Comparative Study of the Use of HPA Lanolin and Breast Milk for Treating Pain Associated with Nipple Trauma

Abstract Objective To compare two different treatments—the use of highly purified anhydrous (HPA) lanolin and expressed breast milk—for women with pain and nipple trauma during the breastfeeding process. Method A total of 180 puerperal women were randomly assigned to 2 groups: one was treated with HPA lanolin and the other with their own expressed breast milk. All of the participants received the same breastfeeding technique instructions and therapeutic care standard. Three assessments were performed: at the time of inclusion in the study (after randomization); after 48 hours; and after 7 days. At each interval, data was collected in relation to pain and trauma. A numerical/verbal category scale was used for the pain variable, and the nipple trauma score for the trauma variable. The results were subjected to statistical analysis using the chi-squared test, the Fisher exact test, the student t-test, and the Kolmogorov-Smirnov test. Generalized estimating equations were calculated using the STATA 12 statistical software package (StataCorp LLC, College Station, TX, USA) and IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp, Armonk, NY, USA). Results There was pain improvement from the second to the third assessment in the group that used HPA lanolin, while the pain remained unchanged between these two periods (p< 0.001) in the breast milk group. In terms of trauma, improvement was identified in its extension and depth from the first to the third assessment, and it was higher in the HPA lanolin group than in the breast milk group (p= 0.025). Conclusion The treatment of pain and nipple trauma with HPA lanolin achieved better results than the one with breast milk, based on a 7-day treatment period.摘要 目的：比较两种治疗方案——高纯化无水（HPA）羊毛脂（highly purified anhydrous lanolin）与自身挤出母乳——对母乳喂养过程中产褥期妇女乳头疼痛及乳头创伤的治疗效果。方法：招募180名产褥期妇女，按随机分组原则分为两组：一组接受HPA羊毛脂治疗，另一组使用自身挤出的母乳进行治疗。所有受试者均接受统一的母乳喂养操作指导与标准化治疗护理。本研究共开展三次评估：研究纳入时（随机分组完成后）、干预后48小时、干预后7天。每次评估均采集疼痛与乳头创伤相关数据：疼痛指标采用数字/言语等级量表评定，创伤指标采用乳头创伤评分量化。统计分析采用卡方检验、Fisher确切概率法、Student t检验及Kolmogorov-Smirnov检验；使用STATA 12统计软件包（StataCorp LLC，美国德克萨斯州大学城）与IBM SPSS Statistics 20.0版（IBM公司，美国纽约州阿蒙克市）完成广义估计方程计算。结果：HPA羊毛脂组在第二次至第三次评估时疼痛症状显著改善，而母乳治疗组的疼痛症状在该时段无明显变化（p<0.001）。在乳头创伤方面，两组均在首次至第三次评估时实现了创伤范围与深度的改善，但HPA羊毛脂组的改善效果优于母乳治疗组（p=0.025）。结论：基于7天的治疗周期，采用HPA羊毛脂治疗母乳喂养相关乳头疼痛与创伤的临床效果优于母乳治疗方案。