Hi Lora,
That sort of situation is obviously frustrating for you. So let's rephrase your last sentence.  Rather than look for research that supports not washing breasts/nipples before every feeding, I suggest you and your clients ask this paediatrician to provide credible evidence to support doing so.  Since he is so out of step with current practice and is wanting an intervention, he needs to justify the intervention.
Gosh! I wrote refuting the need for this intervention in the first edition of my first book in 1974.
I'd go easy with the soap, too, as it can be drying - especially if applied constantly!
Virginia

Dr Virginia Thorley, OAM, PhD, IBCLC, FILCA
Private Practice Lactation Consultant (cohort of 1985)
In Brisbane, Queensland, Australia

I recommend to my clients that they wash their breasts/nipples with mild soap once a day and explain that routine washing of breasts/nipples before every feeding is not necessary and could cause the skin to dry and crack. However, a pediatrician that I work with is still instructing moms to wash breasts before every feeding so that the infant's saliva does not cause an infection. I understand that if nipple damage has occured, then care of the nipples may require more frequent cleansing. 
Does anyone know of any research articles that supports not washing breasts/nipples before every feeding?

Lora Elston, BSN, RNC, IBCLC

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