INTRODUCTION
nipple pain, Pain, nipple damages, factors)As, fissures, pain, Nipple damage, ankyloglossia, nipple damage, tissue damage
Nipple damage is a common cause for the early cessation of exclusive breastfeeding (EBF), mainly due to the intense and limiting nipple pain related to poor latch-on during breastfeedingEarly cessation suppresses the mothers and their infant from receiving the benefits that involve breastfeeding (BF) practiceAccording to data from the Brazilian National Survey on Child Nutrition (ENANI-2019)The care of women with nipple damage during BF is an old challenge and, despite the extensive knowledge of its cause and the understanding of the importance of preventive guidelines, such as correct positioning and latch-on during BF, it is not always possible to prevent its occurrenceIn addition, other factors refer to woman and child anatomy and breast care, categorized into: external influences (nipple size and shape, infant presence and length of ankyloglossia and use of pumps); modulation via central nervous system (maternal social and emotional conditions, past history and training); and local stimulus (nipple damage characteristics and healing factors)As for nipple damage resolution, there is no consensus regarding the best treatment method for tissue repair and nipple pain reliefComplaint of nipple pain, often assessed using the Visual Analog and Numerical Pain ScaleNipple damages related to the BF phase can occur at different times, being more frequent in the first postpartum week due to the beginning and establishment of infant at the breastSystematic assessment contributes to the target on the resolution and opportune treatments, adequate to the process of tissue healing and pain perception, which confer the necessary celerity and allow the linear maintenance of BF. Thus, the identification of the types of nipple damages and the moment of their occurrence can contribute to differentiation of the causal factor and the proposed treatment.Furthermore, nipple damage assessment is also related to management. Among the assessment resources and methods, the performance of a detailed clinical examination stands out, including the use of measuring instruments (scales, indices or scores) to measure the damages, use tools for better visualization (magnifying glasses, direct light) and recording by photographic images for evolutionary analysis of nipple damagesIn this context, in nipple damage assessment, both the tissue damage degree and its morphology classification can contribute to a more specific treatment. It is known that nipple damages can reach the epidermis and/or dermis, and involve different skin structuresThis assessment is still being explored in the literature and its applicability in clinical practice, therefore, little used by health professionals, who still call nipple damages as fissures in a generalized way