![]() ![]() By using a powder, the concentration of the other two ingredients is not as decreased as they would be if another ointment were used for the anti-fungal agent (for example, nystatin ointment). Where miconazole or any of the above mentioned drugs (fluconazole, clotrimazole) are not easily available as powders, it is better to use only the mupirocin and betamethasone ointments mixed together than to add a cream or gel or nystatin ointment for example. Miconazole cream or gel cannot be substituted for miconazole powder as the compound will usually separate. However, we believe that clotrimazole (Canesten) irritates more than the other drugs in the same family. Fluconazole powder added so that the final concentration is 2% may be substituted for miconazole and so can clotrimazole powder to 2%. We believe, based on experience, that 2% is the ideal concentration for most situations. Because it is added as a powder, the concentration of miconazole can be increased to 3% or even 4% or decreased to less than 2%. Miconazole is an antifungal agent, very effective against Candida albicans. Miconazole powder to a final concentration of 2%. Corticosteroids are not rarly prescribed for babies and children, often by inhalation or by mouth.ģ. Most of the betamethasone in the ointment is absorbed into the skin by the parent, so that the baby takes in very little. By decreasing the inflammation, the APNO also decreases the pain the breastfeeding parent feels. Betamethasone is a corticosteroid which decreases inflammation. Most of it gets stuck to the skin so that very little is taken in by the baby.Ģ. ![]() Although some mupirocin is absorbed from the gut when taken by mouth, it is so quickly metabolized in the body that it is destroyed before blood levels can be measured. Treatment of sore nipples with an antibiotic alone sometimes seems to work, but we feel that the antibiotic works best in combination with the other ingredients discussed below. Mupirocin apparently has some effect against Candida albicans (commonly called “thrush” or “yeast”). Staphylococcus aureus is commonly found growing in abrasions or cracks in the nipples. Mupirocin (Bactroban is the trade name) is an antibiotic that is effective against many bacteria, including Staphylococcus aureus including MRSA (methicillin resistant Staphylococcus aureus). The following blogs on our website contain photos and a video which can be helpful: ġ. Please note that the “all-purpose nipple ointment” is a stop gap measure only and that the definitive treatment of sore nipples is to help the baby latch on as well as possible. Of course, preventing sore nipples in the first place is the best treatment and adjusting how the baby takes the breast can do more than anything to decrease and eliminate the breastfeeding parent’s nipple soreness. Breastfeeding parents with sore nipples do not have time to try out different treatments that may or may not work, so we have combined various treatments in one ointment. We call our nipple ointment “all purpose” since it contains ingredients that help deal with multiple causes or aggravating factors of sore nipples. THE “ALL-PURPOSE NIPPLE OINTMENT” OR APNO ![]()
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