The Compounder has been making a nipple ointment for nursing mothers for over a decade, and while it isn’t preferable to expose newborns to drugs, it’s important to consider the alternatives when picking an issue to be outraged over.
The compounded Newman’s All Purpose Nipple Ointment contains minute amounts of Mupirocin (antibiotic), Betamethasone (an anti-inflammatory steroid), and Miconazole (antifungal).
This combination of ingredients helps nursing mothers deal with multiple causes of sore nipples. Of course, preventing sore nipples in the first place would be the best treatment and often adjusting how the baby takes to the breast can do more than anything to decrease and eliminate the mother’s nipple soreness. When that hasn’t happened, soreness develops and it must be addressed in the safest manner possible.
Talk to any new mother who is living with nipple soreness and you will soon discover it isn’t anything trivial.
Contents of Dr. Jack Newman’s All Purpose Nipple Ointment:
- Mupirocin is an antibiotic that is effective against many bacteria, particularly Staphylococcus aureus including MRSA (Methicillin-resistant Staphylococcus aureus). Staph is commonly found growing in abrasions or cracks in the nipples and probably makes nipple soreness worse. Mupirocin apparently has some effect against Candida albicans (commonly, but inaccurately called “thrush” or “yeast”). Although mupirocin is absorbed when taken by mouth, it is so quickly metabolized in the body that it is destroyed before blood levels can be measured. Moreover, most of it gets stuck to the skin so that very little is taken in by the baby. Thus it is safe to swallow if indeed the baby gets any.
- Betamethasone is a corticosteroid, which decreases inflammation. A large part of the pain mothers experience when they have sore nipples is due to inflammation. The redness of the nipples and areolas is another sign of inflammation. By decreasing the inflammation, the ointment also decreases the pain the mother feels. Most of the betamethasone is absorbed into the skin by the mother so that the baby takes in very little.
- Miconazole is an antifungal agent. It is very effective against Candida albicans.
Last week, a question came up about our compounded All Purpose Nipple Ointment that feigned outrage over using medicines that would be ingested by the newborn baby – and possibly do some harm. While we have long felt that too many people take too many drugs, there will always be legitimate drug uses that relieve symptoms and help bring on a cure. That’s what the All Purpose Nipple Ointment does for thousands of new mothers.
I’ve listened to women tell me the pain can be intense and that it penetrates deep inside and over the whole body. It would not be unexpected for someone in that kind of pain to have animosity toward the person causing the pain – her new child. And I’ve heard fathers say that their wife had been crying from the pain.
The combination of these three drugs is effective at giving the mother relief and no one has ever offered evidence that any harm has been done to the child or the mother. The doses are exceptionally small and the length of therapy rarely exceeds a couple of weeks. We have seldom had a woman request a refill. And when we’ve talked to them later they all say they don’t know how they would have made it through that time without the relief they obtained from the nipple ointment.
Insensitivity to a mother’s pain
It’s the height of insensitivity to even suggest a new mother’s nipple pain is unworthy of the best treatment because there is no so-called scientific proof she has “nothing beyond ‘soreness’” (a comment made by someone who opposes the use of this healing ointment). It would be irresponsible for any doctor and compounding pharmacist to refuse to prepare and dispense the Newman ointment. It works exceptionally well and has a solid record of safety.
Medicine is far more than lab tests and prescriptions. It means finding ways to help relieve suffering. Yes, extremely sore nipples can cause suffering even though it may seem inconsequential to someone who hasn’t had the experience.
For those concerned about the actual doses, consider that the final preparation contains one-third betamethasone 0.1%, meaning the final preparation is 0.0333% betamethasone, which delivers 0.333 mg of the drug in each gram. The applied dose is somewhere in the neighborhood of 0.05 gram, which works out to 0.0166 mg of betamethasone – only a part of which actually comes in contact with the baby. Five feedings per day will total of 0.08 mg. A pittance.
The All Purpose Nipple Ointment requires a doctor’s prescription.
Update November 28, 2018 LJJF