Aloe vera effective choice for relieving breast pain or irritation in lactating women
Breastfeeding is considered the most important factor in reducing the infant mortality rate, as well as has many benefits for maternal health. Accordingly, the World Health Organization and UNICEF recommend that every infant should have exclusive breastfeeding for at least six months after birth and it should continue for 2 years. Despite their recommendation, only 37% of infants aged less than six months are exclusively breastfed in low-income and middle-income countries.
Treating breastfeeding is an art that requires many skills and knowledge, especially for new mothers. Improper attachment of the infant to the breast, along with the growth factor of mucus present in infant saliva and breast milk, can be associated with nipple damage. Nipple pain is a protective response of damaged tissue following vasospasm of the nipple tissue, reduction of capillary blood supply, swelling, and oedema.
Breast and nipple pain can reduce oxytocin and milk secretion by increasing catecholamine secretion, as well as increasing cytokines and proinfammatory factors. Various methods have been proposed for the prevention and treatment of nipple fissures, such as correcting breastfeeding techniques, rubbing milk on the nipple, glycerin pads, using topical and collagenase ointments, hydrogel, honey, and herbal medicine, neither of which is superior to the other.
Today, herbal medicine is widely used in the fields of obstetrics and gynaecology. Aloe vera is one of the herbal products with anti-inflammatory, antioxidant, moisturizing, bactericidal, anti-viral, and anti-fungal effects that was used to relieve pain and irritation
There are high amounts of molecular material, water, polysaccharides, sugars, minerals, proteins, lipids, phenolic compounds, as well as many vitamins such as A, C, E, B1, B2, and B9 in Aloe vera. In addition, there are many enzymes such as bradykinase, carboxypeptidase, cellulase, amylase, catalase, and oxidase in this plant. These enzymes by blocking the synthesis of bradykinin, cyclooxygenase-2, and thromboxane synthase can reduce the pain intensity. Carboxypeptidase inactivates bradykinase at the wound site and exerts anti-inflammatory and pain-relieving effects. The anti-inflammatory effects of this plant are attributed to the presence of salicylic acid (effective in inhibiting the formation of bradykinin and histamine) and the arachidonic acid oxidation pathway through cyclooxygenase. Magnesium lactate in the Aloe vera plant prevents the histamine reaction, therefore relieving itching and skin irritation.
Many studies show a positive impact of Aloe vera on the relief of irritation and pain in the nipple, but there is a controversy in their results. Therefore, this study by Azam Maleki and team was a first systematic review and meta-analysis was conducted to determine the effect of Aloe vera on the relief of irritation and nipple pain in lactating women which showed that Aloe vera can be considered a choice for relieving breast pain or irritation in lactating women compared with routine care or another treatment.
A search was carried out in four English electronic databases including Scopus, Embase, PubMed, and Web of Science until November 2021. All clinical trials that assessed the effect of Aloe vera on the relief of irritation and nipple pain in lactating women were included.
In total, 7 articles with 1670 subjects were included in the meta-analysis. Overall, authors found a positive impact of Aloe vera on reducing breast pain (P value<0.02 ) and irritation (P value<0.001) in lactating women. Tere is a high heterogeneity among pain studies (I 2 = 86%) but was low within irritation studies (I 2 = 26%).><0.001) in lactating women. There is a high heterogeneity among pain studies (I 2 = 86%) but was low within irritation studies (I 2 = 26%).
Based on the available evidence, the meta-analysis showed that Aloe vera can be relieved 0.45- unit pain and 0.48-unit irritation than the no treatment/ breast milk lanolin group, and it was statistically signifcant.
“Our result showed that Aloe vera can be considered a choice for relieving breast pain or irritation in lactating women compared with routine care or another treatment. Considering the limited number of studies conducted on this topic and the low sample size, future studies with a larger sample will be required to draw better conclusions. Future studies with large sample sizes will be required to draw better conclusions.”
Source: Azam Maleki and Samaneh Yousefu; Hindawi Obstetrics and Gynecology International Volume 2022, Article ID 7430581 https://doi.org/10.1155/2022/7430581
