The first thing to do for sore nipples is to correct your baby’s latch with hands-on  help from a lactation consultant or La Leche League leader.  Even after you do this, you may have periodic sore nipple episodes.  Extra saliva and increased nursing frequency from teething or growth spurts can irritate nipples.  New teeth  coming in can to cause abrasions, too.  My personal experience does not, thankfully, include Candida or thrush, so you’ll have to consult Kellymom for that.  Here’s my list of TLC for nipples:

• Saline soak.  This is an excellent first-line treatment for sore and abraded nipples, but it is a bit time-intensive.   Use saline nasal spray (new bottle) or 1/2 teaspoon salt in 1 cup of water.  Fill shot glasses half full.  Microwave for 5 seconds.  Test water to prevent scalding.  Heat more if necessary.  Cup shot glasses over nipples and hold for five minutes.  Air dry.
  
  
• Soothies.  These gel-lined pads can be refrigerated and applied to sore and abraded nipples.  I love them, and really feel that they contribute to healing as well as soothing.  You can buy them at most drugstores.
  
  
• Ozonated olive oil.  This paste made from bubbling ozone gas through organic olive oil is what I currently use to heal nipple abrasions.  I dab a little bit on to each abrasion after showering and before bed.  You will want to do your own research on this product before using it yourself; I learned about it from a listserv that I belong to for alternative tooth care for babies, and from my personal perspective it comes with a lot less “baggage” than antibiotics.   In my experience it is effective; I first used it on a cold sore and the pain went away overnight.
  
  
• Creative nursing positions.  Giving abraded skin a rest from being poked by teeth is crucial for healing.  To give the skin a rest while continuing to nurse, I use creative nursing positions.  We call it  “upside-down na-na,” and my daughter thinks it’s funny.  Basically, I turn her body or my body 180 degrees so that instead of her top teeth pressing on the top of the nipple, it’s her bottom teeth (covered by her tongue). This is easiest to do lying down on a bed, but can be done on a couch, as well.  Since my daughter nurses to sleep and throughout the night, I nurse with a creative position on the injured side when she goes to sleep, and then use the uninjured side throughout the night.  (This works well until you have abrasions on both nipples, as I’ve had recently.)
  
  
• Expressed hind milk.  A drop of hind milk (thicker milk that comes at the end of a nursing session) is often the best treatment for sore nipples.   Give your nipple a gentle squeeze and rub it in.  Easy and free!
  
  
• Going topless.  Give your nipples a chance to breathe.  Do this after the saline soak, after applying expressed milk, and any other time you feel like it.
   
• Mupirocin. I used mupirocin (Bactroban), a prescription antibiotic ointment that I received from a physician specializing in breastfeeding medicine, to treat my nipple abrasions.  It is considered safe for babies to ingest.  Despite this, I wonder about a connection between its use and my baby’s problems with tooth decay.  It did accelerate the healing of the abrasions, though, in my opinion, ozonated olive oil is at least as effective.  On the advice of my daughter’s pediatrician, I also tried Bacitracin, an over-the-counter antibiotic, but it didn’t seem to do much to heal the abrasions.
  
  
• Lansinoh.  All lactation experts are comfortable with the use of ultra-pure lanolin ointment, such as Lansinoh, to soothe sore nipples.  I don’t care for lanolin, because the consistency annoys me and it stains clothes, but this is entirely a personal preference. 
  
  
•  Motherlove Nipple Cream is made of marshmallow root and calendula in olive oil, shea butter and beeswax.  I prefer this to Lansinoh because I find it easier to apply and it’s less staining.  It is harder to find in stores (but easy enough to find online at The Pump Station and elsewhere).
  
  
• Kellymom’s page on Healing Nipple Cracks and Abrasions

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