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Journal of Human Lactation
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*Antibiotics
*Breast Diseases
*Pain
*Skin Infections
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The Treatment of Staphyloccocus Aureus Infected Sore Nipples: A Randomized Comparative Study

Verity Livingstone, MBBS, FCFP, IBCLC

Vancouver (Canada) Breastfeeding Centre; Department of Family Practice, University of British Columbia. 690 West 11th Ave., Vancouver, BC V5Z 1M1 Canada.

L. Judy Stringer, MBBS, MRCGP, IBCLC

Vancouver Breastfeeding Centre; Department of Family Practice. University of British Columbia.

Sore, cracked nipples are commonly experienced by breastfeeding mothers. We have previously reported a strong correlation between sore, cracked nipples and S. aureus colonization. A prospective, randomized clinical trial was performed to compare four treatmnent regimes for S. aureus infected sore nipples. Eighty-four breastfeeding mothers were enrolled in the study. After 5 days to 7 days of treatment, only 8% of mothers showed improvement in the "optimal breastfeeding technique alone" group, 16% improved with topical mupiricin, 29% improved with topical fusidic acid, yet 79% improved with oral antibiotics (p<.0001). Optimal breastfeeding techniques and topical antibiotics ointment failed to heal most infected, sore, cracked nipples. Mastitis developed in 12% to 35% of mothers not treated with systemic antibiotics compared to 5% of mothers treated with systemic antibiotics (p<.005). In conclusion, S. aureus infected sore, cracked nipples should be diagnosed as a potentially widespread impetigo vulgaris and treated aggressively with systemic antibiotics in order to improve healing and decrease the risk of developing mastitis due to an ascending lactiferous duct bacterial infection.

Key Words: breastfeeding • treatment of sore nipples • Staphyloccocus aureus nipple

Journal of Human Lactation, Vol. 15, No. 3, 241-246 (1999)
DOI: 10.1177/089033449901500315
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Home page
 J Hum LactHome page
B. Wilson-Clay
Case Report of Methicillin-Resistant Staphylococcus aureus (MRSA) Mastitis With Abscess Formation in a Breastfeeding Woman
J Hum Lact, August 1, 2008; 24(3): 326 - 329.
[Abstract] [PDF]