Of course I am not commenting on the journal club article I have not read.
 I have questions about Staphylococcus aureus.  Since this is a common skin
organism, do we know if it is usually present on all nipples, including
healthy ones?
My microbiology class was recent.  I doubt I will forget the show-stopper
hand cleaning experiment.  We touched our thumbs into soy agar to innoculate
petri dishes, before and after hand washing with various hand cleaners.
Few pathogens grow on this agar, but we saw a beautiful S. aureus bloom in a
perfect thumbprint.  We only saw growth like that After washing.
According to my lab manual, soaps bring staphylococcal colonies to the
surface.  That is certainly what we saw.   Lots of bacterial growth after
washing with all the types of old and new cleaners.
Is the S. aureus in a nipple crack really THE pathogen?  The problem that
prevents healing?
Would topical antibiotics bring out additional S. aureus?
What is milk doing in this situation?  Reducing or increasing staphylococcol
growth?
Do we want mother washing with soap?
Enquiring minds want to know.
I haven't a clue, but am suddenly afraid to suggest anything.
Pam Easterday  LLLL

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