Effect of the Topical form of Achillea millefoliumon on Nipple Fissure in Breastfeeding Women: A Randomized Controlled Clinical Trial

Document Type: Original Article

Authors

1 Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran

2 Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran

3 Medicinal Plants and Natural Products Research center, Hamadan University of Medical Sciences, Hamadan, Iran

4 Medicinal Plants and Natural Products Research center, Hamadan University of Medical Sciences, Hamadan, Iran Department of Pharmacognosy, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran

Abstract

Background: Nipple fissure is one of the most common diseases in breastfeeding which leads to maternal pain and disruption of the mother-infant relationship. Since the most important consequence of nipple fissure is the deprivation of the infant from breast milk, it is very important to prevent and treat this condition. The aim of this study was to investigate the effect of the topical form of Achillea millefoliumon on nipple fissure in breastfeeding women referring to the comprehensive health centers of Hamadan, Iran.
Methods: This study was a randomized double-blind clinical trial that was conducted in Hamadan comprehensive health centers in 2018. Treatment methods were taught by the researcher to 80 eligible breastfeeding women who were randomly divided into two groups of 40 subjects. After breastfeeding, the intervention group covered their own nipples with a tea bag of Achillea millefolium, while the control group applied some of their own hindmilk on their nipple. These interventions were performed at least 4 times a day for 14 days. Checklists of store fissure scale, visual analog scale, and midwifery and demographic characteristic questionnaire were completed in both groups before the treatment and 4, 8, and 14 days after starting the treatment. The data were analyzed using SPSS software (version 16).
Results: The results showed that the intensity of fissure and the mean pain score in the two groups were not statistically significant in the pre-intervention phase. However, the scores of the intensity of fissure and pain in the Achillea millefolium group were lower than those in the breast milk group on days 4, 8, and 14 after the intervention, and these differences were statistically significant (P<0.001).
Conclusion: The results of this study showed that the topical form of Achillea millefolium was more effective than breast milk in treating nipple pain and fissure.

Keywords


1. Mosca F, Gianni ML. Human milk: composition and health benefits. Pediatr Med Chir. 2017; 39(2):155.
2. ESPGHAN Committee on Nutrition, Agostoni C, Braegger C, Decsi T, Kolacek S, Koletzko B, et al. Breast-feeding: a commentary by the ESPGHAN committee on nutrition. J Pediatr Gastroenterol Nutr. 2009; 49(1):112-25.
3. Leung AK, Sauve RS. Breast is best for babies. J Natl Med Assoc. 2005; 97(7):1010-9.
4. Gonzalez-Jimenez E, Garcia PA, Aguilar MJ, Padilla CA, Alvarez J. Breastfeeding and the prevention of breast cancer: a retrospective review of clinical histories. J Clin Nurs. 2014; 23(17-18):2397-403.
5. Zhang M, Xie X, Lee AH, Binns CW. Prolonged lactation reduces ovarian cancer risk in Chinese women. Eur J Cancer Prev. 2004; 13(6):499-502.
6. Ahmadi S, Kazemi F, Masoumi SZ, Parsa P, Roshanaei G. Intervention based on BASNEF model increases exclusive breastfeeding in preterm infants in Iran: a randomized controlled trial. Int Breastfeed J. 2016; 11(1):30.
7. Jackson KT, Dennis CL. Lanolin for the treatment of nipple pain in breastfeeding women: a randomized controlled trial. Matern Child Nutr. 2017; 13(3):10.
8. Goyal RC, Banginwar AS, Ziyo F, Toweir AA. Breastfeeding practices: positioning, attachment (latch-on) and effective suckling - A hospital-based study in Libya. J Family Community Med. 2011; 18(2):74-9.
9. Kent JC, Ashton E, Hardwick CM, Rowan MK, Chia ES, Fairclough KA, et al. Nipple pain in breastfeeding mothers: incidence, causes and treatments. Int J Environ Res Public Health. 2015; 12(10):12247-63.
10. Niazi A, Rahimi VB, Soheili-Far S, Askari N, Rahmanian-Devin P, Sanei-Far Z, et al. A systematic review on prevention and treatment of nipple pain and fissure: are they curable? J Pharmacopuncture. 2018; 21(3):139-50.
11. McClellan HL, Hepworth AR, Garbin CP, Rowan MK, Deacon J, Hartmann PE, et al. Nipple pain during breastfeeding with or without visible trauma. J Hum Lact. 2012; 28(4):511-21.
12. Akram M. Minireview on Achillea millefolium Linn. J Membr Biol. 2013; 246(9):661-3.
13. Orav A, Arak E, Raal A. Phytochemical analysis of the essential oil of Achillea millefolium L. from various European Countries. Nat Prod Res. 2006; 20(12): 1082-8.
14. Mahady GB, Pendland SL, Stoia A, Hamill FA,

