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Keywords:

  • breastfeeding;
  • breastfeeding pain;
  • primary care provider;
  • support;
  • management;
  • mastitis;
  • candidiasis;
  • engorgement;
  • nipple pain;
  • plugged milk ducts

ABSTRACT

Objective

To describe breastfeeding pain reported by breastfeeding women during the first-year postpartum and providers’ management of the pain as recorded in medical records.

Design

Retrospective, descriptive.

Setting

Mid-South metropolitan obstetric and gynecologic medical practice.

Participants

A convenience sample of 117 breastfeeding women.

Methods

Data were collected using a retrospective review of medical records of breastfeeding mothers during their infants’ first year of life.

Results

Participants reported a breastfeeding rate of 56.4%, and of those 23% reported breastfeeding pain during the first year. Major reasons for pain were mastitis (67.5%), candida (32.4%), engorgement (18.0%), nipple tenderness (8.1%), and clogged milk ducts (4.5%). Medications were used most frequently to treat mastitis and candida. However, limited documentation of breastfeeding support beyond prescribing medications was found. Nonpharmacological measures were rarely recommended, and few referrals were documented to specialized providers such as lactation consultants or community support groups. Routine infant feeding choices, breastfeeding discussions, and breastfeeding counseling were rarely documented and multiple non-evidence-based strategies were noted.

Conclusions

Inadequate breastfeeding support and management were evident, and non-evidence-based recommendations were routinely practiced. It is recommended that primary care providers adopt evidence-based practices for breastfeeding and breastfeeding pain that support women in successfully reaching their breastfeeding goals.