Dr. Jack Newman's All-Purpose Nipple Ointment (APNO)

One of the most popular nipple-healing and infection-preventing recipes around, Dr. Jack Newman's "All Purpose Nipple Ointment" consists of three properties -- an antibiotic, an anti-inflammatory, and an anti-fungal. Here is what Newman had said about his ointment:

"It seems to help for many causes of sore nipples, including poor latch, Candida (yeast), dermatologic conditions, infections of the nipple with bacteria and possibly other causes as well. It is always good, however, to try to assure the best latch possible, because improving the latch helps with any cause of pain."

The Recipe

• The antibiotic: Bactroban (mupirocin) 2% ointment (not cream): 15 grams. You'll need to get a prescription from your doctor for this ingredient.
• The anti-inflammatory: Betamethasone 0.1% ointment (not cream): 15 grams. You can get this over-the-counter.
• The anti-fungal: Miconazole powder, so that the final concentration is 2% miconazole. You can get this over-the-counter.

Sometimes it is helpful to add ibuprofen powder as well, so that the final concentration of ibuprofen is 2%. This combination gives a total volume of approximately 30 grams. Clotrimazole powder to a final concentration of 2% may be substituted if miconazole powder is unavailable, but both exist (the pharmacist may have to order it in). Using powder gives a better concentration of antifungal agent (miconazole or clotrimazole) and the concentrations of the mupirocin and betamethasone remain higher.

Some pharmacies will make up the ointment for you. If not, it is easy for you to combine the ingredients together in equal parts.

The combination is applied sparingly after each feeding (except for feedings when you use gentian violet -- .5 to 1 percent solution used once daily for 3 days -- which can be purchased in any natural foods store). Do not wash or wipe it off, even if the pharmacist asks you to.

_Source:

Handout #3b. Treatments for sore nipples and sore breasts. January 2005. Written by Jack Newman, MD, FRCPC.