Air-drying nipple damage

Does nipple damage need to air-dry?

Air-drying is an old way to treat nipple damage. Keeping the damage moist has been shown to be more effective. Instead of air-drying, nipple damage should be treated with an appropriate wound care product and then covered. Air should not contact the damage until it is completely healed. Nipples that are allowed to air-dry form scabs and heal more slowly. Breastfeeding on scabbed, dry nipples can cause more nipple damage and pain by deforming the nipple, ripping off the scab, or stretching the damaged area.

A) Why air-drying should not be used

Air-drying is an old way of treating skin damage. In the 1960s, moist-wound healing was shown to be more effective. Nipples that are allowed to air-dry form hard, inflexible scabs. The scabs shrink and pull on the surrounding skin, creating tension in both and slowing healing. Scabs may also prevent normal skin cells from migrating into the area of damage, and further slow healing.

Breastfeeding on scabbed, dry nipples can cause pain or more nipple damage by:

  • Ripping off the scab.
  • Stretching the damaged area.
  • Affecting the baby’s latch.

Not surprisingly, damaged nipples heal more quickly and with less pain when kept moist with purified lanolin than when exposed to air (Abou-Dakn 2011; Neto 2018).

As much as possible, mother should not allow air to contact the damage until it is totally healed, as this delays healing and increases pain. Rather, immediately after breastfeeding, mothers should apply an appropriate wound care product and a cover.

B) Examples of air-drying

In the past, mothers were told to air-dry their damaged nipples by:

  • Leaving their bra flaps open.
  • Drying their nipples by exposing them to:
    • Heat lamps.
    • Sun lamps.
    • A hair dryer.
  • Exposing nipples to sunshine.
  • Using breast shells (without an appropriate wound care product) to allow air to circulate.

Currently, some mothers are told to apply breast milk to nipple damage. However breast milk does not keep the nipple moist because it is quickly absorbed into the bra or breast pad. If left exposed to air, it will dry quickly. This is different from using breast milk to wash off a medicated ointment, which is appropriate.

References

Abou-Dakn M, Fluhr JW, Gensch M, et al. Positive effect of HPA lanolin versus expressed breastmilk on painful and damaged nipples during lactation. Skin Pharmacol Physiol. 2011;24(1):27-35
 
Neto CM, de Albuquerque RS, de Souza SC, et al. Comparative Study of the Use of HPA Lanolin and Breast Milk for Treating Pain Associated with Nipple Trauma. Rev Bras Ginecol Obstet. 2018 Oct 29