An Unusual Traditional Practice for Damaged Nipples During Lactation

Dear Editor:

Nipple pain associated with breastfeeding is common, with incidences varying between 34% and 96%. ¹ Reported characteristics associated with nipple pain include traumatized, chapped, sore, bleeding, edematous, erythemic, blistered nipples that may or may not have fissures and eschar present. ² Painful nipples can cause women to become discouraged and ultimately lead to the early cessation of breastfeeding. Treating sore or traumatized nipples effectively is an important factor for preventing complications such as mastitis or breast abscesses. ³ Some interventions have been used for either the prevention of or treatment for nipple pain. These treatments include topical creams, solutions, sprays, warm water compresses, tea bag compresses, heat, lanolin, vitamin A, collegenase, dexpanthenol, hydrogel therapy, glycerin gel therapy, time-restricted breastfeeding, application of expressed mother's milk, exposure of the nipples to dry heat or ultraviolet light, and air-drying. ⁴

Our patient's 24-year-old mother was admitted with complaints of pain and swelling of both breasts of 3 days in duration. Informed consent has been obtained from her. Her child was a full-term normal baby delivered vaginally. The first week of the neonatal period was normal. On examination at admission the mother was not febrile, and swelling on the left and right sides was not fluctuant. The total white blood cell count was 9,800/mm³, and the hemoglobin platelet count, urea, creatinine, glucose, and C-reactive protein levels were normal. We offered warm water compresses and breastfeeding. One week later, she was admitted again. No pain or swelling was observed. She patted the nipples dry after each feeding and applied onion rings to the nipple and areola, keeping this area covered with onıon juice at all times, including between feedings, in order to create a moist healing environment. This is an example of a traditional practice regarding newborn care that has been followed for a few thousand years, generation after generation.

This is an unusual home remedy for nipple pain and swelling of breasts. It is believed that the flavonoids (quercetin and kaempferol) in onion extract play a role in reducing scar formation through inhibition of fibroblast activities. Even though several commercial products are composed of onion extract, the precise molecular mechanisms of onion extract in reduction of scar formation in skin are still largely unknown. ⁵ We think that the biochemical effect of onion must be observed, and comparative studies with other topical creams must be done. Perhaps ın such cases, rather than using pharmaceutical medicines, it is better to use homemade remedies.