Prevalence of Cracked Nipple and its Associated Factors during Postpartum Period

Document Type : Original Article


1 Woman's Health & Midwifery Nursing, Faculty of Nursing, Mansoura University, Egypt

2 Woman's Health and Midwifery Nursing, faculty of nursing, Mansoura university, Egypt

3 Professor of Woman's Health and Midwifery Nursing, Faculty of Nursing, Mansoura University, Egypt


Background: Cracked nipples as a complication associated with breast-feeding is considered the most
significant factor affecting the uptake and continuation of breastfeeding, especially in the first 30 days postpartum.
Aim:This study aimed to estimate the prevalence of cracked nipples and its associated factors during postpartum
period. Study design: A descriptive cross sectional study design was used. Setting: The study was carried out at
Nabaroh Central Hospital and Nabaroh Health Care Center, Nabaroh, Egypt. Study subjects: A convenient sample of
817 postpartum women were utilized. Tools: Three tools were used: A structured interview questionnaire, Nipple
soreness rating scale and the Cracked Nipples-Associated Factors Questionnaire. Results: Nearly three-quarters of
postnatal women had cracked nipples, more than one-third of women had 2nd and 3rd degrees of cracked nipples,
nearly two-thirds of women had incorrect nipple attachment; and most women performed improper breastfeeding
techniques. Conclusion: The prevalence of cracked nipples was high among the studied postpartum women and
associated with women who aged 20–30 years, unemployed women, delivered via cesarean section, not receiving
guidance about breastfeeding during the 1st week of the postpartum period, incorrect nipple preparation during
pregnancy, breast engorgement, incorrect breast care technique, feeding baby on demand, pulling the nipple from
baby's mouth by force after breastfeeding, using pacifiers, improper latch-on technique, improper body position
technique during breastfeeding, and improper breastfeeding techniques. Recommendation: Designing nursing
.guidelines for pregnant and postpartum women about proper breastfeeding technique and cracked nipple prevention