Fabricant D, Dietz BM, et al. In vitro susceptibility of Helicobacter pylori to botanical extracts used traditionally for the treatment of gastrointestinal disorders. Phytother Res. 2005; 19(11):988-91.
15. Ayoobi F, Shamsizadeh A, Fatemi I, Vakilian A, Allahtavakoli M, Hassanshahi G, et al. Bio-effectiveness of the main flavonoids of Achillea millefolium in the pathophysiology of neurode-generative disorders- a review. Iran J Basic Med Sci. 2017; 20(6):604-12.
16. Chandler R, Hooper S, Harvey MJ. Ethnobotany and phytochemistry of yarrow, achillea millefolium, compositae. Econ Botany. 1982; 36(2):203-23.
17. Jenabi E, Fereidoony B. Effect of achillea millefolium on relief of primary dysmenorrhea: a double-blind randomized clinical trial. J Pediatr Adolesc Gynecol. 2015; 28(5):402-4.
18. Benedek B, Kopp B, Melzig MF. Achillea millefolium L. s.l. -- is the anti-inflammatory activity mediated by protease inhibition? J Ethnopharmacol. 2007; 113(2):312-7.
19. Alamolhoda SH, AmirAliAkbari S, Baghban AA, Esmaili S. Effects of Aloe vera gel on breast fissures in breastfeeding women. Pajoohandeh J. 2014; 19(1):13-7.
20. Storr GB. Prevention of nipple tenderness and breast engorgement in the postpartal period. J Obstetr Gynecol Neonatal Nurs. 1988; 17(3):203-9.
21. Hemmati A, Arzi A, Amin M. Effect of Achillea
millefolium extract in wound healing of rabbit. J Natural Remed. 2002; 2(2):164-7.
22. Mohammadzadeh A, Farhat A, Esmaeily H. The effect of breast milk and lanolin on sore nipples. Saudi Med J. 2005; 26(8):1231-4.
23. Sayyah Melli MS, Rashidi MR, Delazar A, Madarek E, Kargar Maher M, Ghasemzadeh A, et al. Effect of peppermint water on prevention of nipple cracks in lactating primiparous women: a randomized controlled trial. Int Breastfeed J. 2007; 2(1):7.
24. Kazemirad M. Comparison of calendit-e cream versus expressed breast milk. Adv Nurs Midwifery. 2013; 23(80):5380.
25. Akbari SA, Alamolhoda SH, Baghban AA, Mirabi P. Effects of menthol essence and breast milk on the improvement of nipple fissures in breastfeeding women. J Res Med Sci. 2014; 19(7):629-33.
26. Gharakhani Bahar T, Oshvandi K, Zahra Masoumi S, Mohammadi Y, Moradkhani S, Firozian F. A comparative study of the effects of mint tea bag, mint cream, and breast milk on the treatment of cracked nipple in the lactation period: a randomized clinical trial study. Iran J Neonatol. 2018; 9(4):72-9.
27. Hajhashemi M, Ghanbari Z, Movahedi M, Rafieian M, Keivani A, Haghollahi F. The effect of Achillea millefolium and Hypericum perforatum ointments on episiotomy wound healing in primiparous women. J Matern Fetal Neonatal Med. 2018; 31(1):63-9.