A mother I've been dealing with has had various diagnoses for her nipple
troubles.  I sent her the following link to Dr. Newman's ointment recipe
http://www.breastfeedingonline.com/3b.html
which she took to her dermatologist.  The mom reports that her dermatologist
"didn't agree with the medications in the ointment.  She said there are 7
types of cortisones, 1 being the strongest and 7 being the weakest.  The
cortisone in Dr. Newman's ointment is a 2 and the one prescribed for me is a
6.  She said she would never prescribe such a strong cortisone for the
breast area since that's such a delicate area."  The dermatologist warned
against thinning of skin (I've heard of that with steroids before) and
development of stretch marks with extended use.

Please educate me, those of you with steroid and APNO training and
experience:

1.  Is betamethasone in a .05% concentration truly "big guns" as far as
steroids go?

2.  Is the thinning of skin a permanent or temporary effect?  This mom
seemed concerned that there would be implications for skin strength as she
ages.  What do you know about steroids and stretch marks?

3.  Do you recommend APNO often?  How long do you usually recommend a mom
use APNO?  Why?  In other words, do you have anything in particular to say
about appropriate terms and risks vs. benefits of its use?

Many thanks,

Ruth Piatak, LLL Leader
Plano, TX

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