Rachel,

I have seen two types of hydrogel dressings marketed in this area.
Sherwood Medical Company markets a brand named Dermacea ("for use on
minimally to moderately exudating partial and full thickness wounds").
The Kendall Company (a Tyco International Ltd. company) markets a hydrogel
dressing named MaterniMates, "made of three primary components: water,
moisturizer, and polyurethane."  Could the hydrogel dressings you have seen
as MotherMates be what is known as MaterniMates here?

Appreciated your comments re: pacifier use and these products - - a
research study would be helpful in this regard.  I bf my two daughters in
the '70's with never a moment of nipple soreness, and pacifiers were not
part of our lives.  My grandmothers bf their children in very small towns
in West Virginia and Pennsylvania, but my mother, her sisters-in-law,
friends and acquaintances did not bf (my sisters and I were born from 1953 -
1961, in rural/small towns in WV - - towns so small as to be
unincorporated).  Among both my mother and father's sides of the family as
well as my husband's family, I was the first mother in my generation to bf,
apparently starting a trend.  As a child and adolescent, I spent many
hours in fascinated observance of family pets (dogs, cats) giving birth and
nursing their young.  I am thankful for that normalizing experience.

As a first-time mom at age 19 following an unplanned pregnancy, I made it
to the 4-month mark nursing my first daughter.  Babe then politely refused
my breast by simply turning away, following mother-in-law's unauthorized
feeding of a bottle she must have brought with her, MIL convincingly
arguing that I was "drying up." Babe then refused the next several attempts
at bfing.  Such heartache.  Thought about calling LLL but could not bear to
be again told what I then thought was the obvious - - that I truly
was "drying up."  Of course LLL would not have given that information, but
in my inexperience, that seemed to be the only response I could imagine - -
nothing then in the mainstream about nipple confusion and nipple
preference.  I felt simply too young and inexperienced as a parent
to "know" that I was not adequately nourishing my child (in spite of her
recent peds visit where all was well).  Next baby four years later was bf
until age 3.  I was determined that if anyone had anything negative to say
about bfing, they were coming no closer than a 20-foot radius. Entered
nursing school three years later.

Back to the hydrogels.  I have recommended these products to mothers in
cases of visible nipple damage, but not in all cases, however.  I use my
clinical judgment based on mother's description of the pain and the extent
of the visible nip damage.  The typical response from mothers who are
applying them for the first time is, "Ahhhh."  It's important that they are
used according to the directions.  Patient teaching should also emphasize
that these products are not intended to prevent nipple soreness/damage
("good positioning and a deep latch does that"), but to merely speed up the
healing.  I also give mothers a choice when visible nipple presents itself:
to use pure lanolin with breast shells OR to use hydrogels (I provide all
these to the moms), emphasizing the healing approaches of each and
hopefully empowering the mother to determine what works best and most
quickly for her, while reassuring the mother that she will finesse
positioning and latch with many breastfeeding "practice" sessions, as in
any newly acquired motor skill.  I use analogies such as learning to play a
musical instrument or to ride a bike or play a new sport - - practice
improves our agility in  all these.  I have found appropriate breast
compression - a la Jack Newman (thank you, Jack Newman) - to be invaluable
in correcting nipple creasing and other nip damage.

Avoiding pacifiers sounds particularly appealing, in light of the
polyurethane in these hydrogel products.

In gratitude for this forum and for everyone here,

Debbie


Debra Swank, RN BSN IBCLC RLC
Winchester, Virginia USA

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