Date of Award


Degree Type


Degree Name

Master of Nursing


School of Nursing


Faculty of Health and Human Sciences

First Advisor

Dr Petricia Percival

Second Advisor

Esme Kershaw

Third Advisor

Davina Poroch


The purpose of this experimental study was to investigate whether a prenatal teaching intervention on position and attachment of the baby on the breast had any effect on postpartum nipple pain and trauma, and breastfeeding rates at six weeks. Many mothers who Initiate breastfeeding, discontinue because they experience nipple pain and trauma. Correct position and attachment of the baby on the breast for feeding Is paramount in preventing these problems. Using Orem's supportive-educative nursing system, i was hypothesised that the teaching Intervention would result in significantly less nipple pain and trauma, and would Increase breastfeeding rates at six weeks. The teaching in this intervention was given by a qualified midwife, who was also a lactation consultant, and who was not involved In any date collection. Seventy primiparae at a suburban hospital In Perth, Western Australia were randomly assigned to the experimental group (n = 36), who received the teaching Intervention as well as the usual prenatal education, or the control group (n=35) who received the usual prenatal education. During the first four postpartum days the LATCH Instrument was used to measure position and attachment of the baby on the breast; the Visual Analogue Scale (VAS) measured nipple pain, and tho Nipple Trauma Severity Index (NTSI) was developed to measure nipple trauma. A questionnaire measured demographic data, breastfeeding progress and breastfeeding rates at six weeks postpartum. The researcher was observer blind to group allocation unlit all observations were completed on day four postpartum. A significance level of 0.05 was set for all statistical procedures. There was no difference between groups for other variables which have the potential to influence breastfeeding success. All hypotheses were supported. Repeated measures ANOVA showed a significant difference between groups, with the experimental group having less nipple pain and trauma. Breastfeeding rates were analysed by Chi-Square (y²) and showed 92% of mothers in the experimental group and 29% In the control group still breastfeeding at six weeks postpartum. The findings of this study will have Implications for health professionals educating mothers on breastfeeding. It is anticipated that such an intervention has the potential to increase breastfeeding rates and encourage the continuation of breastfeeding up to at least six weeks postpartum.

Included in

Nursing Commons