Speaker Type: GOLD Lactation 2017, Ruth Lucas - Self-Management of Breast and Nipple Pain,
Country: USA
Biography:
Ruth Lucas, PhD, RNC, CLS, received her Bachelor of Science in Nursing from George Mason University (1986) and her Doctor of Philosophy of Science (2011) from the University of Illinois at Chicago. Based on 20 years of supporting women and infants to initiate breastfeeding, her research focuses on the biobehavioral mechanisms of breastfeeding, such as breast and nipple pain. Dr. Lucas and her team conducted a pilot randomized control trial (RCT) as part of the Center for Accelerating Precision Pain Self- Management (CAPPS-M) (P20NR016605). The pilot RCT tested the feasibility, acceptability, and efficacy of a breastfeeding self-management (BSM) intervention for breast and nipple pain during breastfeeding and found the BSM intervention significantly reduced breast and nipple pain and is associated with pain sensitivity polymorphisms. Her published work describes management of pain during breastfeeding, a clinical indictor of infant breastfeeding behaviors, and a biomedical device to measure breastfeeding in real time.
Infant feeding behavior is a complex neurodevelopment behavior. Infant feeding is compressed of infants’ latch and SuPPRT (sucking pressure pattern regulated over time) in both bottle and breastfeeding sessions. In preterm bottle feeding infants, the regulation of these two components is a measure of neurodevelopment. However, infants’ latch and SuPPRT in breastfeeding has not been explored. Dr. Lucas will review infants’ latch and SuPPRT during bottle and breastfeeding and explore how these differences make breastfeeding a more sensitive newborn neurodevelopmental measure. Finally, Dr. Lucas will propose why we should consider differences in infant latch and SuPPRT to be a neurodevelopmental infant measure.
Despite 90% of women experiencing breast and nipple pain during breastfeeding, mothers rarely receive adequate knowledge and skills for breastfeeding pain self-management and cease breastfeeding. Our randomized control trial (RCT) pilot study tested the feasibility, acceptability, and efficacy of a breastfeeding self-management intervention (BSM) on breast and nipple pain and breastfeeding outcomes. Sixty women were recruited after delivery and completed survey measures of pain and breastfeeding outcomes, pain sensitivity testing and a biological sample to assess genetic risk for pain at baseline. Both groups completed pain and breastfeeding outcomes surveys via texting links using REDCap 7.4. Women in the intervention group received biweekly nurse-lead texting and cloud-based educational modules addressing breast and nipple pain and breastfeeding challenges. The BSM intervention was acceptable and sustainable for 94% of the women who continued to breastfed to 6 weeks. Acute breast and nipple pain at 1 and 2 weeks were significantly reduced and was associated with pain sensitivity polymorphisms, suggesting a genetic risk profile of pain-associated breastfeeding cessation.
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