanto à técnica de amamentação e rigor terapêutico e foram avaliadas em três momentos: na inclusão no estudo (após a randomização), em 48 horas e em 7 dias. Em todos os momentos, foram colhidos dados em relação à dor e ao trauma. Para a variável dor, utilizou-se escala de categoria numérica/nerbal e, para a variável trauma, a pontuação de traumas mamilares. Os testes estatísticos utilizados foram: Qui-quadrado, teste exato de Fisher, t de Student, e Kolmogorov-Smirnov, sendo que os modelos de equações de estimação generalizadas foram calculados por meio dos pacotes STATA 12 (StataCorp LLC, College Station, TX, EUA) e IBM SPSS Statistics for Windows, Versão 20.0 (IBM Corp, Armonk, NY, EUA).

Resultados Houve melhora da dor da segunda para a terceira avaliação no grupo que utilizou a lanolina HPA, enquanto que no grupo que usou leite materno a dor permaneceu inalterada entre esses dois momentos (p < 0,001). Quanto ao trauma, foi identificada melhora em sua extensão e profundidade, da primeira para a terceira avaliação, e a melhora foi maior no grupo tratado com lanolina HPA do que no grupo tratado com leite materno (p = 0,025).

Conclusão O tratamento da dor e do trauma mamilar com lanolina HPA teve melhor resultado comparado com o leite materno, com base em um período de tratamento de 7 dias.

Keywords

nipples/injuries - wound healing/drug effects - lanolin/therapeutic use - breastfeeding/adverse effects - breastfeeding/nipple pain

Palavras-chave

mamilos/lesões - cicatrização de feridas/efeitos de medicamentos - lanolina/uso terapêutico - aleitamento materno/efeitos adversos - aleitamento/dor no mamilo

Contributions

Mariani Neto C., Albuquerque R. S., Souza S. C., Giesta R. O., Fernandes A. P. S. and Mondin B. contributed with the project and the interpretation of data, writing of the article, critical review of the intellectual content and with the final approval of the version to be published.

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