* Breastfeeding ‘struggles’: care and management for sore and cracked nipples

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This article reviews the care and management offered to women who are experiencing sore or cracked nipples basing it on a case history of one woman's care. Where breast milk and breast feeding has immediate and long term health outcomes for both the mother and the baby (NICE 2006, UNICEF 2008), the development of sore or cracked nipples threatens the establishment and overall duration of breastfeeding. Breast milk protects babies from gastrointestinal, urinary, respiratory and middle ear infections and some familial skin allergies while maternal benefits of breastfeeding include a reduced risk of premenopausal breast cancer (World Cancer Research Fund 2007) and some forms of ovarian cancer (Gwinn et al 1990). To maximise these health benefits, lactation needs to be established so that breast milk provides all the baby's nutritional requirements within the first six months of life. Where women develop sore and cracked nipples within the first two to five days of giving birth, there is a need for appropriate advice, support and treatment to ensure that the breast milk continues to be produced and that a way can be found to continue breastfeeding for a longer duration. This article offers some discussion about the occurrence of sore or cracked nipples and the current advice given to women about their management and treatment.

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