Sue wrote: " ...I saw a young woman in her last trimester of pregnancy
who has recently developed alot of thickness on her nipples. The thickness
is about .5 cms and a yellow  brown.....
What I found in the archives suggested normal washing followed by triple
lanolin daily and soft towel rubbing. Another post recommended nothing -
stating that the skin would basically slough with baby's sucking and not
harm the baby or mom.....
So - to recommend doing anything or not - that is my question. This mom is
without symptoms. I am tending toward letting it go. Gradual sloughing with
feeds would be ok. If the whole piece pulled off - now that would be
interesting for mom or baby. What are the chances? Not good - I think.
Anybody out there want to jump in on this - feel free."

I worked with a Mom about 6 months ago who had a similiar "build-up" on the
nipple tips. After a couple of days of BF (she was in the hospital for a
C/S, so stayed 3 days), the thickened patch gradually loosened and came off
in one piece.  Under it the skin was very tender.  This was thin skin that
had been covered/protected by this crusty area, and was suddenly exposed.
Even without BF I think it would have been tender.  She then had very
painful nipples.

We decided that, before the next baby, she should do some daily nipple
soaks, use lanolin, and gentle rubbing to try to decrease and remove this
build-up.

Barb Berges BS, RN, IBCLC
Rochester, New York

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