When I went to Betty Bowles workshop, she presented this same information
on "wound care" of damaged nipples.  I have incorporated teaching moms
with any cracks or scabs of the nipples to clean daily with gentle soap,
and to apply plain triple antibiotic ointment ( not neosporin and not
anything with lidocaine)instead of lanolin to the nipples after expressing
some of their own milk and "dabbing" it in. My opinion,in many women the
lanolin aggrevates the condition. Anticdotally, the moms seem to heal
faster, and have less incidence of mastitis.  I also use hydrogel sheet
dressing, which was recommended by our Wound Care department for 72 hours.
The cooling sensation is very comforting, and the healing process is
improved. I am very careful however to tell mom's that this is only for 3 -
4 days until the "raw" area on the nipple is healed and the baby is
nursing comfortable at breast. Otherwise, I find that they want to
continue "wound care" all the time because they are afraid the problem
will come back.  It's ironic that such common sense care of a skin wound
has been so slow to transfer over to "nipple wound" care.

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