i haven't been recommending salt water, although if barbara believes this to
be a good practice, it will be implemented immediately. we did discuss this
idea of whether to wash or not when we discussed verity livingstone's studies
at journal club. i myself am not quite sure why there had been a
recommendation to *not* wash nipples by nursing mothers in normal condition.
that is to say, people who take a shower tend to wash everything, and i don't
think we ever worry that one shower per day is robbing the skin of the normal
flora (although i think we do see people washing more frequently and with
strong antibacterial soaps, which is truly a problem). and i would never
think to add to general breastfeeding advice "never wash your nipples."

but the important point is that injured skin needs different care, and the
conclusion we reached in discussion was that washing once a day with milk
soap and water would be a good addition to treatment of injured nipples,
based on what these studies showed.

of course, a mom was told here that she had to soak her nipples for some
ridiculous period of time (luckily, i forgot this detail) after EVERY feeding
to get rid of a plugged duct. why? because the water would flow up in the
ducts and wash out the offending dried milk.

wow! and she wasn't even told to use sterile water, what was this person
thinking?

carol brussel IBCLC

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