Abstract
Dear Editor:
Olive oil is an easily accessible and relatively cheap substance. Although it had been used for sore nipples in the Mediterranean countries for many years, the usage of olive oil in the management of sore nipples has not been discussed in the literature yet.
We aimed to define a new, safe, effective, and cheap modality for preventing sore nipples. We conducted the study on the patients who were delivered in our clinic between February 2012 and June 2012. Ethical committee approval and the written consent of patients were obtained. An education on breastfeeding was given to all patients by the same nurse. Patients' nipples were examined to evaluate if both of them were suitable for suckling or not. Patients who did not give consent, could not breastfeed in the first 24 hours, had a difference between nipples that might affect suckling, had contraindication for breastfeeding, did not have sore nipples with their previous babies, and had an allergy to either olive oil or lanolin were excluded.
Patients were requested to put olive oil on one nipple and lanolin on the other one before suckling and breastfed the baby without cleaning the ointment. They were asked to use the same ointment to the same nipple every time until the end of the study. They were advised to use one of the modalities for both nipples if they were satisfied with the modality. They were also advised to record the time they chose the modality if a selection was done. After a month, patients were evaluated once more. They were asked about satisfaction from the modalities, their choice if there was, and the pain during the suckling. Data were analyzed with the SPSS version 11.5 software program (SPSS, Inc., Chicago, IL). A value of p<0.05 was defined as statistical significance.
The mean age of the 31 patients included to our study was 27.84±6.33 years. Among the study group 64.5% of them were primiparous, and 51.6% of them were delivered by cesarean section. Education levels of patients were evaluated: nine (29%) of them graduated from a primary school, 17 (54.9%) of them graduated from a secondary school, and five (16.1%) of them graduated from a university. From the study group, 15 patients (48.4%) lived in an urban area with a downtown, and 16 (51.6%) of them lived in rural areas.
In total, 18 (58.1%) patients preferred olive oil, five (16.1%) preferred lanolin, three (9.7%) continued to use both modalities, and five (16.1%) of them gave up both methods at the end of 1 month (p<0.001).
Although nine (29%) patients decided to choose one of the methods in the first week of the delivery, the rest made their choice after 1 week. Of the ones who had decided in the first week of delivery, eight (89%) patients chose olive oil, and one of them gave up both methods.
When a regression analysis was done for age, education levels, gravidas, parities, pain during suckling, delivery route, and method choice, we found a significant relationship only between the pain during suckling and the choice of method.
As it is well established, breastmilk is the ideal nutrition for a newborn. In a population-based study that examined the breastfeeding rate and patterns among 3,161 infants younger than 6 months, it was found that 22.8% of mothers experienced sore nipples. 1 Unfortunately, sore nipple might cause breastfeeding cessation.
When Mohammadzadeh et al. 2 compared hind milk rubbing after suckling and lanolin usage three times a day with the control group, they concluded that there was no difference among groups in terms of clinical manifestations of sore nipples. Tachev et al. 3 concluded that highly purified lanolin (Lansinoh®; Lansinoh Laboratories, Alexandria, VA) was suitable for both preventing and treating sore nipples. Melli et al. 4 recommended peppermint gel for sore nipples compared with placebo and lanolin.
Olive oil has strong antioxidant and antimicrobial properties, and it had been used for wound healing for a long time. 5 It is also known that even parenteral usage of olive oil for newborns is safe. So it is well tolerated by the babies and the families.
To our knowledge this is the first article that evaluates the satisfaction of lactating women with olive oil for preventing sore nipples in the English literature. Using the contralateral nipple of the patient as a control group is the major factor that strengthens our study. In this way we eliminated many factors that might affect our results.
A majority of women in the current study chose olive oil compared with lanolin in the first week of the study.
We found that olive oil is a preferable dressing for nipples to protect from cracking during suckling, especially in early lactation. Large sample-sized studies must be done to clarify the possible effects of olive oil for both the new baby and the new mother.