# Effective Interventions to Prevent Breastfeeding-Related Nipple-Areolar Lesions: A Systematic Review

## TL;DR

This study reviews effective strategies to prevent nipple injuries during breastfeeding, which can improve maternal and infant health outcomes and reduce healthcare strain.

## Contribution

The study systematically identifies specific interventions, such as educational practices and natural remedies, that effectively prevent breastfeeding-related nipple injuries.

## Key findings

- Educational practices like simulations and demonstrations by qualified professionals are effective in preventing nipple-areolar lesions.
- Natural remedies such as peppermint, olive oil, and honey show effectiveness in preventing breastfeeding-related injuries.
- Early identification of risk and continuous follow-up improve maternal and child outcomes.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Nipple-areolar lesions are a public health problem because they compromise breastfeeding, leading to maternal suffering, early weaning, and negative impacts on infant health and key breastfeeding indicators.They also increase avoidable demands on health services and strain on health systems, especially in vulnerable contexts, making their prevention essential for efficient, equitable, and sustainable care.

Nipple-areolar lesions are a public health problem because they compromise breastfeeding, leading to maternal suffering, early weaning, and negative impacts on infant health and key breastfeeding indicators.

They also increase avoidable demands on health services and strain on health systems, especially in vulnerable contexts, making their prevention essential for efficient, equitable, and sustainable care.

Public health significance—Why is this work of significance to public health?
This study synthesizes evidence on effective interventions to guide breastfeeding promotion, prevention, and care, supporting safer, more effective, and evidence-based clinical practice.By preventing injuries, reducing pain, and improving the breastfeeding experience, it strengthens maternal autonomy, supports sustained breastfeeding, reduces childhood illness and healthcare costs, and contributes to global maternal-child health goals such as the SDGs.

This study synthesizes evidence on effective interventions to guide breastfeeding promotion, prevention, and care, supporting safer, more effective, and evidence-based clinical practice.

By preventing injuries, reducing pain, and improving the breastfeeding experience, it strengthens maternal autonomy, supports sustained breastfeeding, reduces childhood illness and healthcare costs, and contributes to global maternal-child health goals such as the SDGs.

Public health implications—What are the key implications or messages for practitioners, policymakers, and/or researchers in public health?
For practitioners, the evidence shows that preventing nipple injuries must be a core element of breastfeeding care, with early risk identification, active guidance on positioning and latching, and continuous follow-up to reduce pain and improve maternal and child outcomes.For policymakers and researchers, the findings support strengthening education strategies, care protocols, and preventive technologies, guiding future research and policies that improve care quality and promote sustainable breastfeeding support.

For practitioners, the evidence shows that preventing nipple injuries must be a core element of breastfeeding care, with early risk identification, active guidance on positioning and latching, and continuous follow-up to reduce pain and improve maternal and child outcomes.

For policymakers and researchers, the findings support strengthening education strategies, care protocols, and preventive technologies, guiding future research and policies that improve care quality and promote sustainable breastfeeding support.

This study synthesizes the evidence on effective interventions for the prevention of breastfeeding-related nipple-areolar injuries. A systematic review was performed and guided by the evidence synthesis manual of the Joan Briggs Institute, carried out in six databases, with only intervention studies. Interventions with a positive outcome for the prevention of nipple-areolar lesions were considered effective. Methodological quality was assessed by the Grading of Recommendations Assessment, Development and Evaluation. The final sample of 14 articles found the following to be effective strategies: educational practices (simulations and demonstrations of the breastfeeding technique, with a qualified professional or by video) and the use of peppermint (aqueous solution or gel), extra virgin olive oil, honey, guaiazulene ointment, and venix caseosa. Each intervention was used in specific situations and ways, which should be considered for use in clinical practice. The interventions discussed can help prevent nipple-areolar lesions and breastfeeding difficulties, encouraging breastfeeding.