Hi Lou,

That is a long time to have the nipple fissure (6 wks ago). I would think
that it's going to take some anti-bacterial product and stop bf on that
breast for a little while. I find that an antibiotic ointment (she might
want to try the one that has a painkiller in there too) applied with a
clean cotton-tipped applicator (like Q-tip brand) several times a day
helps. I would also advise her to gently wash the wound with mild soap and
water, rinse (saline rinses are good), and pat dry with clean dry towel
first, then apply the ointment. Probably 4-6 x a day, keeping it "sealed"
with the ointment. I think the Medihoney would be a good alternative to the
antibiotic ointment. I am not familiar with it other than what I've learned
on lactnet or read about.

She might try something to keep clothes or bra off of the area too or just
leave the wound open to light and air if she can as much as possible. I
would hope that resting that nipple for a day or two would allow a good bit
of healing. She should express that breast, of course, throughout the day,
I am thinking hand expression, pushing from behind, would work better than
a pump pulling the nipple. She should always have very clean hands when
using the ointment and doing hand expression etc.

Sometimes long-term wounds that don't heal do need systemic antibiotics.

I am just assuming a 10 month old would not nurse with a shield but maybe
he might. I think at this point in time, I would recommend a day or two of
just expressing though.

Laurie Wheeler RN MN IBCLC
MISSISSIPPI USA

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