Question

For mothers breastfeeding:

What is an inverted nipple? What causes it? What can be done about it?

What are the various “degrees” of nipple wounds?

What are the steps of wound healing? What is “moist wound healing strategy”?

What is a nipple vasospasm? A compression stripe? What causes these issues?

Answer 1

1.) INVERTED NIPPLE:- It is the condition in which the tissue of the nipple is retracted into tissues of breast instead of pointing outward. Sometimes it is accompanied with severe itching and pain.

• Causes of Inverted Nipples:- Breast abscess, Mastitis, Breast Cancer, Born with this condition, Mammary duct ectasia, Breast sagging, Trauma such as fat necrosis or result of any surgery.
• Treatment of Inverted Nipples:- Use of proper breast feeding technique and use of breast pump is also helpful in lactating infant with inverted nipples. Some people alsp use kind of cosmetic surgeries to correct the condition.

3.) VARIOUS DEGREES OF NIPPLE WOUNDS:- There are mainly six degrees or grades of nipple wounds classification that is defined as follows:-

• Grade-1:- no microscopically visible skin changes occur.
• Grade-2:- erythema or edema is present or both are present.
• Grade-3:- superficial damage with or without scab formation of less than 25% of nipple surface.
• Grade-4:- superficial damage with or without scab formation of more than 25% of nipple surface.
• Grade-5:- partial thickness wound with or without scab formation of less than 25% of nipple surface.
• Grade-6:- partial thickness wound with or without scab formation of more than 25% of nipple surface.

4.) STEPS OF WOUND HEALING:- Healing is the body response to injury in an attempt to restore normal function and structure. The entire wound healing process is a complex series of events. Wound Healing process has main three phases which are described as following:-

1. INFLAMMATORY PHASE:- It is immediate to 2-5 days. Vasoconstriction and platelet aggregation occurs. Thromboplastin makes clot. Sign of inflammation is present.
2. PROLIFERATIVE PHASE:- 2 days to 3 weeks. In this phase granulation occurs and fibroblasts lay bed of collagen, fills defects and produces new capillaries. Wound edges pull together to reduce defects. Epithelialization occurs.
3. REMODELING PHASE:- 3 weeks to 2 years. Newq collagen forms which increase the tensile strength of the wound. Scar tissue is 80% as strong as original tissue.

?MOIST WOUND HEALING STRATEGY:- In this moist dressing is used for wounds instead of dry. Moist dressings reduce the amount of pain for patients and reduce the chances of re-injury and trauma during dressing changes. They also have a benfit of Autolytic debridement. The key to optimizing wound healing is to maintain environment that balances the amount of moisture. These dressings need to be changed every six hours in order to prevent infections.

5.)NIPPLE VASOSPASM:- It is defined as sudden constriction of blood vessels of breast tissues. It is trigerred by breast feeding baby in shallow latch.It causes pain, itching and soarness in nipples. Deep breast pain is also present.

• Causes of Nipple Vasospasm:- Poor latch or biting, Periods of severe emotional stress, Nipple crack or trauma, Ciggarette smoking, Exposure to cold temperature, Migraines and Hypothyroidism.

COMPRESSION STRIPE:- It is defined as throbbing pain on nipples after and during nursing the baby and causing nipple blanching. Nipple compression restricts blood flow an dpain starts as circulation returns to normal. Sometimes nipples start turning white in this.

• Causes of Nipple Compression Stripe:- Mainly it occurs due to poor positioning and poor latch of baby during feeding.