My own system goes something like this:
1. Damaged nipples - correct/enhance attachment - no ointments (lanolin or
otherwise - unless mother insists - risk of sensitivity to ingredients in
oitments - upset to baby's smell/taste - but mainly using ointments
distracts from the root cause ie. poor attachment).
2. Keep in mind principles of moist wound healing - avoid excessive drying
of nipples - a purified lanolin *may* have a place if dry climate/air
conditioning - if wound particularly deep/wide, UK midwives often suggest
applying a small moisture-retaining dressing - paraffin-gauze, or whatever
(very informative article in recent J.Hum.Lact.)
3. Nipples not healing in spite of 1-2 days of improved technique -
consider s&s candida - treat if indicated - certainly no other ointments if
treatment needed.
4. Nipples still not healing in spite of above - consider bacterial
infection - try appropriate topical medication but keep in mind that
(rarely) oral antibiotics may be needed.
A fine Spring day here in England - too early!!
Hannah
(midwife and National Childbirth Trust breastfeeding counsellor, UK)
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