This moisture prevents a hard scab forming. When applying this to cracked nipples, a softer wound has an extra advantage. There is less risk of further damage happening during breastfeeding as there is no hard scab to pull off during a feed, taking the new skin cells lying underneath with it.
Keeping the wound moist also reduces pain by keeping air from drying out the exposed nerve endings then more pain as it rehydrates ref 6, p We are, however, unaware of any study that has looked at this specifically. Normally a new wound heals when the edges close together. An established wound heals from the base upwards, with the new skin growing over the edges, so they look smooth — often described as a rolled edge.
As these wounds look like they are healing relatively slowly, women can feel disheartened. It helps to explain this and to look for the wound getting shallower. These wounds are most likely to benefit from moist wound healing, reducing any scab formation and allowing the skin cells to glide over each other. This is sometimes referred to as secondary wound healing, as opposed to the primary wound healing that occurs for more recent and superficial wounds.
This process takes longer, and the wound is more susceptible to infection and scab formation in the meantime. Newly healed wounds are not as strong as normal skin, so can re-open if the baby slips when feeding. This is more likely to happen when the mother or baby is sleepy. Feeding lying side-on may help reduce the chance of this happening during night-time feeds.
While the wound is healing, it sometimes helps to talk about a pain scale — imagine a ruler numbered 0 to 10, with 10 being unbearable pain. Suggest trying to drop down the scale at each feed so the mother can see a progression towards no pain at all. Correcting the position should give her an instant drop someway down the scale but not necessarily to 0. Depending on the extent of the wound, it may take some time before she reaches 0. If pain stays the same, or increases, ask her to contact you again.
Finding a comfortable feeding position however, is usually less trouble than expressing milk, which puts suction on the wound. The table below reviews the different moist wound healing treatments available. Choosing a moisturiser is not easy. Vaseline is widely used in wound care, either directly, or as a base for other creams.
Lanolin is also used as a base but concerns over allergic responses and high levels of contaminants ref 2 and 7 limit its use. Purified lanolin is a purified anhydrous version. Unfortunately, these comments are not referenced and the standard reference book for drugs, Martindales Pharmacopoeia, makes no reference to this.
Softened paraffin is likely to stay on the surface of the skin longer than purified lanolin but this is what makes it so useful in preventing hard scab formation. It is worth noting that white soft paraffin, or its unbleached version yellow soft paraffin, has been widely used over many years for lip care in special care baby units — if it was unsafe for ingestion why is it used directly on babies lips?
Petrolatum remains on the surface of the skin. Further research is required to answer this question. Nipple soreness can sometimes be caused by factors other than breastfeeding, such as the following. If in doubt, contact a medical professional. Correcting positioning is paramount in allowing a damaged nipple to heal and enable pain free, effective breastfeeding.
Sore nipples alone are unlikely to need further treatment, no evidence exists to support the use of creams, sprays or ointments to prevent or treat nipple soreness Some women may not like a particular choice of treatment.
It may be useful to check whether they have any allergies to creams or cosmetics. Creams can be tested on their inner arm, but bear in mind that healthy skin is often less likely to react than damaged skin. This is certainly an area in urgent need of systematic review and further, independent, research.
We would like to hear from anyone with any experience of moist wound healing, with examples of what worked or not. We would like to collect this information.
Using expressed breastmilk encourages hand expressing — may have benefits not considered in studies of nipple healing. Is used in many cultures on skin irritations 2. USP-modified lanolin, warm compresses, and expressed breast milk with air drying were compared to a control group women with sore nipples 3.
Results No differences in pain or duration of breastfeeding. Exclusive breastfeeding rather than partial was a better predictor of breastfeeding beyond 6 weeks. Friction from the cloth of a loose shirt or a poorly fitting bra can rub against the sensitive nipple skin, causing chafing, cracks, and even bleeding.
Nipple fissures caused by friction may also occur in surfers and bodyboarders due to the board and seawater rubbing against the nipples while paddling. Certain fabrics may be more irritating than others, with synthetic fibers, such as nylon, often causing more damage.
Nipple fissures may also be due to an allergic reaction to something touching the skin. These allergens can be chemicals or fragrances in products such as:. Dermatologists may be able to recommend replacements to prevent the symptoms from coming back. Depending on the cause, nipple fissures can develop on one or both nipples. Symptoms can vary from person-to-person, but the trademark symptom is cracked, painful skin on the nipple or areola.
It may also be accompanied by:. Many people find that keeping the affected nipple and surrounding skin slightly moist with a natural oil or moisturizer is an essential first step to treatment. A study posted to the Journal of Caring Sciences found that lanolin, peppermint oil, and dexpanthenol creams all had a similar effect on nipple trauma in breast-feeding women.
Some people are concerned, however, that the use of any nipple cream may interfere with the natural environment where newborns establish breast-feeding. It is important to remember that too much moisture may make symptoms worse. Women who are breast-feeding should avoid non-breathable bra pads, as they can hold too much moisture against the nipple.
During pregnancy, the glands surrounding the nipples secrete a natural oil that lubricates and discourages bacteria. When washing this area, women should use only clean water that does not strip away this natural protection. Breast-feeding women may find relief from bathing their nipples in warm water and applying warm compresses to help soothe any irritation after the baby has fed.
Expressing some milk and rubbing it into the nipples before each feeding or pumping may also soothe irritation. Some people may find similar relief by applying diluted peppermint oil or peppermint water to the affected nipples between feeding. Breast-feeding women with nipple fissures may also be able to avoid further complications by encouraging the baby to latch onto the breast with a full mouth, alternating breasts at each feed, or using a nipple shell between feeds to allow air to circulate to the nipple.
Using a nipple shield during breast-feeding may keep the nipple too moist, which might make symptoms worse. Athletes can often help the fissures heal by avoiding loose, rough, or scratchy shirts and covering the nipples with soft gauze or waterproof bandages while active.
If symptoms are left untreated, nipple fissures can lead to more serious complications, such as inflammation or infections. Hopefully something works out for you and you can continue nursing : Best of luck to you! Popular questions in Breastfeeding How can I get my baby to take a bottle?
How can I handle my friends' disapproval that I'm still breastfeeding? How should I handle my relatives who disapprove of breastfeeding? Reason for reporting Offensive or inappropriate materials Spamming or advertising Vulgarity or profanity Personal attack Invasion of privacy Copyright infringement.
Cancel Submit. Ask a question. Featured video. New to BabyCenter? Join now. Password Forgot your password? They can also occur when a person accidentally snags or pulls out a nipple ring or during intense exercise. Smaller injuries can heal with proper care.
While rare, one or both nipples can be lost in an accident. They can also be lost due to illness; in breast cancer surgery, for example, it is sometimes necessary to remove one or both nipples. The nipples are located on the breasts in the center or darker areas of skin called areolas. In women, the areola contains tiny glands. These glands release oils during breastfeeding that help keep breasts clean and lubricated during breastfeeding. Milk is produced in breast tissue and is released during breastfeeding, through the nipple, to the baby.
Some people may feel self-conscious about losing one or both nipples. This surgery can make it possible for a person who has lost one or both nipples to regain confidence about their breasts. The surgeon cuts a star-shape into the area where the new nipple will be located. Then they take the skin from this incision and sew it together to form a new nipple. Lastly, the surgeon will tattoo a new areola around your reconstructed nipple.
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