SORE NIPPLES
The nipple must be kept dry between nursings, which should be limited to twenty minutes. Regularity should be maintained. The nipples should never be touched or handled by hands that have not been scrubbed with soap and a nail brush. During the early nursing days they are wet much of the time and are subject to much stress and strain in the "pulling effort" of the baby, as a result of which they become very tender, chapped, cracked, and often bleed. Allowing the baby to go to sleep with the nipple in his mouth also exposes the nipple to unnecessary moisture which increases the possibility of painful cracking. The pain occasioned by nursing at this time is truly indescribable, and is most often the cause of absolute refusal on the part of the mother to nurse her babe—with the result that it is put on the bottle. Again, the fear and dread of being hurt so often tends to diminish the flow of milk. It is entirely possible so to prepare the nipple for this exposure, during the last months of pregnancy, that all this discomfort and pain may be entirely avoided (See chapter, "[The Hygiene of Pregnancy]").
Before the mother is put to rest after the birth of the baby the breasts are prepared as follows: A thorough cleansing with soap and water is followed by a careful disinfection with alcohol which leaves the nipple perfectly dry. A soft sterile pad is then applied and held in place by a breast binder. Before and after each nursing the nipple and surrounding area is swabbed with boracic acid (saturated solution) and carefully dried by applying a clean, dry, sterile pad.
Painful cracks and fissures are nearly always due to lack of the care described above, and are almost wholly preventable. When the first crack appears and nursing becomes painful, the baby's mouth should not touch the nipple again until healing has taken place. A thorough cleansing with boiled water should be made and then the sterile nipple shield should be applied through which baby will get abundant satisfaction, while the mother is spared the pain, and the nipple has an opportunity to get well.
In the case of sore and cracked nipples, thorough cleansing with boiled water and boracic acid solution follows each nursing seance; and, after careful drying, balsam peru—equal parts with glycerine—may be applied with a tiny piece of sterile gauze or cotton; a sterile cotton pad is then applied to each breast which is held in place by a breast binder.
The nipple shield, when employed, is boiled after each nursing and washed in boracic acid solution just before each nursing. The strictest cleanliness must be observed, and then we hope to bring relief and comfort to the mother, and effect the saving of nature's best food for the baby.