In post-natal women with nipple pain, does photobiomodulation therapy (PBMT) at 660 nm compared with sham PBMT reduce pain on breastfeeding? A case series during COVID-19

Submitted: 13 January 2023
Accepted: 16 March 2023
Published: 18 April 2023
Abstract Views: 3017
PDF: 84
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

The analgesic role of photobiomodulation therapy (PBMT) for breastfeeding women with nipple pain is inconclusive. This study aimed to determine the efficacy of PBMT at 660 nm in post-natal women with nipple pain planning to exclusively breastfeed. A randomised, placebo-controlled clinical study was initiated at a tertiary hospital in Brisbane, Australia on the inpatient maternity wards from May 2020 to September 2020. Eligible participants were randomised into two groups, an intervention group receiving usual care and PBMT (Group A) and a control group receiving usual care and sham PBMT (Group B). Usual care involved consultation with a midwife and/or lactation consultant to assist with infant latching and breastfeeding positioning. PBMT (660 nm; 250 Hz; 17 mW; 0.5 cm2 spot size) was administered three times within 24 hours. Nipple pain was the primary outcome measure analysed using a Visual Analogue Scale. Quality of life (QoL) and the participants’ perceived efficacy of treatment were secondary outcome measures evaluated using the PROMIS Global Short Form and a combined 5-point Likert scale and thematic analysis, respectively. Due to the impact of COVID-19, only 10 participants were recruited. Compared to sham, three applications of PBMT at 660 nm provided no significant difference to participants’ nipple pain, QoL or perceived efficacy of treatment. Three key themes of PBMT treatment were simplicity, safety and support. This study was unable to demonstrate the impact of PBMT at 660 nm on relieving nipple pain due to low participant numbers. An adequately powered RCT with COVID-19 modifications, is recommended.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Council of Australian Governments (COAG) Health Council. Australian National Breastfeeding Strategy 2019 and Beyond. Canberra: Department of Health; 2019. Version current 9 January 2023. Accessed 9 January 2023. Available from: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.health.gov.au/sites/default/files/documents/2022/03/australian-national-breastfeeding-strategy-2019-and-beyond.pdf
Smith JP (2013): “Lost milk?” counting the economic value of breast milk in gross domestic product. J Hum Lact 2013;29:537-46.
Australian Bureau of Statistics. Breastfeeding. Canberra: ABS; 2020-21 Financial year. Accessed 9 January 2023. Available from: https://www.abs.gov.au/statistics/health/health-conditions-and-risks/breastfeeding/latest-release#data-download
Dias JS, Vieira TD, Vieira GO. Factors associated to nipple trauma in lactation period: a systematic review. Rev Bras de Saude Matern Infant 2017;17:27-42.
McClellan HL, Hepworth AR, Garbin CP, et al. Nipple pain during breastfeeding with or without visible trauma. J Hum Lact 2012;28:511-21.
Kendall-Tackett K. A new paradigm for depression in new mothers: the central role of inflammation and how breastfeeding and anti-inflammatory treatments protect maternal mental health. Int Breastfeed J 2007;2:1-4.
Coca KP, Pinto VL, Westphal F, et al. Bundle of measures to support intrahospital exclusive breastfeeding: evidence of systematic reviews. Rev Paul Pediatr 2018;36:214-20.
Dennis CL, Jackson K, Watson J. Interventions for treating painful nipples among breastfeeding women. Cochrane Database of Systematic Reviews 2014;12:CD007366.
Niazi A, Rahimi VB, Soheili-Far S, et al. A systematic review on prevention and treatment of nipple pain and fissure: are they curable? J Pharmacopuncture 2018;21:139-150.
