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Patient instructions

All Purpose Nipple Cream Patient Instructions

These instructions are for compounded all purpose nipple cream or ointment — a combination of an antibiotic, an antifungal, and an anti-inflammatory — prescribed for sore or cracked nipples during breastfeeding. Sore nipples are not a normal part of breastfeeding; causes include latch problems, bacterial infection, yeast, skin conditions, and vasospasm. Available by prescription only.

Shiny, not visible

Apply sparingly after each feeding. The nipple should look shiny, but there should be no visible layer of ointment left on the skin.

No need to wipe off

The ointment generally does not have to be wiped off before the next feeding. Ask the pharmacy if your prescription says otherwise.

Wash your hands

Wash your hands before and after every application, and keep the ointment away from your eyes.

How to Use

  1. 1Wash your hands before each application.
  2. 2After a feeding, apply a thin layer to the nipple and areola. Use it sparingly — the nipple should look shiny, with no visible amount of ointment sitting on the skin.
  3. 3You generally do not need to wipe the ointment off before the next feeding.
  4. 4Keep using it after each feeding until your nipples are pain free, then gradually reduce applications over about a week.
  5. 5Wash your hands again when you are done. This ointment is for external use only — keep it away from your eyes.

If You Miss a Dose

  • Apply the missed dose as soon as you remember.
  • If it is nearly time for your next application, skip the missed one and continue your regular pattern. Do not apply extra to catch up.
  • If you are unsure what to do, call the pharmacy.

Side Effects

Side effects are very uncommon with this ointment. When they do occur, it is usually early in treatment, while the skin is still damaged and more of the medication can be absorbed. You may notice:

  • Itching or soreness where the ointment is applied.
  • Dry skin, irritation, or burning.
  • Redness.
  • Headache or dizziness — more likely early in treatment, when damaged skin lets more of the medication be absorbed.

Serious Allergic Reaction

A very serious allergic reaction to this medication is rare. Seek immediate medical attention if you notice any of the following:

  • Rash
  • Itching or swelling, especially of the face, tongue, or throat
  • Severe dizziness
  • Trouble breathing

Storage

Store at room temperature, away from extremes of heat or moisture, and out of reach of children. Check the beyond-use date on the pharmacy label — compounded ointments have shorter dating than commercial products.

When to Call the Pharmacy

  • Your nipples are still painful after several days of use — sore nipples are not a normal part of breastfeeding, and a latch check with a lactation consultant or breastfeeding clinic is often the next step.
  • You have been using the ointment for more than a few weeks — it is not meant for long-term use.
  • Side effects are bothering you or are not settling.
  • You are running low — compounded ointments are prepared to order, so plan refills a few days ahead.