> << the ob  prescribed  1% Hydrocordisone  to the breasts but not the nipples
>  and areola as this area was not involved. >>
>
> Really, I was under the impresion that HC was too strong to be applied there.
>  Meaning it would cross over to the milk.  Anyone with a definite?

Sometimes cortisone is necessary, but exercise caution about longer term
use on the nipples for chronic conditions:
    De Stefano P et al (1983) Factitious hypertension with
    mineralocorticoid excess in an infant. Helv Paediatr Acta 38:185-89
    "Corticosteroid excess, with hypertension and profound suppression
    of pituitary-adrenal function, has been reported in an infant whose
    mother used a corticosteroid on her nipples for two months."

A dual management regime is worth considering - managing the dryness from
the psoriasis/eczema/dermatitis with an inactive nipple topical
(hypoallergenic and safe for breastfeeding) and adding in active product/s
as required, usually in smaller amounts or for shorter periods.
Dermatologists call this "steroid sparing".


Ros Escott BAppSc IBCLC
Tasmania, Australia
mailto:[log in to unmask]