Nipple hardness and length in the early stage of postpartum breastfeeding

Abstract

Purpose
We examined the relationship between the success-rate, as shown by the LATCH score, of breastfeeding mothers who were in the early stages of postpartum and the basic data collected regarding the hardness and length of their nipples.
Methods
The exam was carried out targeting 394 breastfeeding, Japanese female who had given birth 1-2 days prior. The survey included assessments of nipple hardness, nipple length, and the LATCH score. The nipple hardness was subjectively measured and classified into 3 stages. Nipple length was measured using the same manufactured plastic syringe that was used in previous Thai studies. The cooperating facilities' nursing staffs were provided training in advance of the study. Statistical analysis was performed using Welch's t-test and the χ² test. The cut-off for nipple length that leads to successful breastfeeding was calculated using the ROC curve. This study was approved by the Saga University Ethics Committee.
Results
For this study, 311 (87%) people from 11 facilities cooperated. Compared to the primipara group for the first 1-2 days postpartum, the multipara group's nipples were more flexible. Over all, the average nipple length was 12 (SD 3.4) mm. The average primipara nipple length was 11 (SD 3.2) mm while the nipple length of multipara women was 13 (SD 3.2) mm; thus the multipara group was longer (p<0.001). The overall average LATCH score was 7.4 (SD 1.9) points. The average primipara LATCH score was 6.5 (SD 1.7) points. The average multipara LATCH score was 8.0 (SD 1.7) points. The multipara groups' LATCH score was higher (p<0.001). There is a relationship between the LATCH score and the nipple hardness. Hard is 6.0 (SD 1.8) points. Medium is 7.5 (SD 1.8) points. Soft is 8.2 (SD 1.7) points. As the flexibility increases, so does the LATCH score. In order for the latch score to achieve 8 points or higher, the nipple length cut-off must be 11mm. When compared with the previous studies' decubitus female nipple length cut-off value of 7mm, that is 4mm more than before.
Conclusion
The flexibility of early postpartum nipples in the multipara group was more flexible and nipple length was longer. When breastfeeding was successful, nipple length was greater than 11 mm, and was longer compared to the Thai women.
When nipples were flexible the LATCH Score was higher. Challenges concerning the thorough education on the measuring method of nipple length and LATCH Scores and securing the trust between the determination on measurement of nipple length and LATCH scores remain.