Coach Smith here. I haven't been following this thread closely, so please no
flames. First, find the cause before picking a "treatment" for any kind of
nipple or breast pain. Think for a minute...

Early-onset nipple pain is usually mechanical in nature - physical
compression by the baby's tongue, gums, etc. The remedy for mechanical pain
should be mechanical. First, correct positioning at breast so the mechanics
of the infant's suck response do not damage the nipple. If mechanical pain
can't be quickly fixed at breast, then consider taking the baby off the
breast so as to preserve nipple skin integrity and prevent further physical
damage. Mom should pump and cup feed (or use another express-and-feed
regimen) until the mechanical problem(s) can be corrected.

Later onset pain, or sudden-onset pain after a period of comfortable BF is
almost always infectious - either fungal, bacterial, or both. The remedy for
pain from infectious conditions is treatment of the infection with the
proper medication.

Infected skin is fragile and is easily damaged, therefore sudden-onset
cracking often is a sign of a subtle infection. The converse is also true -
cracked skin quickly becomes infected with yeast and/or bacteria, so if
there is mechanical damage that does not heal quickly, consider that
infection may also be present.

Normal skin stretches normally and usually doesn't need additional
lubricants. If the mom's nipple skin is dry, her lips and other body areas
and mucus membranes are probably also dry - she needs better overall
hydration (probably) and possibly a look at her diet for long-term
nutritional issues that affect skin integrity.

There are a few rare causes of nipple pain that aren't mechanical or
infectious, and that need careful attention to find the cause and remedy.

Linda J. Smith, BSE, FACCE, IBCLC
Bright Future Lactation Resource Centre www.bflrc.com
6540 Cedarview Ct., Dayton, OH 45459-1214 USA
(937) 438-9458 email [log in to unmask]

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