Breastfeeding and skin

Breastfeeding for mothers with skin problems.

There are multiple proven benefits for breastfeeding babies and mothers. Breastfeeding should be encouraged and supported whenever possible. Women with long-standing or severe skin conditions should be counseled during pregnancy on managing their skin condition after delivery and specifically while breastfeeding. Seeking the advice of a lactation consultant is recommended.

Medications during breastfeeding

Some medications used to treat skin conditions are not suitable during breastfeeding. Alternatives should be considered if first-line dermatological medications are contraindicated. However, there may be circumstances where this is not possible due to the severity of the maternal skin disease and decisions regarding breastfeeding must be made on a case-by-case basis.

Commonly Prescribed Dermatologic Medications

Antibiotics

• Penicillins, cephalosporins, current clindamycin, metronidazole: compatible with breastfeeding. It can be associated with gastrointestinal symptoms, candidiasis, and drugs. allergy in the infant

• Tetracyclines, fluoroquinolones: contraindicated in breastfeeding due to risk of interference with bone growth and dental development in the infant.

• Erythromycin: compatible with breastfeeding. Caution in prescribing in lactating women less than 2 weeks of age, as associated with pyloric stenosis.

• Rifampicin: compatible with breastfeeding.

Antivirals

• Acyclovir, valacyclovir, famciclovir: cCompatible with breastfeeding.

Antifungals

• Clotrimazole (topical): compatible with breastfeeding.
• Nystatin (topical): compatible with breastfeeding.

• Fluconazole (oral): compatible with breastfeeding.

• Ketoconazole (oral and topical): compatible with breastfeeding.

• Griseofulvin (oral): no data available. Considered compatible with breastfeeding

• Gentian Violet 0.5–1%: Commonly used in the US, UK, and Canada for candidiasis of the nipple. It is no longer available in New Zealand.

• Miconazole (topical): preferred topical azole. Compatible with breastfeeding.

• Terbinafine (oral and topical): limited data. Caution in prescribing during lactation.

Antihistamines

• Promethazine: present in breast milk. It can cause drowsiness in a breastfed baby. Not recommended.

• Cetirizine / loratadine: compatible with breastfeeding.

Immunomodulators

• Hydroxychloroquine, cyclosporine: compatible with lactation <

• Azathioprine: Excretion in human milk has been shown to be very low in a small sample of lactating women [1].

• Methotrexate, mycophenolate, cyclophosphamide: contraindicated in breastfeeding

Biological products

• Adalimumab, Etanercept infliximab: considered safe during lactation

• Anakinra, rituximab ustekinumab: there are insufficient data to address the question of the safety of breastfed infants.

Antipsoretics

• Calcipotriol: cCompatible with breastfeeding. No reports of adverse effects on breast-feeding.

• Tar Topical Preparation - Likely Safe in Lactation. Do not apply on the nipple or areolae.

• Acitretin: contraindicated in breast-feeding. Potential for toxicity in the infant.

• Topical preparations containing salicylic acid: no data. Caution in breastfeeding. Potentially dangerous in systemic dose Do not apply on the nipple or areolae.>

Corticosteroids

• Prednisone: oral prednisone in short courses compatible with breastfeeding. Prolonged or high-dose therapy is not contraindicated in breastfeeding; however, the infant requires close monitoring for growth and development.

• Topical corticosteroids: Apply topical corticosteroids to the breasts and nipples after breastfeeding. Ointments are preferred over creams. The amount used and the duration of therapy should be minimized.

Current calcineurin inhibitors

• Pimecrolimus, tacrolimus: compatible with breastfeeding.

Oral contraception

• Estrogen, combined oral contraceptives: not recommended in nursing mothers; the suppression of lactation is a major concern.
• Progesterone-only pill: oral contraceptive of choice in lactating women.

Insecticides

• Permethrin: recommended as a first-line agent. Compatible with breastfeeding.

• Malathion: compatible with breastfeeding.

• Lindane: compatible with breastfeeding.

• Ivermectin: use with caution. Low milk levels. Transfer limited to infant.

Analgesics

• Ibuprofen, acetaminophen / paracetamol: compatible with breastfeeding.
• Opioid pain relievers, codeine - Commonly used pain reliever in the postpartum period. Rare case reports of neonatal Deaths due to transfer of opiates through breast milk in women using codeine: Caution advised.
• Aspirin: compatible with breastfeeding when administered in small doses (80 mg / day). Potentially dangerous in higher doses.>

Acne Therapies

• Topical therapies: topical benzoyl peroxide retinoids (tretinoin, isotretinoin, adapalene): compatible with breastfeeding.

• Oral isotretinoin: contraindicated in breastfeeding.

Skin problems during breastfeeding.

Some common skin problems, particularly of the nipple, areola and breasts may appear during lactation / lactation. There may be an underlying skin condition, such as atopic eczema or psoriasis that contribute to this. It may be that there is poor management of breastfeeding that also contributes. Along with treating the skin disorder, women will likely need support and advice regarding breastfeeding.

Common presentation problems are described below.

Vaginal dryness

Breastfeeding can cause vaginal dryness and subsequent discomfort. This is a common problem in the postpartum period and is believed to be due to decreased levels of estrogen during breastfeeding (atrophic vulvovaginitis). Sensitivity of the vagina and genital area can also be accompanied by itching. Sex can be painful (dyspareunia) There may be division or fissure of the later fourchette (the entrance to the vagina). Using water-based vaginal lubricants can reduce discomfort during intercourse, but these are sometimes itchy or irritating. Petroleum-based products may be better tolerated or may also cause irritation; They can cause condom breakage, so they should be avoided if you rely on barrier contraception. Vaginal moisturizers can also relieve vaginal dryness and pain.

