One of my latest tricks on the antibiotic cream is to apply it directly to the hydrogel, spread it around by folding together the gel pad (like you do vaseline on gauze for a circumcision dressing), then apply to the nipple.  No rubbing of the nipple required.  It works WONDERFUL and no pain to mom of rubbing.  You can do it with lanolin products also on a non-infected nipple.  I have moms wipe the remaining (if any) cream off the gel pad with a damp cloth and re-apply before reusing.  In infections, I have found better to use only 24 hour hydrogels as I've seen exacerbation in the ones people reuse for 3-5 days. 

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of laurie wheeler
Sent: Monday, November 07, 2011 9:46 AM
Subject: nipple cracks

I have had good success with gentle soap and water cleansing of the nipples several times per day and gently dried. Follow this with a coating of antibacterial ointment (In USA we have neosporin, polysporin, bactroban, or a generic triple antibacterial ointment, most of these over the counter). I caution mom to apply this ointment with either very clean hands or clean or sterile cotton-tipped applicator (so she doesn't contaminate the wound). Then apply some brand of hydrogel pads which I find very helpful for wound healing).
She does not have to wash this off but may feel better with a gentle rinse prior to feeding.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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