Treatment of nipple pain in breastfeeding women in the postpartum ward of the University Hospital of Lausanne: a best practice implementation project.

Breast milk represents the optimal nutrition for a child and is recommended during the first six months. However, nipple pain often occurs during the onset of lactation and may affect breastfeeding and exclusive breastfeeding duration rates. Multiple treatments are available in the postpartum units of the Lausanne University Hospital (CHUV, Lausanne, Switzerland) and are used empirically, according to caregiver preferences. The aim of this project is to implement a care plan for nipple pain according to best recommendations and evidence-based studies. The project was developed using the Joanna Briggs Institute framework and Practical Application of Clinical Evidence System (JBI-PACES). Five audit criteria were used in pre- and post-audits to observe any changes in compliance with the recommendations. The Getting Research into Practice (GRiP) was used between audits to identify stakeholders, barriers and facilitators of the project. Compliance in four criteria improved, with no increase in pain experienced by breastfeeding mothers. More women received adequate information (from 47% to 64%) and support (from 47% to 58%). Each item under criteria 2 (adequate information) and 3 (adequate support) showed improvement. The adequate management of nipple pain also increased from 8% to 31%. However, it remains an important issue to consider. Despite the limitations associated with small samples, the results of this project show that implementation of best practice is possible, even though it involved the withdrawal of unnecessary treatment. Another evaluation is necessary in the future to consolidate and improve these results