Women suffering from excoriated nipples are apt to keep the infant chiefly to the healthy breast, and only to apply it to the tender side for the purpose of obtaining present ease from the pain of over distension. In this way the ducts remain always full and are apt to get inflamed. Sore nipples, therefore, are to be attended to as much on account of the evils to which they lead, as of the suffering they directly occasion. The excoriation of the nipples begins as a chap. This shows no tendency to heal; and the child's mouth being often applied, rubs off the skin around the crack, and this naked surface soon becomes an ulcer. These ulcers are sometimes only on the surface; at other times they are profound, going deep into the substance of the nipple.
Treatment. These excoriations and ulcers might be easily healed, were it not that the newly formed skin is apt to be continually rubbed off by the child's mouth in the act of nursing. Two things are therefore to be done, to favor the healing, and to protect the tender part from renewed injury.
For the first object, a strong infusion of green tea or port wine may answer very well in ordinary cases. A little alum or borax, dissolved in rosewater, or water (201), (202), is often used. A weak solution of sulphate of zinc, or sulphate of copper, or nitrate of silver (209), (211). But one of the very best articles is composed of glycerin and tannin (306). To
protect the nipple from injury in the act of sucking, use a shield made of India rubber. When the infant is not at the breast the nipple should be covered by a shield.
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