Q: What should I do about dry and cracking nipples after I breast-feed?
A: As a certified breast-feeding counselor, I have a few suggestions for cracked and dry nipples.
First, never put lotion on them or use soap. Second, after nursing, squeeze out a bit of breast milk and massage it onto your nipples. Breast milk has incredible healing properties and is the best thing to put on them.
Also, keep your nipples dry. Allow air to circulate. You can do this by keeping a bra off them after you nurse for a while or by using perforated nipple shields in your bra. nipple is getting in the mouth, you will have pain and be uncomfortable.
Don't forget to use the lactation consultant at the hospital you delivered at or your pediatrician's office.
Kelley Mariano, Rochester, NY

A: I am both a La Leche League leader and an International Board Certified Lactation Consultant in private practice. The two most common reasons for dried and cracked nipples are that the baby is sucking incorrectly or that mother and baby have developed a fungal infection called thrush.
Thrush infections often, though not always, develop as a secondary infection after either mother or child has been treated with an antibiotic. If breast-feeding has been pain-free and then the cracks developed, thrush is a likely culprit. Although the baby may show white spots in his mouth, it is possible to have a thrush infection of the nipples with no visible symptoms in the baby's mouth.
Even though only one breast-feeding partner may show symptoms, both mother and baby need to be treated. You will need to call your physician to get medication for mother's nipples and for baby's mouth.
To find a La Leche League leader in your area to help determine if your baby is sucking correctly, call (800) LALECHE (525-3243). To find a certified lactation consultant who accepts referrals, call the International Lactation Consultant Association at (919) 787- 5181.
D.K., Collinsville, Ill.

A: There are many things available to help with sore, cracked nipples damaged by breast-feeding. They include items such as breast shells, purified lanolin ointment and hydrogen dressings. But it is important to have breast- feeding evaluated to make sure your baby is nursing correctly. Many hospitals have board certified lactation consultants on staff, or check with your obstetrician or baby's pediatrician.
Sue Muehling, RN,
lactation consultant, St. Charles, Mo.

FROM JODIE: If it is a problem of sore and cracking nipples, without other complications, air drying is the No. 1 solution to this painful and horrid challenge, doctors I interviewed said. Keep both breasts uncovered for an hour or more each day. Avoid tight- fitting clothing and nursing bras that may have metal or plastic closures on top of and covering the slits. Avoid soap on these areas while bathing.
Jodie Lynn is the author of "Mommy-CEO."

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