Dear LACTNET Listmates,
 
I too have advised mothers to use a "mild soap" without really analyzing  
what is in the ingredient list, so, thank you Jennifer for enlightening me. 
 
If we wash other skin wounds, like scrapes and small cuts with soap and  
water, how is gently washing the nipple once daily much different from that? I 
 think back to my Visiting Nurse experience caring for wounds where we  
encouraged patients to shower before we did wound care, and there was soap  
involved, to be sure. I know I have seen some research on nipple wound care  
that is listed on the "Sore Nipples and Nipple Trauma Algorithm" from Nancy  
Morhbacher and Ameda, but don't have it in front of me at the moment. Also  
Kellymom.com talks about cleaning nipple wounds once daily with a "Non  
antibacterial or non perfumed soap." Most mothers in my area are going to try to  
heal nipple wounds with lanolin ointment. Some of them will go to a LC for  
assistance with latching. Posterior tongue tie is not generally recognized 
as a  problem around here. Sometimes, anterior TTs are also discounted.
 
Besides helping mothers to get a deep latch, how do we best help mothers  
who are not going to try coconut oil, or APNO, or other topical treatments,  
or consult a tongue tie specialist if the LC thinks that decreased tongue  
mobility is occurring? Mothers seem to want to do "something" that will  help 
get rid of the pain, and they will very often turn to the pump and bottle  
feeding EBM which we have been discussing at length. 
 
I would love to hear your collective wisdom on this.
 
Mary-Jane Sackett, RN, IBCLC, RLC
Pittsfield, MA

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