Breastfeeding is an important phase for both the mother and her baby. However, this significant phase may not always be a pleasant experience. The woman may experience nipple pain or infection, and dry, sore or cracked nipples during breastfeeding that often results in cessation of exclusive breastfeeding.1 Nipple creams are often prescribed to help ease the symptoms and pain associated with breastfeeding.2 While several topical preparations are used to manage sore and cracked nipples, such as lanolin, white petrolatum, antibiotics, vitamin E oil, etc., only a few have been scientifically evaluated.3

Topical preparations must be chosen only after giving due consideration to their impact on the nipple skin and the baby. While products containing petrolatum can interfere with skin respiration and can prolong nipple soreness, alcohol containing products can further dry out the nipples which are already dry and cracked. They should better be avoided.4

Coconut oil and kokum butter, on the contrary, seem to be effective and safe for the management of dry, sore and cracked nipples during breastfeeding.

Virgin coconut oil has often been used for skin ailments.5 It possesses antifungal and antibacterial properties.6 Data suggest that coconut oil has a positive impact on sore nipples.5 Topically applied coconut oil forms a chemical barrier on the skin and protects it from and heals infections. It is also known to moisturize and soften dry skin and has been found to repair cracked, sore, dry nipples from nursing.7

Virgin coconut oil has a broad spectrum of activity against S. aureus, fungi, and viruses. Its use is linked with faster would healing in comparison with untreated wounds. Virgin coconut oil has also been found to be better than olive oil in eliminating S. aureus from skin with atopic dermatitis.5 Coconut oil is effective and safe to treat dry skin conditions when used as a moisturizer, with no adverse reactions.8 Virgin coconut oil relieves the symptoms of skin disorders on account of its moisturizing and skin soothing potential.9 It inhibits TNF-α, IFN-γ, IL-6, IL-8 and IL-5 in THP-1 cells and has anti-inflammatory activity. It suppresses the inflammatory markers and protects the skin by enhancing skin barrier function. Coconut oil is a natural emollient that can be used in the treatment of xerosis.9

Coconut oil’s skin barrier repair, antibacterial, anti-inflammatory and antioxidant effects make it a potential topical agent for conditions with dry, cracked skin such as sore, dry and cracked nipples.

Kokum butter is another natural emollient that can be used for the prevention and treatment of sore nipples. Kokum, or Garcinia indica, contains anthocyanin pigments, tannins, pectin, omega oils, hydroxycitric acid, garcinol, citric acid, oxalic acid and ascorbic acid. Kokum infusion has cooling properties and can be directly applied to skin rashes, burns and dry skin. Kokum butter has soothing properties and is an astringent. It is used to treat fissures and cracked skin.10 Kokum oil or kokum butter has nutritive, demulcent, smoothening, softening, astringent, and emollient properties. Ointment prepared from kokum butter can be used for local application for treating ulcers, fissures, cracks/cuts, etc.11

The anti-hyaluronidase and anti-elastase activities of kokum have potential role in skin care. Kokum is commonly used for chaffed skin.12 Besides being used as an application for ulcerations, fissures and chapped skin, kokum butter is also used to treat wounds and sores associated with inflammation.13 Kokum butter has excellent emollient properties and high oxidative stability. On account of its emollient property, it is used as a natural moisturizer which helps in keeping the skin supple and silky smooth. It serves as an effective treatment for severely dry skin, ulceration and fissures.11

Its emollient, moisturizing and healing effects on dry, irritated and cracked skin, make it a potential remedy for dry, sore and cracked nipples.

References

1. Kent JC, Ashton E, Hardwick CM, et al. Nipple Pain in Breastfeeding Mothers: Incidence, Causes and Treatments. Int J Environ Res Public Health 2015;12(10):12247-63.
2. Bainbridge J. Dealing with breast and nipple soreness when breastfeeding. British Journal of Midwifery. Available from: https://www.magonlinelibrary.com/doi/pdf/10.12968/bjom.2005.13.9.19621.
3. Lactation and Breastfeeding. Newton ER (ed.). In: Obstetrics: Normal and problem pregnancies. Gabbe SG, Niebyl JR, Simpson JL, et al. (ed).
4. Breastfeeding techniques and devices. In: Counseling the Nursing Mother: A Lactation Consultants Guide. Lauwers J, Shinskie D (eds.).
5. Walker M. Are There Any Cures for Sore Nipples? Clinical Lactation 2013;4(3), http://dx.doi.org/10.1891/2158-0782.4.3.106.
6. Buck ML, Amir LH, Donath SM. Topical Treatments Used by Breastfeeding Women to Treat Sore and Damaged Nipples. Clinical Lactation 2015;6(1), http://dx.doi.org/10.1891/2158-0782.6.1.16.
7. Raj JA, Magesh L. Medicinal Use of Coconut. International Journal of Science and Research 2017;6(6):1898-1900.
8. Gediya SK, Mistry RB, Patel UK, et al. Herbal Plants: Used as a cosmetics. J Nat Prod Plant Resour. 2011;1(1):24-32.
9. Varma SR, Sivaprakasam TO, Arumugam I, et al. In vitro anti-inflammatory and skin protective properties of Virgin coconut oil. Journal of Traditional and Complementary Medicine 2018 January 17.
10. In: Healing Spices: 50 Wonderful Spices, and How to Use Them in Health-giving Foods and Drinks. Hartvig K (ed.)
11. Swami SB, Thakor NJ, Patil SC. Kokum (Garcinia Indica) and its Many Functional Components as Related to the Human Health: A Review. Journal of Food Research and Technology 2014;2(4):130-142.
12. Jagtap P, Bhise K, Prakya V. A Phytopharmacological Review on Garcinia indica. International Journal of Herbal Medicine 2015;3(4):2-7.
13. In: Dr. K. M. Nadkarnis Indian Materia Volume 1.