A nurse is caring for a client who is 2 days postpartum, is breastfeeding, and reports nipple soreness. Which of the following measures should the nurse suggest to reduce discomfort during breastfeeding? (Select All that Apply.)

Choice A rationale Starting with the less sore nipple allows the infant to establish a good latch on the less painful side, promoting oxytocin release and milk let-down without immediate exacerbation of discomfort. This can ease the initial pain of breastfeeding and encourage the infant to feed effectively, thus reducing the total suckling time on the more painful side. Choice B rationale Changing the infant's position on the nipples ensures that pressure is distributed differently across the areola and nipple, preventing sustained pressure on one specific area. This variation reduces localized trauma and irritation, allowing different parts of the nipple to recover, thereby minimizing soreness caused by repetitive mechanical stress. Choice C rationale While breast milk has some antimicrobial properties and can be soothing, applying it *before* each feeding may not significantly reduce mechanical soreness caused by improper latch or sustained pressure. It is often recommended *after* feeding for its healing properties, but not as a primary measure to reduce discomfort during the feed itself. Choice D rationale Wearing a tight-fitting nursing bra with breast pads can increase pressure on already sensitive nipples, potentially exacerbating soreness and friction. It can also trap moisture, creating a warm, damp environment conducive to bacterial or fungal growth, which can worsen nipple pain and increase the risk of infection. Choice E rationale Applying ice packs to the nipples before each feeding provides a topical analgesic effect by constricting blood vessels and numbing nerve endings. This reduction in sensation can temporarily alleviate pain, making the initial latch and milk ejection reflex less uncomfortable, thus promoting more effective and less painful breastfeeding.