Breastfeeding seminars

Nurse researcher receives NIH grant to help women manage breastfeeding pain

Health experts agree that breastfeeding leads to optimal health for infants and their mothers. According to the Centers for Disease Control and Prevention, breastfed infants are less likely to suffer from childhood illnesses like croup or diarrhea; asthma; obesity; and type 1 diabetes, among other problems. Breastfeeding can also reduce a mother’s risk of being diagnosed with ovarian and breast cancer, high blood pressure, and type 2 diabetes.

But many women don’t breastfeed their children for the recommended minimum of six months because the process can be painful. Faculty member of the School of Nursing Ruth Lucas has dedicated her research to supporting women in their breastfeeding journeys and helping them manage their breast and nipple pain, or BNP. Recently she received a National Institutes of Health High Priority Short-Term Project Award (R56) to help with this research.

Ruth Lucas (Photo submitted).

“Most women who stop breastfeeding do so within three weeks of giving birth, and 30% stop because of breast and nipple pain,” Lucas explains. “We found that women who experience this pain also report low self-efficacy – the belief in themselves that they are capable of breastfeeding and caring for their child – as well as higher rates of anxiety. , depression, stress and fatigue.

Stopping breastfeeding before three weeks also costs society an estimated $3 billion a year, due to formula purchases, increased doctor visits and childhood illness rates, and lost wages. . About $2.3 billion of this total comes at the expense of mothers.

“Women will continue to breastfeed even with unresolved pain because they want to provide the best for their baby.” Lucas said. “However, unresolved breast and nipple pain triggers a complex pain feedback loop that can lead to increased pain sensitivity. As a result of this study, we may be able to use increased pain sensitivity to identify women at high risk of stopping breastfeeding due to pain and future risk of chronic pain, which will help us create targeted interventions for breast and nipple pain.

Work with the School of Nursing P20 Center for Accurate Pain Self-Management AccelerationLucas has developed a method — the BNP Breastfeeding and Self-Management (BSM) intervention — to empower mothers and teach them to cope with their pain.

“We use a cloud-based platform to provide breastfeeding information and skills to women, and the nurses provide support via text message,” says Lucas. His first study to test the method was successful, with women reporting less pain one to two weeks after starting to breastfeed, leading to increased self-confidence and decreased anxiety at six weeks.

Now, with this preliminary data in hand, Lucas is replicating and expanding the study. With the R56 grant from the NIH, she plans to recruit more than 200 women for a randomized controlled trial. The women will be randomly divided into two groups: one receiving the specialized Lucas BSM intervention and the other receiving general postpartum and infant care. After establishing each woman’s baseline pain, Lucas and his team will reassess them eight times over the course of 24 weeks. With each recording, the researchers will assess the pain of the women’s breasts and nipples, whether they are still exclusively breastfeeding or supplementing with formula, and their feelings of self-efficacy and well-being.

“We suspect that women who receive the BSM intervention will report lower breast and nipple pain intensity and interference with their daily lives in the first three weeks,” says Lucas. “They should also have a lower cumulative pain score over time, compared to the group that received general support.”

Her team also believe that the group receiving the BSM method will have more women exclusively breastfeeding for the 24 weeks than the control group and will also report higher well-being and self-efficacy throughout.

“This study could potentially lead to new nurse-led breastfeeding support initiatives in clinical settings,” says Lucas. “The BSM intervention is easily accessible to women, as texting and cloud-based learning can be done at home and could easily be scaled up to large-scale health care settings.”

Support for this research is provided by National Institutes of Health National Institute for Nursing Research Grant R56NR020041. Visit for more information.

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