I wanted to share some thoughts on helping mothers with bites on nipples.
Bites are dirty wounds, and what I know from other skin injuries (like my
torn up hands when I garden without my gloves) is that  dirty wounds don't
heal. I need to wash the wound carefully, and then apply a safe topical
antibiotic.  If I have a similar wound on two fingers and only treat one,
the untreated wound often gets inflammed, healing is delayed, and it hurts
whenever I use the finger.  Nipple wounds still occur on skin, and, in my
experience  the same principals of wound cleaning and treatment apply.

 I think that it works well to tell mothers to do some gentle breast soaks (
I like a mild, warm saline solution mixed in a bowl.)  Mom should rinse off
the wound initially, and after nursing/pumping.  A dab of polysporin or
Bactroban (topical antibiotics, for our international friends) are safe for
infants to be exposed to, and will manage any superficial bacterial
contamination of the wound which is contributing to delayed healing/pain.
Wounds heal from bottom up and outside edges in.  Moisture barriers (like
purified lanonin or hydrogels) can prevent such deep scabbing with resultant
re-injury when sucked off.    A mechanical barrier can help too.  I have
often carved up nipple shields to make a protective donut cover which
fastens down a dressing, or at least prevents direct contact with the wound
surface.  Women who arent very skilled at hand expression may need to rent
an electric pump to keep the breast soft.  A real set up scenario for
mastitis is a contaminated nipple wound combined with milk stasis from a
poorly drained breast.

Barbara

Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html