>I was thinking last nite that I wonder if the incidence of mastitis would go
>down (a nice prospective study to do?) if we instructed moms in prenatal
>classes and in bf advice to WASH THEIR BREASTS AND NIPPLES WITH A MILD SOAP
>and rinse well, with their regular bathing routine. Rather than telling moms
>to avoid getting soap on their nipples - which BTW I don't say. Would a
>regular soap and water wash be helpful or would this dry the skin or remove
>the Montgomery secretions? What do you all think?

I vote for no soap on breasts, other than what might run over them in the
bath.  If one is to recommend "mild soap", she should be sure to warn
against antibacterial soaps. In many households in the US all soaps are
antibacterial, a fact that is of grave concern among scientists and
knowledgeable health care professionals. Their concern is the resistence to
abx and the "super bugs."

There are naturally occurring antimicrobial secretions on the nipples and
areola that serve to maintain nipple health, if they aren't removed.  It is
my opinion that most infective mastitis is caused by poor feeding practices
resulting in damaged nipple tissue. Then the ordinary bacteria are
introduced into the breast via the damaged nipples. I don't believe that
washing with soap would help in these cases.

And on the topic of antibacterial soaps, they destroy bacteria that are
part of a healthy skin, whether it be nipple tissue or other skin tissue. I
am certain that part of the yeast "epidemic" is this use of antibacterial
cleaners. We can assist in the education of our clients on this issue of
healthy balance of bacteria and the role of environmental bacteria on
immune system strength. As I read in an article on this topic recently, "If
we continue to use abtibiotics as a cure-all, they will eventually become a
cure-nothing."

Laurie, excuse me for going off on a tangent, away from your question. I'll
await a prospective study, and am always ready to change my mind, as I've
done many times over the years that I have been a part of this list.

Pat Gima, IBCLC
Milwaukee, Wisconsin


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