I have some concerns about the use of peroxide on nipple cracks and ulcers.
I have heard and read that we should no longer use peroxide in the cleansing
of wounds as it impairs fibroblast function.  Fibroblasts  are the skin
cells that help cover wounds.

In medicine, any partial or full thickness wound is treated with moist
healing.  When I tried dry healing in the "early years" of my practice I had
very poor success with it.  Moist healing seemed to be much more effective.

In order to afford moist healing, I have tried many different preparations
and treatments including antibiotic ointments, medicated gauzes and steroid
creams.   All of these were to be gently but thoroughly washed off before
nursing using breastmilk and a soft cloth . The last agent I tried has
turned out to be extraordinarily successful.  It is a high grade medical
lanolin.  The trade name is probably familiar to many of you (L-------).  I
do not like product endorsements and I intend to keep trying other products
but for now I recommend this to most mothers.

The mothers get a good deal of pain relief during the first week as the
initial skin layer is put down.  I also offer them a small amount of codeine
to help with the pain.  Complete healing can take from one to five weeks
depending on the depth and size of the crack or ulcer.  This may seem like a
long time but as long as we are controlling the pain it is less of a concern.

You also have to try to prevent further injury with good positioning and
latch but this erudite crowd already knows all of that! I tend to advise
mothers to change positions from one nursing to another to distribute the
stress of nursing.   Nipple cracks and ulcers can also lead to mastitis.
Accordingly it is a good idea to warn mothers about the signs and symptoms
of mastitis.   The pain can also inhibit letdown and result in a hungry and
underfed baby so you need to watch the weights.


Dr. Shirley Gross (from the great north)
Edmonton Breastfeeding Clinic
Alberta, Canada
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