1. Saline rinses/soaks a. Saline is neutral ph and is just like tears. It is used to clean wounds and soothe soothe throats and well now . It will not burn or sting when applied. b. Mix 1 mug of water and ½ teaspoon salt. Keep near nursing area and covered. c. After each feeding, saturate clean cotton balls with the solution and sit on nipples for 1-2 minutes. You can also fill 2 shot glasses with solution and either compress the cups over the nipples/ for a soak or lean or the glass to soak the nipples. d. Throw out the use solution and wash out the glass after soaking. e. Make new saline solution every 24 hours or keep in fridge for 3 days. 2. Silverette cups. Silver is a natural anti-inflammatory and anti microbial. Do not use ointments while using theses. http://amzn.to/2ofG9Sw https://silveretteusa.com/ ​ ​ ​ 3. Medihoney gel: This honey is irradiated and contains no botulism spores. It is ​ anti-microbial and anti-inflammatory and safe to use with . As part of nipple wound care, wash this off with mild soap before breastfeeding. Apply after every feeding, if possible. http://amzn.to/2pQMwf6 ​ 4. Non-Stick gauze pads: Wear on top of scabbed nipples and under pads http://amzn.to/2oxhll6 5. Nipple ointment: Choose one, there is no evidence that shows one works better than another. a. MotherLove: http://amzn.to/2oU87Sp ​ b. EarthMammaAngelBaby: http://amzn.to/2oU87Sp ​ 6. Soft breast pads: http://amzn.to/2ofW8zY ​ 7. Disposable breast pads: http://amzn.to/2ox6ibA ​

*Note on gel pads. Please do not use them. If a cool compress feels good on the nipple, use a cold wet washcloth instead. Gel pads stick to the nipple requiring you to peel them off and increase time of healing.

Nipple Bleb treatment 8. Hydrocortisone ointment 1%- apply thin layer to affected nipple after breastfeeding twice a day. Wash off before feeding with soap and water. Use washcloth in shower to exfoliate. Try to unroof dry skin within 4-5 days of using hydrocortisone ointment.

www.storkandcradle.com Tamara Hawkins, NP-C, IBCLC 646-627-7334 ​