A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.
Division of Nutrition Physical Activity and Obesity. National Center for Chronic Disease Prevention and Health Promotion. Infant Feeding Practices Survey II: Results. Centers for Disease Control and Prevention. 2009. Available at www.cdc.gov/ifps/results/ch2/table2–37.htm (accessed November11, 2015).
3.
US Department of Health and Human Services. Guide to Clinical Preventive Services: Report of the U.S. Preventive Services Task Force, 2nd edition. Washington (DC): US Preventive Services Task Force. 1996. Available at www.ncbi.nlm.nih.gov/books/NBK15430/ (accessed January4, 2016).
4.
OdomE, LiR, ScanlonK, et al.Reasons for earlier than desired cessation of breastfeeding. Pediatrics, 2013; 131:e726–e732.
5.
BuckML, AmirLH, CullinaneM, et al.Nipple pain, damage, and vasospasm in the first 8 weeks postpartum. Breastfeed Med, 2014; 9:56–62.
6.
LiR, FeinSB, ChenJ, et al.Why mothers stop breastfeeding: Mothers' self-reported reasons for stopping during the first year. Pediatrics, 2008; 122(Suppl 2):S69–S76.
7.
AmirLH, DennersteinL, GarlandSM, et al.Psychological aspects of nipple pain in lactating women. J Psychosom Obstet Gynaecol, 1996; 17:53–58.
8.
WatkinsS, Meltzer-BrodyS, ZolnounD, et al.Early breastfeeding experiences and postpartum depression. Obstet Gynecol, 2011; 118:214–221.
9.
BlairA, CadwellK, Turner-MaffeiC, et al.The relationship between positioning, the breastfeeding dynamic, the latching process and pain in breastfeeding mothers with sore nipples. Breastfeed Rev, 2003; 11:5–10.
10.
Morland-SchultzK, HillP. Prevention of and therapies for nipple pain: A systematic review. J Obstet Gynecol Neonatal Nurs, 2005; 34:428–437.
11.
WoolridgeMW. Aetiology of sore nipples. Midwifery, 1986; 2:172–176.
12.
LauC, SmithEO, SchanlerRJ. Coordination of suck-swallow and swallow respiration in preterm infants. Acta Paediatr, 2003; 92:721–727.
13.
PowerRF, MurphyJF. Tongue-tie and frenotomy in infants with breastfeeding difficulties: Achieving a balance. Arch Dis Child, 2015; 100:489–494.
14.
BallardJL, AuerCE, KhouryJC. Ankyloglossia: Assessment, incidence, and effect of frenuloplasty on the breastfeeding dyad. Pediatrics, 2002; 110:e63.
15.
SegalLM, StephensonR, DawesM, et al.Prevalence, diagnosis, and treatment of ankyloglossia: Methodologic review. Can Fam Physician, 2007; 53:1027–1033.
16.
WallV, GlassR. Mandibular asymmetry and breastfeeding problems: Experience from 11 cases. J Hum Lact, 2006; 22:328–334.
17.
QiY, ZhangY, FeinS, et al.Maternal and breast pump factors associated with breast pump problems and injuries. J Hum Lact, 2014; 30:62–72.
18.
BarankinB, GrossMS. Nipple and areolar eczema in the breastfeeding woman. J Cutan Med Surg, 2004; 8:126–130.
19.
SchalockP, HsuJ, ArndtK. Lippincott's Primary Care Dermatology. Philadelphia: Wolter Kluwer Health/Lippincott Williams & Wilkins, 2010, pp. 29, 146–147, 174–175, 232–236.
20.
BarrettME, HellerMM, Fullerton StoneH, et al.Dermatoses of the breast in lactation. Dermatol Ther, 2013; 26:331–336.
21.
MervicL. Management of moderate to severe plaque psoriasis in pregnancy and lactation in the era of biologics. Acta Dermatovenerol Alp Pannonica Adriat, 2014; 23:27–31.
22.
KollmorgenDR, VaranasiJS, EdgeSB, CarsonWE, 3rd. Paget's disease of the breast: A 33-year experience. J Am Coll Surg, 1998; 187:171–177.
23.
AmirLH, DonathSM, GarlandSM, et al.Does Candida and/or Staphylococcus play a role in nipple and breast pain in lactation? A cohort study in Melbourne, Australia. BMJ Open, 2013; 3:e002351.
24.
von EiffC, ProctorRA, PetersG. Coagulase-negative staphylococci. Pathogens have major role in nosocomial infections. Postgrad Med, 2001; 110:63–64, 69–70, 73–66.
25.
MelchiorMB, VaarkampH, Fink-GremmelsJ. Biofilms: A role in recurrent mastitis infections?. Vet J, 2006; 171:398–407.
26.
HarriottMM, NoverrMC. Candida albicans and Staphylococcus aureus form polymicrobial biofilms: Effects on antimicrobial resistance. Antimicrob Agents Chemother, 2009; 53:3914–3922.
27.
AdamB, BaillieGS, DouglasLJ. Mixed species biofilms of Candida albicans and Staphylococcus epidermidis. J Med Microbiol, 2002; 51:344–349.
28.
ProctorRA, von EiffC, KahlBC, et al.Small colony variants: A pathogenic form of bacteria that facilitates persistent and recurrent infections. Nat Rev Microbiol, 2006; 4:295–305.
29.
EglashA, PlaneMB, MundtM. History, physical and laboratory findings, and clinical outcomes of lactating women treated with antibiotics for chronic breast and/or nipple pain. J Hum Lact, 2006; 22:429–433.
30.
DelgadoS, ArroyoR, JiménezE, et al.Mastitis infecciosas durante la lactancia: Un problema infravalorado. Acta Pediatr Esp, 2009; 67:77–84.
