Karyn-grace:  Check the archives - APNO and it's cheaper OTC counterpart 
(thus the term Cheap All-Purpose Nipple Ointment per Tom Hale) have been 
discussed, with some "recipes" posted.
The Cheap APNO that I have found to be useful is one "discovered" by one of 
my moms who could not get ahold of her OB to get a prescription.  She looked 
into her medicine chest at home and stirred together Neosporin ointment, 
Lotrimin cream, and 1% hydrocortisone cream in a clean covered container and 
called it her "miracle cure".  All of these ingredients can be found in her local 
drug store over the counter (at least in the USA).  I tell a mother to apply to 
nipple/areolar area after feedings and gently massage in well.  No need to 
wash nipples at next feeding.  Most moms seem to get good relief within 24 
hours.  She should be told to use it only until her problems have resolved 
themselves.
Last week, a mom that I worked with with her 1st baby (nursed him for 13 
months!) immediately after delivery asked me for the recipe for the "cream 
that saved my life!".  Fortunately, this 2nd baby seems to be off to a better 
start and hopefully she won't need it.
Of course, it goes without saying that if things don't improve or are getting 
worse, mom should also consult her doctor.


Pam Hirsch, BSN,RN,IBCLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL    USA

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