I have had mothers with these sort of cracks which don't respond to thrush treatment very well either. They have all been postnatal however and one mother found after treating herself for thrush for 3 months that topical application of Savlon  fixed it in 24hrs. This would imply that the crack was infected with something, swabs were not conclusive. Its now made me wonder how many other "infected" nipples there are out there and maybe the hygiene procedures we employ for thrush actually get rid of infections instead!
Just a thought.

Jackie Cesnik IBCLC
De Novo Lactation Consultants 
Vice President ALCA Vic
NMAA Breastfeeding Counsellor
Vic Branch Information Service Co ordinator


-----Original Message-----
From:   Val Best RN RM IBCLC [SMTP:[log in to unmask]]
Sent:   Thursday, 12 June 1997 0:18
Subject:        Painful cracked nipple ante and postnatally

I have a client, para 3, previous 2 babies breastfed for 6 months.
She developed a crack in the nipple antenatally, small and centrally
situated.  Was advised to apply lanolin, now ceased that due to it
been of no help. Nipple painful to feed from from birth.  Baby now 3
weeks old, crack still there and very painful during and after feeds.
 Mastitis in that breast 1 week ago, now cleared.  Mum reluctant to
feed from this side due to pain, so feeding once or twice a day from
this side.  I am treating Mum and baby for thrush since the signs are
"razor blade type pain", itchy nipple", nipple extremely painful",
deep breast pain.  Baby has no thrush on nappy area, may have it
orally (unconfirmed).  What I want to know is why did this crack
develop antenatally?  Is it hormonal changes?  This is what I have
suggested.  Is it thrush, or am I missing something?
Val in Busselton, Western Australia
RN RM IBCLC