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