There is a hospital in my area that sends many mothers home with *hydrogel*
dressings
(any brand name) with complaints of nipple soreness and in place of purified
lanolin. I worry about the lack of research regarding the efficacy and even
safety of it's routine use and recently consulted with a Mom illustrating
this concern;
consult provided on day 6, baby had latched well initially and for 1st few
days til breast engorgement, Mom began using shield, nipples had been
slightly tender with/without shield. Day of discharge (4), nipples sorer but
w/o cracks but given dressings and instructed to wear all the time.
 AT time of consult nipples appeared sl. macerated and top layer of skin
pealed off in scattered areas when dressing was removed leaving abraded
tissue. Nipples appeared generally water logged, as if they had been sitting
in h2o for too long. Baby unable to latch w/o shield, Mom opted to use
postition change and persist with nursing at breast(with shield) despite
abrasions. I advised to d/c dressings and apply lansinoh, small amts., after
each fd. Mom called 2 days later to report that nipples had improved
dramatically and most noticeably within 12hrs. w/o drssng use despite cont'd
need for nipple shield.
This is an extreme but not isolated case as I have seen at least a few other
cases where the drssngs have been reapplied for many days and/or seemingly
used in instances where the nipple has only slight abrasion. How does this
compare to what others are seeing in their communities?
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachsuetts

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