Washing nipples would increase skin breakdown. I would be more concerned
about direct contact in the baby's mouth than passing through breastmilk.
What if the baby gets lidocaine in the mouth, which would numb his mouth,
esophagus, or possibly respiratory function? Would this be helpful to the
baby? I don't think so.

If the majority of sore nipples is caused by poor positioning, maybe this
midwife could take classes on how to better assist mothers to create a
better latch, or maybe she could refer to someone with expertise?

Prescribing suggests she is a health care provider with prescription rights,
is she a certified nurse midwife? Perhaps she could give you the evidence
based information on how this is helpful, and not harmful. If she does not
have prescription rights, she is outside of her legal boundaries.

Best wishes,
Sam Doak



We're going to Candy Mountain, Charlie!


<<Input please -

A midwife has started prescribing Lidocaine 2% for sore nipples.  Her
instructions include applying the medication post-feedings and washing
nipples pre-feedings.  This concerns me.  Have I missed something in my
years as an LC...Is this a new treatment?  Is it evidenced based?  Is it
a standard of care anywhere?  Is this treatment included in anyone's
policy and procedures?
>>

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