A Clinical Study to Evaluate the Efficacy of Madhuka Ghrita Lepana in Nipple Crack in Lactatig women

NEED FOR THE STUDY:

 Nipple areolar complex appears painful due to loss of surface epithelium with formation of raw area or due to

a fissure at tip or base of nipple.These two conditions frequently co-exist and is termed as cracked nipple.1In ayurveda nipple crack can be correlated with ‘Ghrista sadyovrana as it is characterized by vigatatwak

occurring due to gharshana or abhighata.

 Acharya charaka  mentioned about stana sampat laxanas  in shareera sthana 8th chapter 53 sloka as stana

should not be situated at very high level,they should  not  hang very loose,they should neither be very lean

nor very plump.  They should have nipples of proportionate size. The child should find it easy to suckle them.3

 Cracked nipple is extremely painful when infants sucks,that interferes breast feeding and cause premature weaning.when infected,it may spread to deeper tissue producing mastitis.4 In Astanga Hrudaya utharsthanamsadhyovrana pratishedhan adhyayam a reference about madhukaghrita is explained.5

 The study drug madhuka (Glycyrrhiza glabra) is vrana Shodhana ropanaand varnakrit.6 It possess anti-inflammatory ,and antioxidant properties,itcontains glycyrrheinitic acid which promote the migration of

dermal fibroblast and promotes wound healing.7 Cracked nipple means any type of damage to nipple or

around areolar region associated with or without pain.It appears as cracks/ small lacerations or breaks on

skin of nipple.8

 Contemporary treatments includes usage of glycerine nipple pads, nipple shields,creams,lotions,ointments

( eg Lanolin ).The incidence of nipple crack is higher with in first 30days of postpartum period.

Prevalence rate of nipple crack shows that 32% mothers is having cracked nipple with in first month of postpartum period.9Among them 80-90% experience nipple pain that can results in early weaning. Ongoing research works in the field of nipple crack still prove that herbal preparations with peppermint,pisticiaatlantica showed better result than lanolin.Even though nipple crack is effectively managed in ayurveda ,systematic assessment and documentation has not been done.