Nipple Creams - Do's and Don'ts

Standing in the infant aisle, looking at all the products while you're over-tired trying to decide which nipple cream will help you... I've been there! And, it's one of the questions I get most often from new parents. Now, choosing the right product doesn't have to be complicated. In fact, the most effective option might already be at home with you.

Read on for a clear breakdown of what's worth using, what to skip, and one widely prescribed treatment that deserves a closer look.

Start Here: Your Own Milk

Before reaching for any product, it's worth knowing that research supports the use of your own milk - especially the thicker, fat-rich milk produced toward the end of a feed. Use this as a first-line option for nipple soreness. Studies have found it to be AS effective as lanolin for pain and healing.

All you have to do is express a small amount after each feed, apply it to the nipple and areola, and let it air dry quickly. It's free, always available, and carries no risk to your baby.

Lanolin: The Most Studied Option

Lanolin has been used on nipples for decades, and a 2024 meta-analysis confirmed it is superior to routine care for nipple pain and trauma. If you choose to use lanolin though, purity matters. Look for HPA (highly purified anhydrous) lanolin. Standard lanolin can contain residues and contaminants from wool processing. Highly purified versions however, such as Lansinoh HPA Lanolin and Medela Purelan, have been processed to remove these and are the formulations used in most clinical settings.

One note: if you have a wool allergy or sensitivity, lanolin may not be the right fit because it is derived from sheep's wool.

Organic Creams and Butters - Blends

For those who prefer lanolin-free options - like myself - whether due to sensitivity, preference, or wanting a certified organic or plant-based product, there are a few well-formulated choices. Here are just 2 that I like.

Earth Mama Organic Nipple Butter

Made with certified organic ingredients including olive oil, beeswax, cocoa butter, shea butter, mango butter, and calendula extract. It is organic, does not need to be wiped off before feeding, and is used in a number of hospital NICUs.

Motherlove Nipple Cream

Contains organic olive oil, beeswax, shea butter, marshmallow root, and calendula. It has a clean ingredient list, no wipe-off needed before nursing, and well-tolerated by most.

Ouchie Mama Nipple Rescue 🥇This one is my personal favourite!🥇

Contains medical grade sterile manuka honey. This ingredient is super helpful for speeding up the healing process in addition to creating a soothing barrier.

Oils

Simple carrier oils are often overlooked as nipple care options, but they are safe, effective, and easy to use.

Extra Virgin Olive Oil

A gentle, skin-safe option that provides effective moisture. Safe for baby and does not need to be removed before feeding. Can be slightly messy, so a small amount goes a long way.

Raw Coconut Oil

Also effective as a moisturizer, with the added benefit of mild anti-fungal and anti- bacterial properties. This is safe for baby, but something worth noting is that it is not recommended when there is an active yeast (thrush) infection.

What to Skip and Why

Not everything on the shelf is appropriate for use on nursing nipples, even if it may be marketed as such. Here are some products worth avoiding:

Products not designed for this use 

Vaseline, Blistex, and Chapstick all contain ingredients that are not safe for babies to ingest. Even small, repeated exposure from nursing is a reason to choose something formulated specifically for breastfeeding.

Anything with added fragrance 

Fragrance can interfere with your baby's ability to locate and latch to the breast. Newborns rely heavily on scent in the early weeks, and artificial fragrance near the nipple can disrupt this. Look for fragrance-free on the label.

Hydrocortisone creams used long-term 

A short course of topical hydrocortisone may be appropriate when prescribed by a provider for a specific reason. Used routinely or for extended periods, corticosteroids thin the skin - the opposite of what healing tissue needs. It's notable that hydrocortisone is found in the commonly prescribed All Purpose Nipple Ointment.

A Note on APNO

All Purpose Nipple Ointment (commonly called APNO) comes up often in breastfeeding conversations, and it's worth understanding what it actually is and when it may or may not be appropriate.

APNO is a compounded prescription ointment that combines three active medications: an antibiotic (mupirocin or bacitracin), a corticosteroid (betamethasone or hydrocortisone), and an antifungal (miconazole). It has been prescribed widely as a catch-all treatment for nipple pain...

Here is where things get nuanced.

APNO can genuinely help in certain situations when there is a confirmed or strongly suspected bacterial or fungal component to nipple pain, and when a steroid is appropriate to manage inflammation. In those cases, the combination of ingredients makes clinical sense - with the caveat that it should probably only be used for around 7-10 days.

The problem is not the medication itself. The problem is how broadly it is prescribed and often without a clear diagnosis, and sometimes for months at a time. When APNO is prescribed for pain that is actually caused by a latch problem, a positioning issue, or an anatomical factor like tongue tie, it may provide temporary relief without ever addressing what's driving the pain. The result is that parents continue struggling, often not knowing that the root cause is still there and fixable. This is so important when you consider one of the greatest reasons people stop breastfeeding is pain!

There are also open questions about long-term safety, particularly regarding the steroid component and repeated infant exposure through nursing.

If APNO has been recommended to you, it is worth asking: what specific diagnosis is this treating? A clear answer to that question is a reasonable thing to expect. Don't boycott it or anything, but just know that it's widely prescribed by practitioners who often - not always - lack the time to tease out the cause of your issue.

In Summary

Nipple creams and balms have a real role in breastfeeding comfort. Keeping damaged skin moist supports healing, and having something gentle and safe to reach for matters in the early days.

What they can't do is fix a latch, resolve a tongue tie, or identify why pain is there in the first place. If soreness isn't improving after the first few days, or if it's present from the very first feed, that's a sign to get eyes on the latch by a skilled IBCLC.

Pain that persists usually has a cause. Finding that cause is almost always more useful than treating the symptom alone.

Thanks for reading!

-Nicole

Disclaimer: The information provided in this blog is for general informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional before making any health-related decisions