I agree with remark that cracks opening at the base of the nipple often
becoming contaminated with bacteria and become infected.  There is another
factor that can cause those kinds of cracks to open up: pumping with a pump
flange that fits too tightly once the nipple begins to swell during pumping.
The frictional trauma this creates can rub open those cracks at the junction
of the nipple/areola.  There is a picture of this phenomenon in the
Breastfeeding Atlas in the ch. on Anatomical Variability as an Issue in
Breastfeeding.

 Lots of different studies talk about the relationship between early
cracking (esp. while still in the hospt.) and nosocomial infections.  It is
very important to keep the breasts draining.  Further, I manage nipple
fissures by telling mothers to keep them clean (maintenance debridement with
normal saline solution or clear water rinsing and the use of  topical
mupirocin) and dry (airing, brief exposure to sun).  These techniques
protect clients from progression to mastitis.   "Clean and dry" is basically
a WHO management guideline.  Clumps of debris in the milk is a sign of
mastitis.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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