Positive effects of an antenatal group teaching session on postnatal nipple pain, nipple trauma and breast feeding rates

Midwifery. 1997 Dec;13(4):189-96. doi: 10.1016/s0266-6138(97)80005-8.


Objective: To assess whether an antenatal teaching session on position and attachment of the baby on the breast had an effect on postnatal nipple pain, nipple trauma and breast feeding duration. The study was planned as a pilot study to allow an adequate sample size to be calculated for a larger study.

Design: An observer blind experimental design was used. Women were randomly assigned to either the experimental group teaching session or the control group.

Setting: One public hospital in Western Australia.

Participants: 70 primiparae who intended to breast feed their baby were recruited from the antenatal clinic of the study hospital at 36 weeks' gestation.

Intervention: Antenatal group sessions on position and attachment of the baby on the breast were conducted by a lactation consultant.

Measurements and findings: During the first four postnatal days, position and attachment was measured by LATCH (Latch on, Audible swallow, Type of nipple, Comfort and Help) (Jensen et al 1994), nipple pain was measured by the Visual Analogue Scale (VAS) and nipple trauma was measured by the Nipple Trauma Index (NTI). The analysis of variance (ANOVA) results indicated that the women in the experimental group were better able to attach the baby on the breast and had significantly less nipple pain and trauma than the control group. At six weeks postnatally, 31 of the 35 women in the experimental group were breast feeding compared to 10 of the 35 in the control group.

Conclusions and implications: These initial findings suggest that midwives can make the best use of decreasing resources by using practical 'hands on' antenatal group teaching as an effective strategy to increase breast feeding rates.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Analysis of Variance
  • Breast Feeding / adverse effects*
  • Breast Feeding / statistics & numerical data*
  • Female
  • Humans
  • Mothers / education*
  • Nipples / injuries*
  • Pain / etiology
  • Pain / prevention & control*
  • Patient Education as Topic / methods*
  • Pilot Projects
  • Pregnancy
  • Prenatal Care / methods*
  • Program Evaluation
  • Puerperal Disorders / etiology
  • Puerperal Disorders / prevention & control*
  • Teaching / methods*
  • Western Australia