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15. Problems of sore nipples and some usual comfort measures to ease the pain

a. Nipples may be red or cracked and may even bleed.

1) This may be normal as the nipples become accustomed to infant's sucking.

2) Other causes may be poor positioning, pull on nipples, taking baby off breast incorrectly, incomplete air drying of nipples after feeding, and irritating chemicals or objects, such as soap, shampoo, strong laundry detergent, rough clothing, or plastic liners against nipples.

b. Comfort measures to manage the discomfort. 1) Rotate positions in which the baby feeds so that the infant does not constantly clamp down on same sore area.   2) Start feeding on the less sore nipple; the infant sucks the hardest in the first 10 minutes.   3) The large portion of the nipple should be in the baby's mouth, not just the tip.   4) Suction should always be broken before removing the infant from the breast.   5) Eucerin cream may be recommended, because it is a mineral oil-based cream and has no preservatives or alcohol. The mother may have other instructions from her physician/practitioner and should consult with that person before changing.

6) Warm salt water soaks may be ordered by the physician/practitioner.
 

(a) Boil 1 quart of water with 1/2 teaspoon of salt for 10 minutes. (Tap water contains germs that may contribute to breast infection.)

(b) Allow to cool for 1/2 hour.

(c) Wash your hands well.

(d) Test the water with your finger; it should not be hot. Do not use until the water is lukewarm.

  (e) Wash your hands at all times before testing the water.

(f) Locate household items that may be used as a compress; peripads are excellent, and washcloths, etc. may be used.

(g) Locate a plastic covering: plastic wrap, plastic bags, etc.

(h) Wash your hands well.

(i) Apply the salt water compresses. Dip the compresses in water, gently apply to nipples, and cover with the plastic to prevent heat loss. Take care that the compresses are not too warm.

(j) The skin should be checked in 5 minutes to make sure the compresses are not too warm.
 

7) Apply ice to the nipple before feeding.   8) Use a nipple shield.   9) Some physicians/practitioners will recommend the use of tea bags on the nipples; tea bags may be saved from a cup of tea, but be certain to wash hands well before handling anything that will have contact with nipples.
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