Having super sensitive skin, I dealt with this kind of thing quite a bit.  I 
used some OTC hydrocortizone cream.  I applied it twice a day, right after 
nursing the baby, at a time that I expected the baby to go a while without 
nursing, I kept a square of a cloth diaper over my nipples, to keep any of 
the cream from getting on my bra.  Before the next nursing, I rinsed with 
warm water, to get off any residue of the cream.  I was very careful about 
how I washed anything that touched my breasts, to get rid of detergent or 
fragrance residue.  Another thing that helped me was to rinse my breasts 
with warm water and air dry, after breastfeeding.

Although this wouldn't be an issue for most moms, I thought I would mention 
that, for a mom who is supplementing at the breast, with a Lact-Aid or SNS, 
the supplement can cause eczema.  I am allergic to soy and could not use soy 
based formulas in the Lact-Aid.  It was like pouring acid on my breasts.  
Any mom who is using ABM in a supplementer might want to try switching to a 
different one and see if it makes a difference.  Another thing to consider, 
which we have discussed here before, is the possibility that something 
remaining the baby's mouth, other foods or toothpaste, may cause a skin 
reaction on the breasts.

I think, as far as the safety issue of using topical steroids, it should be 
considered as with internal medications.  Using it, carefully, may allow the 
baby to keep being breastfed when he wouldn't be if the problem wasn't 
solved.

Darillyn

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