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Subject:
A difference of opinions on nipple damage management
From:
Marie Ivey <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 23 Sep 2010 18:33:16 -0400
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Hello Lactnetters,

We (hospital based LCs in Chattanooga) seem to have differing opinions about how to treat sore nipples and/or nipple damage.  I have searched the archives (and my library) and I am not finding simple, easy, and clear directions.  Okay, assuming we have corrected the obvious (poor latch), checked for tongue-ties, suggested varying nursing positions, etc... here are the issues.  

1.  When we see moms after birth, several of my co-workers do not think Lanolin works and they don't give the free samples to moms...they always recommend moms express colostrum and rub it into the nipple and areola. Some of us (me included) suggest this the first day, but if moms are sore the next day...we like giving lanolin because of its soothing effect.

2.  Now, if there is ANY damage (cracks, fissures, and/or abrasions), some LCs suggest EBM and Hydrogels regardless of the extent of damage (they don't like APNO for some reason).  Others, suggest EBM and hydrogels for very small cracks...BUT, if cracks are larger, nipples are red, and breastfeeding is painful for moms...they go straight to Newman's Nipple Cream (APNO). 

I was under the impression that a crack in a nipple is a portal for bacteria which might lead to a possible breast infection...and APNO would help heal (steroid), prevent or decrease infection (antibiotic), and deter yeast growth (anti-fungals). 

Along with some great advice from this experienced community...if anyone has references, this would be very much appreciated!

Thank you so very much,
Marie Ivey, BSN, RN, LCCE, CLC (sitting for boards next year and the *newbie* on staff)

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