I recommend washing damaged nipples with mild soap and water 2-3 times a 
day, and usually offer some sort of moist wound healing strategy as 
well. I don't love using antibiotics prophylactically, but instead teach 
moms signs of infection to watch for (increasing pain, redness, 
purulence, golden crusting). I'd love to read the studies that indicated 
they are necessary, do you have the citations to share?

Catherine Watson Genna BS, IBCLC  NYC  cwgenna.com


On 3/12/2012 12:16 AM, Laura Spitzfaden wrote:
> A few weeks ago I posted about a nipple ointment that has beeswax in it and wondered if there is the same concern as with honey in babies under 1 year.  The consensus seemed to be that it would be best to avoid beeswax but it also seemed that others didn't think that it was necessary to use anything more than breastmilk or maybe coconut oil on nipples.  I didn't have time then to follow up on my other questions.
>
> When I took a Lactation course for earning the credits I needed to sit for the IBCLC, I was presented with research based information that nipple tissue that was damaged needed antibacterial ointment to avoid bacterial infection.  Additionally, it was advised that rinsing (with salt solution if possible) after nursing and washing with soap and water at least once a day was important to avoid bio-film which would slow healing.
>
> So, what do others recommend to moms when they have cracks or other tissue damage?  I always recommend rinsing with salt water solution and once-a-day soap and water washing for tissue damage but I am always uncertain about what antibacterial ointment to recommend.  My fall-back is APNO but I don't like the steroid and prefer natural ingredients.  Is coconut oil (which seems to be protective against candida and staph) strong enough?  I really prefer to avoid pharmaceuticals and I really like the beeswax/teatree/oregon grape root/thyme mixture in the salve I would like to recommend except that I have concerns about the beeswax.
>
> What is your ideal nipple damage recommendation?
>
> Laura Spitzfaden LLLL, IBCLC
>
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