I would be a little nervous about making compounds for nipples myself,
although I have "suggested" OTC ointments separately.    I know there are
some things which have adverse reactions when put together, for example, or
where the effect of one is nullified by another.  The dermatologist who
works closely with us has told us that neosporin should not be used on
nipples, nor should triple antibiotic cream.   A better choice is
polysporin.  Mupirocin (Bactroban) is the best choice, according to him, but
requires a Dr.'s
prescription.

Our solution to the problem is to provide a physician's information sheet
and a mother's information sheet about Newman's APNO.  We  fax the doctor
the information sheet with references, and a prescription all filled out
with the recipe for making it in the U.S. (written by our NICU pharmacist)
and a list of pharmacies who will compound it.  Newman's ointment calls for
10% clotrimazole, which isn't available in the U.S., and we have found that
the 1% vaginal
cream does not work well.  THere is a way for a pharmacist to get10%
clotrimazole into the compound  and it works beautifully, if anyone is
interested.
Those who are hospital-based might try an approach similar to this, since we
cannot manufacture our own compounds.
Deanne Francis, BsN   IBCLC
NICU

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