CRACKED AND RETRACTED NIPPLE
CRACKED NIPPLE: THE NIPPLE MAY BECOME PAINFUL DUE TO
1) Loss of surface epithelium with the formation of a raw area on the nipple.
2) Due to a fissure situated either at the tip or the base of the nipple. These two conditions frequently coexist and are referred to as cracked nipple. It is caused by—
(a) Unclean hygiene resulting in formation of a crust over the nipple, (b) retracted nipple, and (c) trauma from baby’s mouth due to incorrect attachment to the breast,
(d) Infection with Candida albicans and S. aureus is often present. The condition may remain asymptomatic but becomes painful when the infant sucks. When infected, the infection may spread to the deeper tissue producing mastitis.
PROPHYLAXIS: - includes local cleanliness during pregnancy and in the puerperium before and after each breastfeeding to prevent crust formation over the nipple.
MANAGEMENT: - Correct attachment (latch on) will provide immediate relief from pain and rapid healing. Fresh human milk and saliva have got healing properties. Purified lanolin with the mother’s milk is applied three or four times a day to hasten healing. When it is severe, mother should use a breast pump and the infant is fed with the expressed milk. Inflamed nipple and areola may be due to thrush also. Nipple shields (thin latex) can be used. The persistence of a nipple ulcer, in spite of therapy mentioned, needs biopsy to exclude malignancy.
RETRACTED AND FLAT NIPPLE: It is commonly met in prim gravidae. It is usually acquired. Babies are able to attach to the breast correctly and are able to suck adequately. In difficult cases, manual expression of milk can initiate lactation. Gradually breast tissue becomes soft and more protractile, so that feeding is possible.
HOMOEOPATHIC MEDICINES FOR MANAGING CRACKED AND RETRACTED NIPPLES: -
- Graphites :- administered when Nipples are Cracked and painful. The nipples also become sore. In some cases, small blisters may be present on the nipples. There may be ulcers on the nipples sometimes. It is well indicated for sore, cracked Nipples that may ooze fluid in a nursing woman.
- Phytolacca:- this medicine benefits mothers with sore, sensitive, cracked Nipples. Sometimes small ulcers around the nipples may show up. It is very useful for nursing mothers, whose nipples are intensely sensitive and there can be pain while breastfeeding.
- Silicea:- works well in cases of cracked and ulcerated nipples. The Nipples can be inflamed too in some cases. Soreness and tenderness is marked in the nipples.
- Castor Equip: - it is very useful medicine for managing Cracked nipples during breastfeeding. The nipples are sore and very tender also. The tenderness is so intense that even touch of the clothes is not bearable to the sufferer.
- Sulphur: - it is very beneficial medicine for women with sore, cracked Nipples. They also present itching and burning pain. Cracks may be deep at the base of nipples. Burning sensation is intense. Sometimes there may be smarting and stinging sensation that gets worse after breastfeeding session.