The effects of clinical nursing practice guideline for preventing and reducing cracked nipple on nipple pain and cracked nipple of breastfeeding mothers at postpartum ward, Ramathibodi Hospital

Abstract

Cracked nipples are most common causes of nipple pain in breastfeeding mother which can be
decrease suckling of newborns. These reasons can initiate discontinue or failure successful breastfeeding.
This quasi -experimental research aims to compare the effect of clinical nursing practice guideline
(CNPG) for preventing and reducing nipple scores on nipple pain and level of cracked nipple. The purposive
participants were selected from the postpartum women in the obstetric ward at Ramathibodi Hospital
during December 2014 - January 2015. All samples were equally classified into 2 groups. The first 35
postpartum women were assigned to the control group and received the usual nursing standard, while the
other 35 postpartum women were assigned to the experimental group and received the clinical nursing
practice guideline for preventing and reducing nipple in addition to the usual nursing intervention. Research
tool was the CNPG for preventing and reducing cracked nipple. The content validity was examined by three
experts. Measuring tools consisted of: 1) Pain assessment using the Numerical Rating Scale (NRS); and 2)
Level of cracked nipples modified by Thussanasupap (2006). Data were analyzed by Descriptive statistic, Chi
square, Independent t-test, and Mann -Whitney test. Results found that the experiment group had lower
nipple pain scores than the control group at day 1 and day 2 after delivery. However, there was no
different level of cracked nipple between control and experiment group but the number of cracked
nipples in experimental group lower than control group.
The results of this study support that the CNPG is useful for preventing and reducing nipple pain
and cracked nipple. Nursing staff in postpartum ward can use this standard CNPG for caring breastfeeding
mothers