All About Nipple Creams and Ointments|
Deciding to nurse your baby doesn't mean that you'll always have to
have a special nipple cream or ointment on hand. Some mothers never
require anything to apply to their nipples. Others, on occasion, may
find a certain cream soothing. And in some cases, the right type of
cream or ointment may actually prevent drying and cracking of the
nipple and help speed healing. Other antibacterial ointments and
antifungal ointments may be necessary as part of a care plan to treat
these types of infections if they should occur.
Creams and Ointments to Avoid!
Because anything you apply to the nipple area may be ingested by the
baby, it's important to use only those products that are known to be
safe or which absorb so quickly into the skin that only minute amounts
are left on the surface. Washing the area to remove a cream or ointment
that might be harmful to the baby is not acceptable either as this
results in naturally occuring antibacterial and lubricating properties
to be removed from the breast which can result in over-drying.
Any all-purpose breast or nipple cream sold over-the-counter
which has any other ingredients besides 100% lanolin should be avoided.
Other ingredients may be toxic to the baby. This would include the
populuar Masse Breast/Nipple Cream sometimes given out in hospitals as
well as Vitamin E in any form and Bag Balm. No other lotions or creams,
normally used on other parts of the body as moisturizers, should be
applied to the nipple area.
Lanolin: New Evidence to Support Its Worth!
In recent years research has concluded that not only is a 100% pure
lanolin ointment or cream soothing to new mothers' nipples but it can
also prevent nipple trauma by maintaining the internal moisture of the
skin. For this same reason, it may also speed healing when nipple
trauma is already present. An additional benefit of lanolin is that it
does not have to be washed off prior to nursing as it is non-toxic and
safe for the baby. Most babies seem to have no difficulty with any
"after-taste" after lanolin application either.
Lanolin can be applied after every feeding if desired,
preferably after the nipple tissue has been pat dry. A small amount
goes a long way, so you'll need very little. Warming the ointment by
rolling it between fingers can make application easier. There are two
popular brands of 100% lanolin on the market: Purelan made by Medela
Occasionally cracked nipple tissue may become infected. This can
manifest with redness, oozing, heat in the area, fever, and pain. There
may also be no other symptoms of infection other than the cracking
itself. If a cracked area is not healing quickly, there is nothing
wrong with applying an antibiotic ointment for a few days to see if
this might speed healing. Try Neosporin, Triple Antibacterial Ointment,
or Bacitracin. All of these are readily available over-the-counter.
Apply the ointment after feedings once you have rinsed the area with
clear water and patted it dry. You do not have to wash it off before
nursing again. Simply wipe away any excess that might still be on the
surface of the skin with a dry cloth. If relief is not seen within 3-4
days of using an antibacterial ointment, further assistance should be
sought from a lactation consultant.
Antifungal Creams and Ointments
Yeast can infect nipple tissue. Cracked nipples often allow for
yeast to enter. However, yeast can proliferate despite healthy nipple
tissue, especially if there are risk factors for yeast in the history. If a yeast infection of the nipples
is suspected, certain over-the-counter yeast creams can be applied
to the nipple. These include Lotrimin AF, Micatin, and Monistat. They
are applied to the nipple area after feedings and after rinsing the
area of the baby's saliva and patting it dry. Just as with
antibacterial ointments these preparations do not have to be washed off
prior to nursing again. Any excess can simply be wiped away with a dry
cloth. If there is no improvement with the nipple trauma within 3-4
days of using an antifungal cream or ointment, further help should be
sought from a lactation consultant.
Prescription Nipple Ointments and Creams for Those Tough Situations
Occasionally something stronger with more active ingredients may
be warranted. Dr. Jack Newman has suggested an "All Purpose Nipple
Ointment " (APNO) for treating any type of nipple trauma that is slow
to heal. A combination of two antifungal ingredients, one antibacterial
ointment, and one steroid almost ensure that any cause of nipple pain
and trauma will be addressed. The steroid is added for quick relief of
inflammation and pain. This ointment can be called in by a physician
and compounded by a compounding pharmacist. It is applied after
feedings and can be used as long as needed. It does not need to be
washed away prior to feeding. For a complete listing of the
ingredients, including amounts, of APNO, click here.
If your physician will not call in the APNO for you or your insurance
will not cover compounded medications, you can still take several
over-the-counter ingredients and come up with a similar ointment.
Simply take equal parts of an antibacterial ointment, an antifungal
cream, and some cortisone (Cortaid brand is fine) and mix them together
to make one ointment.
Nystatin is an antifungal cream that
is also used to treat yeast on the nipples. Your doctor will need to
call this in as a prescription. It should be applied after every
feeding once the nipples have been rinsed with clear water and patted
dry. It does not need to be washed off prior to nursing again. Because
yeast has become highly resistant to Nystatin, many experts are
recommending that it be skipped completely when treating nipple yeast.
Breastmilk: Nature's Nipple Salve
Because of breastmilk's antibacterial and healing properties it
makes a wonderful nipple salve. It also has Vitamin E in it in amounts
that are obviously safe for the baby. After a feeding, simply express a
little more milk and rub it into your nipples. This practice should be avoided if you think you may have a yeast infection as yeast thrive in milk.
Written by: Becky Flora, BSed, IBCLC
Last Revision: January 22, 2002