Natalie Shenk asked about bacterial infections on the nipple. I heard a talk by a dermatologist, Dr Jennifer Menz, who suggested that when you work with a mother with fissured nipples, with or without thrush, you should always look for bacterial infection. She said the clue was a yellow crust, and fissures that are more painful than with thrush. She suggested Bactroban ointment as being extremely effective for control of bacterially infected nipple fissures. I have found that now I look for bacterial infections, I find them (and the refer the mother to her doctor). With damaged nipples I address the cause (usually attachment) plus treat the damage with modified lanolin. If it doesn't start to heal fast, I suspect thrush and/or infection is complicating healing, even if there are no visible signs. Mastitis is often associated with nipple fissures, so a clean, healthy wound has got to be safer than one with an untreated infection. Ros Escott [log in to unmask] "In every work the beginning is the most important part, especially in dealing with anything young and tender." Socrates