Question:  How aggressive are you when you see a mom the first time and see that
there is broken skin on the nipple - either bleeding due to friction of the
baby's incorrectly positioned mouth or cracks in the tissue?

I am asking as I had just helped the mom position the baby in such a way that it
did not hurt, and if so, assumed the tissue would heal with the normal
breastmilk to the tissue and air drying, etc.

However, two cases in the last two weeks had irritated nipples that were not
exceedingly red or sore and where the mom was able, with my help, to put the
baby to breast fine, but they later developed red, sore tissue surrounding the
break causing considerable pain and requiring cessation of breastfeeding until
the tissue healed enough for mom to put baby back to breast.

Should I have suggested antibiotic/nystatin/cortisone treatment as I have heard
others do?  What do you do?

Jeanette Panchula, BA-SW, RN, IBCLC, LLLL
Puerto Rico
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