Cracked nipples during breastfeeding *New*
ICD-10 code: O92.1 Description General measures Medicine treatment Referral DESCRIPTION The areola and nipple are protected by the secretion of a lubricant from Montgomery's glands. Cracked nipples may lead to infection and mastitis. Causes of cracked nipples include: poor positioning of the baby and incorrect attachment to the breast. removing the baby from the breast before suction is broken. t
ICD-10 code: O92.1
Description
General measures
Medicine treatment
Referral
DESCRIPTION
The areola and nipple are protected by the secretion of a lubricant from Montgomery's glands. Cracked nipples may lead to infection and mastitis.
Causes of cracked nipples include:
- poor positioning of the baby and incorrect attachment to the breast.
- removing the baby from the breast before suction is broken.
- the four signs of good attachment are:
- chin touching breast (or very close).
- mouth wide open.
- lower lip turned outward.
- more areola visible above than below the mouth.
GENERAL MEASURES
- Apply expressed breast milk to the nipples between feeds and air dry.
- If too painful, express the milk and nurse the baby on the other breast until improvement.
- Keep areola and nipple clean and dry.
- Avoid use of soap, creams and lotions on the nipples.
MEDICINE TREATMENT
- Zinc and castor oil ointment.
- Apply between feeds.
If oral thrush is present, treat neonate with:
- Nystatin solution, oral. See Candidiasis, oral (thrush).
REFERRAL
No improvement after 2 days.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare Level, Updated for the 2023 Edition