Does soap really hurt?  I mean that literally.  I was surprised by the gut reaction of "oww" from groups that don't use soap on broken nipple skin, because I don't associate the gentle soapy cleansing of broken skin with pain.  Iodine or alcohol, for sure, but we've always done a gentle soap wash of cuts and scrapes at our house, and no one has ever yelped.  Have others found a gentle soap wash to be painful?

This is from Barbara Wilson-Clay's and Kay Hoover's "The Breastfeeding Atlas, page 65:

"While it is unnecessary to engage in elaborate routines to clean *intact* nipple skin, the authors routinely suggest that mothers clean a cracked nipple in the same way they would provide first aid attention to a bite wound on a finger.  They instruct mothers to immediately clean nipple wounds with warm soapy water.  Following each subsequent breastfeeding, mothers are asked to flush the nipple wounds with normal saline solution or tap water (Angeras 1992).  This reduces the likelihood that pathogens from the baby's mouth will contaminate open nipple fissures.  Mothers can irrigate the wounds by squirting from a squeeze bottle, or can briefly suspend their breasts nto a bowl of warm water.  Mothers should be instructed to handle their injured nipples with clean hands, and are asked to allow the nipples to thoroughly dry before applying expressed milk, purified lanolin, topical antibiotic cream, or a clean hydrogel dressing...  Identifying best practices for the management of cracked nipples awaits more conclusive evidence."  (Those dots represent some very interesting info on the characteristics of chronic wounds).

The thought of warm soapy water on a scrape or cut - even on a nipple - just doesn't make my toes curl.  But then, I haven't had one lately...

Diane Wiessinger, MS, IBCLC  Ithaca, NY  USA
www.wiessinger.baka.com

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