I don't know if our recipe is the one you are talking about or if it came
from somewhere else. But here is a copy of the sheet that we give out to
mom's with an OTC recipe:  (as always, any critiques are welcome)...  Pam
Price IBCLC, Charleston, SC 




	Treatment Plan for Sore Nipples

If your nipples have any blisters, scabbing, abrasions or cuts, your baby is
not nursing well.  A proper latch will stop the damage from continuing, ask
for help with positioning the baby correctly. This mixture is considered
safe for breastfeeding mothers to use on their nipples, however, the primary
care provider should always be consulted prior to using any medications,
even those that are over- the- counter or non prescription. Mom should call
her primary care provider for their recommendation and approval prior to
using this mixture. *See medical reference at bottom of page:
			o	Bacitracin (ointment only)
			o	1% hydrocortisone 
			o	Lotrimin 
				*	Try to find the ointments of these
but cream is acceptable  
	*	Twice daily wash nipples using a wet cotton ball and baby
shampoo.  Wash using a circular motion to work up a lather then rinse well
with warm water. After washing apply mixture if not time to nurse.  If it is
time to nurse then after feeding apply mixture.
	*	After every nursing, mom should apply a thin layer of the
mixture to the nipple and areola on both breasts.    
	*	Allow breasts to be open to air as often as possible. 
	*	Contact              if any problems arise or feedings do
not to go well
			o	Never use ointments or creams that contain
medication for pain relief on the breast or nipple, these would contain a
drug from the "caine"or "xine" family such as lidocaine, bensocaine,marcaine
which are highly absorbed in the breast milk when applied to the breast and
are harmful to the baby. 

The ingredients in the mixture above are available over the counter and
without prescription. They are considered safe for breastfeeding mothers to
use and they do not have to be washed or wiped off prior to nursing. Much of
the mixture will already be absorbed into the skin, and the items are not
available to the baby's system, they are topical and not absorbed through
the gut. The Lactation Consultant is not a primary care provider, (doctor or
midwife), but rather a consultant, educator, and assistant that will helps
moms to have a healthy and positive breastfeeding experience. The consultant
does not make decisions for the mom but will support the mom in her choices
for feeding her infant.   It is the mother's responsibility to communicate
with her primary care providers as to her wishes and concerns regarding
herself and her infant.  Below, Dr. Newman's ointment is available by
prescription only, to obtain, ask your primary care provider, or the
provider that delivered your baby to write a prescription for this and have
it filled at a compounding pharmacy.  It is listed here as a reference. 



www.Breastfeedingonline.com Dr. Jack Newman's  "All purpose nipple ointment"
*This combination of 3 ingredients seems to help for many causes of sore
nipples, including poor latch, Candida (yeast), dermatologic conditions,
infections of the nipple with bacteria and possibly other causes as well. It
is always good, however, to try to assure the best latch possible, because
improving the latch helps with any cause of pain. 
	*	Mupirocin 2% ointment (not cream): 15 grams 
	*	Betamethasone 0.1% ointment (not cream): 15 grams 
	*	To which is added miconazole powder so that the final
concentration is 2% miconazole 
	*	Sometimes it is helpful to add ibuprofen powder as well, so
that the final concentration of ibuprofen is 2% 
This combination gives a total volume of approximately 30 grams.
Clotrimazole powder to a final concentration of 2% may be substituted if
miconazole powder is unavailable, but both exist (the pharmacist may have to
order it in). I believe clotrimazole is not as good as miconazole, but I
have no proof of that. Using powder gives a better concentration of
antifungal agent (miconazole or clotrimazole) and the concentrations of the
mupirocin and betamethasone remain higher.
The combination is applied sparingly after each feeding (except the feeding
when the mother uses gentian violet). Do not wash or wipe it off, even if
the pharmacist asks you to. In Canada, Kenacomb (easier to find) or Viaderm
KC (less expensive) ointments (not cream) can be substituted for the above
combination, but are distinctly inferior. I used to use nystatin ointment or
miconazole cream (15 grams) as part of the mixture, and these work well, but
I believe the use of powdered miconazole (or clotrimazole powder) gives
better results.  

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