Pain in the nipple

Nipple hypersensitivity It is common during the first week postpartum. This usually peaks on day 3–6 and then decreases. Unlike nipple tenderness, pain in the first two weeks postpartum is most commonly due to trauma to the nipple secondary to poor breastfeeding technique. This is associated with redness, swelling, and cracking of the nipples. The injury can range from superficial abrasions to tissue breakdown, a "compression band" and shallow depth. fissures, To the deep erosions through dermis complicated by infection. A lactation evaluation by a midwife or lactation consultant is recommended.

Bacterial nipple infections

A sucking injury to the nipple that does not heal with a change in breastfeeding technique can be a sign Staphylococcus aureus infection is the most common infectious organism and can enter the milk ducts through an injury to the nipple, which can lead to infectious mastitis or breast abscess.

Fungal nipple infections

Nipple yeast infection is overdiagnosed. Pain due to Candida albicans The infection is often mistaken for pain due to poor latch on or vasospasm of the nipple (see below). Early breakdown of nipple skin in the first few weeks of breastfeeding is usually due to suction trauma or a bacterial infection. Breastfeeding technique should be reviewed by an experienced midwife or lactation consultant. Nipple candidiasis usually presents with the subsequent appearance of new nipple pain and usually coincides with oral candidiasis in the infant. The mother or baby can be asymptomatic. Regardless, both the baby and the mother require treatment.

Nipple dermatitis and eczema

Dry, irritated and itchy nipples are a common problem during breastfeeding. Postpartum women may have an increased sensitivity of the skin to the environment. irritants, and those with an atopic history may develop an outbreak of eczema on the nipples. Topical corticosteroids are the main treatment. They should be applied sparingly after breastfeeding. Ointments are preferred over creams.

Vasospasm of the nipple

This is a common occurrence in women who are experiencing difficulties with breastfeeding. Vasospasm in the nipple vessels causes a discoloration of the nipple and a stabbing stabbing pain. Vasospasm can occur in women who experience difficulties with breastfeeding. This is often triggered by an initial injury to the nipple, but can also be a response to cold or a manifestation of Raynaud's phenomenon. This can be managed by using warm, dry compresses and avoiding the cold. Some women have found that squeezing the base of the nipple and massaging it forward can restore blood flow and prevent a painful episode. The input of an experienced lactation consultant or midwife is recommended.

Montgomery gland infected

The Montgomery glands are a normal part of the breast anatomy. These glands are enlarged during pregnancy and have ducts that secrete sebaceous material that lubricates and protects the nipples and areolas in pregnancy and lactation. Mothers should be advised not to squeeze themselves. A small amount of breast milk is also secreted through these tubers. They can become clogged, inflamed, or infected during breastfeeding. Warm compresses and massages are commonly all that is required.

Blisters or white spots on the nipple

The blisters or white spots on the nipple are milk blisters; These generally appear as pale white or yellow sore spots on the nipple. The pain is often focused on the spot or directly behind it. This occurs because sticky breast milk forms a plug inside the milk duct. The obstruction can progress to mastitis. Warm compresses may be enough to dislodge the plug. Occasionally, a blocked milk duct may require impaction with a sterile needle. Consultation with a lactation consultant or midwife is recommended, as this may be due to an underlying problem, such as an excess supply of breast milk and an ill-fitting bra.

Mastitis

Mastitis is inflammation of the breast caused by obstruction of milk flow and if mishandled, it can progress to infection and eventually abscess formation. Staphylococcus aureus is the most common cause of infectious mastitis. In early mastitis, there is pain and swelling in the breasts. There may be red streaks visible on the breast skin overlying the mastitis. Systemic symptoms suggestive of infection include discomfort, fever and chills. Breast milk may appear grainy or stringy. Occasionally there are bugger, pus, or visible blood in breast milk.

The risk factors most commonly associated with mastitis are:

• Infant feeding difficulties causing engorgement and milk stasis.
• Blocked / blocked nipple ducts
• Cracked or bleeding nipples where the normal skin barrier is eroded
• Pain in the nipples and breasts during feeding.
• History of any previous mastitis.
• Recent changes in infant feeding patterns (for example, introduction of a pacifier or bottle feeding)

It is important to identify the symptoms of mastitis as early as possible and address the underlying cause (s) with a complete lactation evaluation by a midwife or lactation consultant. Recognizing risk factors is vital. Progression to breast infection can be prevented, and antibiotic therapy may not be necessary if risk factors are identified and addressed early.

• Express breast milk regularly (with the baby on the breast and a breast pump)
• Apply cold compresses after feeding to reduce inflammation and pain.
• Pain relief may include acetaminophen, ibuprofen, or, if needed, prescription pain relievers.

The most important measure is to ensure that breastfeeding continues. Frequent expression of breast milk with the baby at the breast and through the breast pump is essential to prevent milk stasis. Complete emptying of the breast will aid in recovery. The involvement of a lactation consultant or midwife is highly recommended.

Injuries to the nipple.

A variety of harmless skin lesions can arise on the nipple and occasionally interfere with feeding.

• Viral warts
• Hyperkeratosis nipple
• Scaly papillomas
• Seborrheic keratosis
• Moles

Skin Cancer It's weird on this site. Mammary Paget affects the nipple, but generally affects older women.