Chung H, Dai T, Sharma SK, et al. The nuts and bolts of low-level laser (light) therapy. Ann Biomed Eng 2012;40:516-33.
Pietschnig B, Pani M, Käfer A, et al. Use of soft laser in the therapy of sore nipples in breastfeeding women. Adv Exp Med Biol 2002;478:437–438.
Chaves ME, Araújo AR, Santos SF, et al. LED phototherapy improves healing of nipple trauma: a pilot study. Photomed Laser Surg 2012;30:172-178.
Araujo AR, Nascimento AL, Camargos JM, et al. Photobiomodulation as a new approach for the treatment of nipple traumas: a pilot study, randomized and controlled. Fisioter Bras 2013;14:20-29.
Gonçalves AS, Filipini R, Posso MB. Dor mamilar durante a amamentação: ação analgésica do laser de baixa intensidade. Rev Dor 2009;10:125-129.
Buck ML, Eckereder G, Amir LH. Low level laser therapy for breastfeeding problems. Breastfeed Rev 2016;24:27-31.
Coca KP, Marcacine KO, Gamba MA, et al. Efficacy of low-level laser therapy in relieving nipple pain in breastfeeding women: a triple-blind, randomized, controlled trial. Pain Manag Nurs 2016;17:281-9.
Camargo BT, Coca KP, Amir LH, Corrêa L, Aranha AC (2020) The effect of a single irradiation of low-level laser on nipple pain in breastfeeding women: a randomized controlled trial. Lasers Med Sci, 2020; 35: 63-69. https://doi.org/10.1007/s10103-019-02786-5
Australian Institute of Health and Welfare. Australia’s mothers and babies - Baby length of stay in hospital. Canberra: AIHW; 2022. Accessed 9 January 2023. Available from: https://www.aihw.gov.au/reports/mothers-babies/australias-mothers-babies/contents/baby-outcomes/baby-length-of-stay-in-hospital. Version current 9 January 2023
Diggle P, Heagerty P, Liang KY, Zeger S. Analysis of longitudinal data. Edn 2, 2002, Oxford University Press, Oxford.
Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med 2001;8:1153-7.
Coca KP, Amir LH, Alves MD, et al. Measurement tools and intensity of nipple pain among women with or without damaged nipples: A quantitative systematic review. J Adv Nurs 2019;75:1162-72.
Slavin V, Gamble J, Creedy DK, et al. Measuring physical and mental health during pregnancy and postpartum in an Australian childbearing population-validation of the PROMIS Global Short Form. BMC Pregnancy Childbirth 2019;19:1-9.
R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria: GBIF. 2018. Accessed 9 January 2023. Available from: https://www.R-project.org/
Bates D, Mächler M, Bolker B, Walker S. Fitting linear mixed-effects models using lme4. arXiv preprint 2014;arXiv:1406.5823.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006;3:77-101.
Kuzbari R, Schlenz I. Reduction mammaplasty and sensitivity of the nipple-areola complex: sensuality versus sexuality? Ann Plast Surg 2007;58:3-11.
Liebert A, Waddington G, Bicknell B, et al. Quantification of the absorption of low-level 904 nm superpulsed laser, light as a function of skin colour. In: E-L Laakso and C Young (Eds). Proceedings, World Association for Laser Therapy 9th World Congress of Laser Therapy, Gold Coast, Australia September 28-30, 2012. 2013; pp. 11-15.
Zhang CS, Tan HY, Zhang GS, et al. Placebo devices as effective control methods in acupuncture clinical trials: a systematic review. PloS One 2015;10:e0140825.
National Health and Medical Research Council. National Statement on Ethical Conduct in Human Research (2007) - Updated 2018. Canberra: NHMRC; 2018. Accessed 9 January, 2023. Available from: https://www.nhmrc.gov.au/about-us/publications/national-statement-ethical-conduct-human-research-2007-updated-2018

How to Cite

Ralph, M., Hurst, C., Guyatt, S., Goldsmith, K., & Laakso, E.-L. (2023). In post-natal women with nipple pain, does photobiomodulation therapy (PBMT) at 660 nm compared with sham PBMT reduce pain on breastfeeding? A case series during COVID-19. Laser Therapy, 30(1). https://doi.org/10.4081/ltj.2023.315