Diane and all,
 
We use castille soap, which I believe is vegetable-based, to clean pump  
parts in my hospital. This is the soap I will tell the mom she can use to clean  a 
nipple with an open wound, crack, abrasion, etc. when she is still  
hospitalized.  If the problem is not present in the hospital, but rather  the mom calls 
me after discharge, I will tell her that she can use a soap  with little or 
no perfumes or antibacterial properties added, a "pure"  soap.
 
The rational for cleaning the wounded nipple with soap once a day is that  it 
can help kill germs. We don't hesitate to wash other areas of our skin that  
have breaks in the skin's integrity, like small cuts, scrapes, etc. And  there 
is some thought that a cracked, damaged nipple is a risk factor for  
mastitis. I don't have the reference here at home, but look at the Academy of  
Breastfeeding Medicine's Clinical Protocol on Mastitis. This is the only time I  
recommend using soap on the breasts or nipples, due to the possible effect of  
soap being too drying. And I always stress the importance of handling the  
breasts or doing any nipple treatments such as applying lanolin with clean  hands.
 
Hope that this helps.
 
Mary-Jane Sackett, RN, IBCLC
Pittsfield, MA USA



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