Construction and validation of an instrument for classifying nipple and areola complex lesions resulting from breastfeeding

Low-level laser therapy for nipple trauma and pain during breastfeeding: systematic review and meta-analysis

Objective

This study aimed to investigate the effect of low-level laser therapy (LLLT) on nipple trauma and pain during breastfeeding through a systematic review with a meta-analysis of selected studies.

Source of the data

A thorough search was conducted on March 22, 2022, using the databases PubMed, SciELO, LILACS, PEDro, CINAHL, EMBASE, ScienceDirect, Scopus, Google Scholar, MEDLINE, the Cochrane Library, Clinical Trials, Web of Science, TRIP, DARE, and ProQuest. The search terms included various combinations of low-level laser therapy, nipple pain, nipple trauma, and breastfeeding.

Studies selection

Out of 107 articles identified, only three controlled and randomized clinical trials was included. The extracted data encompassed breast and trauma characteristics, treatment types, outcomes (pain and healing process), evaluation tools, LLLT usage, laser brand, and parameters.

Data collection

Data extraction was performed using RAYYAN for systematic reviews. The risk of bias in the studies was evaluated.

Data synthesis

Pain was measured using the visual analog scale (VAS). The included studies did not use validated tools for assessing physical conditions. All studies employed LLLT with a 660-nm wavelength, though there were variations in equipment power, energy dose, and application methods. The meta-analysis revealed an average difference of -0.60 points (95% CI: -1.52 to 0.31) in the VAS pain scores between the LLLT and control groups. No heterogeneity was observed among the studies (I2=0%), indicating no significant difference in pain relief between LLLT (red light) and control groups.

Conclusion

LLLT may offer a promising option for managing breastfeeding-related complications, though further research is required.

Initial nipple damages in breastfeeding women: analysis of photographic images and clinical associations

OBJECTIVE

to analyze the initial nipple damage degree by breastfeeding practice and to associate findings with clinical manifestations of breastfeeding women.

METHODS

a retrospective, cross-sectional study with primary data and photographic images database from two randomized clinical trials. Photographic images were analyzed by two independent evaluators using the Nipple Trauma Score. For analysis, the chi-square, Mann-Whitney tests and Kappa coefficient were applied.

RESULTS

115 breastfeeding women and their respective 186 photographic images were analyzed. The degree of agreement of evaluators using the Nipple Trauma Score was 93.6%. The nipple pain score during breastfeeding was moderate and compromised more than 25% of the nipple surface area.

CONCLUSIONS

assistance to breastfeeding women should prioritize nipple pain intensity instead of the nipple damage size.

Systematization of perioperative nursing care in robotic surgery: instrument validation

OBJECTIVE

To develop and validate an instrument to assist in the systematization of perioperative nursing care in robotic surgery.

METHODS

Methodological study developed in four phases: content survey; textual elaboration; content validation by the group of expert judges and target audience; and elaboration of the electronic instrument layout.

RESULTS

Eleven expert judges and seven evaluators of the target audience participated. For validation, the Content Validity Index (CVI) was used with a 0.78 cutoff point. The instrument total CVI after evaluation was 0.90 by the expert judges and 0.88 by the target audience.

CONCLUSION

The tool built was proved satisfactory for the systematization of perioperative nursing care. The instrument construction was based on the updated scientific literature and validated by the expert judges and target audience.

Effectiveness of individualized counseling on the duration of exclusive breastfeeding: study protocol for a multicenter, randomized, parallel, and open clinical trial

BACKGROUND

Despite the benefits of breastfeeding, early weaning is a reality, so less than 50% of children worldwide and in Brazil are on exclusive breastfeeding in the sixth month of life. A strategy to counteract this scenario is breastfeeding counseling. This study aims to verify the effectiveness of individualized counseling by nurses trained in breastfeeding counseling, on the duration of exclusive breastfeeding, compared to standard care.

METHODS

Multicenter, randomized, parallel, and open clinical trial, with primiparous women aged over 18 years, hospitalized in rooming-in wards at participating centers and hemodynamically stable, aware, and oriented, who had a single-fetus pregnancy and gave birth, regardless of the type of delivery, with live child, gestational age of 37 to 42 weeks and birth weight greater than 2500 g. The women will be initially approached in rooming-in wards and, upon consent to participate in the study, will be allocated through randomization by blocks composed of eight participants in two groups: intervention and control. The randomization lists will be organized by a central without involvement with the study, which will manage the allocation groups and be prepared in the Randon® program. Women allocated to the intervention group will receive breastfeeding counseling by trained nurses, and those in the control group will receive standard care at the center participating in the study.

DISCUSSION

The results can contribute to breastfeeding by evidencing possible exclusivity and duration of the counseling trained nurses provide.

TRIAL REGISTRATION

REBEC RBR-4w9v5rq (UTN: U1111-1284-3559) ( https://ensaiosclinicos.gov.br/rg/RBR-4w9v5rq ). Posted on March 20, 2023.