31.
HaleTW, BatemanTL, FinkelmanMA, et al.The absence of Candida albicans in milk samples of women with clinical symptoms of ductal candidiasis. Breastfeed Med, 2009; 4:57–61.
32.
GravesS, WrightW, HarmanR, et al.Painful nipples in nursing mothers: Fungal or staphylococcal?. Aust Fam Physician, 2003; 32:570–571.
33.
HaleT, BatemanT, FinkelmanM, et al.The absence of Candida albicans in milk samples of women with clinical symptoms of ductal candidiasis. Breastfeed Med, 2009; 4:57–61.
34.
AndrewsJI, FleenerD, MesserS, et al.The yeast connection: Is Candida linked to breastfeeding associated pain?. Am J Obstet Gynecol, 2007; 197:e421–e424.
35.
Francis-MorrillJ, HeinigMJ, PappagianisD, et al.Diagnostic value of signs and symptoms of mammary candidosis among lactating women. J Hum Lact, 2004; 20:288–295.
36.
ParraJ, CneudeF, HuinN, et al.Mammary herpes: A little known mode of neonatal herpes contamination. J Perinatol, 2013; 33:736–737.
37.
JaiyeobaO, AmayaMI, SoperDE, et al.Preventing neonatal transmission of herpes simplex virus. Clin Obstet Gynecol, 2012; 55:510–520.
38.
AndersonJE, HeldN, WrightK. Raynaud's phenomenon of the nipple: A treatable cause of painful breastfeeding. Pediatrics, 2004; 113:e360–e364.
39.
BarrettME, HellerMM, StoneHF, et al.Raynaud phenomenon of the nipple in breastfeeding mothers: An underdiagnosed cause of nipple pain. JAMA Dermatol, 2013; 149:300–306.
40.
de BoerMJ, StruysMM, VersteegenGJ. Pain-related catastrophizing in pain patients and people with pain in the general population. Eur J Pain, 2012; 16:1044–1052.
41.
de BoerMJ, SteinhagenHE, VersteegenGJ, et al.Mindfulness, acceptance and catastrophizing in chronic pain. PLoS One, 2014; 9:e87445.
42.
BergbomS, BoersmaK, OvermeerT, et al.Relationship among pain catastrophizing, depressed mood, and outcomes across physical therapy treatments. Phys Ther, 2011; 91:754–764.
43.
WilliamsAC, EcclestonC, MorleyS. Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database Syst Rev, 2012; 11:CD007407.
44.
BurykM, BloomD, ShopeT. Efficacy of neonatal release of ankyloglossia: A randomized trial. Pediatrics, 2011; 128:280–288.
45.
GeddesDT, LangtonDB, GollowI, et al.Frenulotomy for breastfeeding infants with ankyloglossia: Effect on milk removal and sucking mechanism as imaged by ultrasound. Pediatrics, 2008; 122:e188–e194.
46.
DollbergS, BotzerE, GrunisE, et al.Immediate nipple pain relief after frenotomy in breast-fed infants with ankyloglossia: A randomized, prospective study. J Pediatr Surg, 2006; 41:1598–1600.
47.
ButlerDC, HellerMM, MuraseJE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol, 2014; 70:417.e1–e10.
48.
BaeYS, Van VoorheesAS, HsuS, et al.Review of treatment options for psoriasis in pregnant or lactating women: From the Medical Board of the National Psoriasis Foundation. J Am Acad Dermatol, 2012; 67:459–477.
49.
LivingstoneV, StringerLJ. The treatment of Staphyloccocus aureus infected sore nipples: A randomized comparative study. J Hum Lact, 1999; 15:241–246.
50.
ArroyoR, MartinV, MaldonadoA, et al.Treatment of infectious mastitis during lactation: Antibiotics versus oral administration of Lactobacilli isolated from breast milk. Clin Infect Dis, 2010; 50:1551–1558.
51.
FernándezL, ArroyoR, EspinosaI, et al.Probiotics for human lactational mastitis. Benef Microbes, 2014; 5:169–183.
52.
KayamaC, GotoY, ShimoyaS, et al.Effects of gentian violet on refractory discharging ears infected with methicillin-resistant Staphylococcus aureus. J Otolaryngol, 2006; 35:384–386.
53.
DekioS, KawasakiY, JidoiJ. Herpes simplex on nipples inoculated from herpetic gingivostomatitis of a baby. Clin Exp Dermatol, 1986; 11:664–666.
54.
ThompsonAE, PopeJE. Calcium channel blockers for primary Raynaud's phenomenon: A meta-analysis. Rheumatology, 2005; 44:145–150.
55.
TchivilevaIE, LimPF, SmithSB, et al.Effect of catechol-O-methyltransferase polymorphism on response to propranolol therapy in chronic musculoskeletal pain: A randomized, double-blind, placebo-controlled, crossover pilot study. Pharmacogenet Genomics, 2010; 20:239–248.
56.
KernermanE, ParkE. Severe breast pain resolved with pectoral muscle massage. J Hum Lact, 2014; 30:287–291.
57.
van Veldhuizen-StaasCG. Overabundant milk supply: An alternative way to intervene by full drainage and block feeding. Int Breastfeed J, 2007; 2:11.
58.
AljazafK, HaleTW, IlettKF, et al.Pseudoephedrine: Effects on milk production in women and estimation of infant exposure via breastmilk. Br J Clin Pharmacol, 2003; 56:18–24.
59.
UNC protocol. UNC School of Medicine at Chapel Hill staff. Health Care Professionals:OB Algorithms: Breastfeeding: Culture Collection Protocol. 2014. Available at http://mombaby.org/PDF/culture_protocol.2.0.pdf (accessed November1, 2014).