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Nipple trauma — DRCOG MCQ

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HardPostnatalNipple traumaDRCOG

A breastfeeding woman has cracked nipples and pain during feeds. She is well, has no fever or breast erythema, and the baby is gaining weight. What is the most appropriate first step?

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Correct answer: B — Observe a feed and optimise positioning and attachment

The best answer is “Observe a feed and optimise positioning and attachment”. Cracked, painful nipples are commonly related to suboptimal positioning or attachment. Observing a feed and providing skilled breastfeeding support can identify and correct the cause while preserving breastfeeding. Mastitis, bacterial infection or thrush need consideration when their specific features are present, but antibiotics, antiseptics and stopping feeds are not routine first steps here.

Reference: NHS: Sore or cracked nipples when breastfeeding: https://www.nhs.uk/baby/breastfeeding-and-bottle-feeding/breastfeeding-problems/sore-nipples/