Correct answer:
Ask relevant questions about the itching and discomfort to facilitate in building a clinical picture. The itching may be the sign of an infection, or it may be due to the use of the lavender oil itself. It is important to try and distinguish between the two and the midwife should use other clinical observations to do so. It is important to gain an understanding of the patterns of use of lavender oil, dilution rates etc. Refer to the woman's notes and discuss use of lavender oil with the woman to gain further information. Women using lavender oil directly upon the perineum should be advised that current evidence suggests its use in highly diluted forms when directly applied to the skin. Skin cell viability of 80-100% was identified at an oil concentration of 0.125%, thereafter an increase in concentration affected cell viability (Prashar et al. 2004). In recommended doses, it is generally considered well-tolerated with minimal adverse effects. Lis Balchin (2006) states that due to the risk of contact with delicate mucosal membranes, the use of oils in sensitive areas should be avoided; however it is not clear if this advice applies to lavender oil in an appropriately diluted solution or neat application. Advise against the use of lavender until the itching and discomfort has stopped, and suggest consulting the GP if symptoms continue after stopping lavender oil treatment. Nursing and Midwifery Council (NMC) registrants are reminded that the use of complementary and alternative therapies should be safe and in the best interests of women and midwives should respect women's rights to self-administer.
Lis Balchin, M. (2006) Aromatherapy Science. London: Pharmaceutical Press.
Prashar, A., Locke, I.C., Evans, C.S. (2004) Cytotoxicity of lavender oil and its major components to human skin cells. Cell Proliferation 37, pp221-229.
Jones, C. (2011) The efficacy of lavender oil on perineal trauma: a review of the evidence. Complementary Therapies in Clinical Practice 17(4), pp.215-220.
