Psychological aspects of nipple pain in lactating women.

The aim of the study was to assess the psychological impact of nipple pain in lactating women. Forty-eight lactating women with nipple pain completed mood scales at their first visit and following resolution of their pain, and 65 lactating women without nipple pain completed one set of mood scales. At the first visit, the mean score on the Edinburgh Postnatal Depression Scale (EPDS) in the nipple pain group was 12.4 and the control group was 7.6 (p < 0.0001). Eighteen women (38%) scored above the threshold for depression (> 12), compared to nine in the control group (14%): p < 0.01. Following pain resolution, the mean score on the EPDS decreased to 7.3 (p < 0.001); and six women (16%) scored 13 or over on the EPDS, significantly less than initially (p < 0.05). Similarly, on the Profile of Mood States (POMS), the nipple pain group scored significantly higher than control group on all mood factors (Tension, Depression, Fatigue, Confusion, Vigor [lower]), except Anger which did not reach a level of significance. After pain resolution, POMS scores returned to similar levels as the control group. In conclusion, both the EPDS and POMS indicated women with nipple pain were experiencing high levels of emotional distress. However, once the pain had resolved their distress also resolved.