What is Newman's Ointment? Nipple Cream for Breastfeeding Moms.

Hey Mommas! I’m so honored to be writing this blog for TheLittleMilkBar.

My name is Amanda Janzen and I’m a (newish) momma to a sweet little girl, Nora. As a registered nurse, lactation consultant (IBCLC), and birth/postpartum doula, let’s just say I live: birth, boobs, babies, and breastfeeding!

Today I’m going to be talking about Newman’s Ointment. A nipple cream that works like magic for breastfeeding moms.

I’m the founder of Midwest Momma Collective, which just happened to be born while navigating my first year of motherhood.

I was desperate to bridge the gap in our maternity care system, while providing evidence to support our intuitions. Your instincts are usually spot on, mommas!

As a resource for moms in all stages of motherhood: pre-conception, pregnancy, birth, and postpartum, I’m so excited to share my education and experience in the saturated market of NIPPLE CREAMS! As a new mom with nipple pain, it can be a hard market to navigate.

Especially if you are running on little sleep and will try just about ANYTHING for some relief! The last thing you want to do is go to the store and get lost in the aisles of creams, ointments, lotions, tinctures, balms, etc.… and not get relief with your purchases.

And don’t get me started on diaper rash remedies, that’s an entirely different blog post! So, let’s assume… Baby’s latch is good (or has been corrected), a knowledgeable provider has done a functional assessment and ruled out oral restrictions, and you are still experiencing nipple pain.

In my practice, I’ve seen nipple damage occur with just one or two feedings, myself included! And to be fair, that’s why this market is booming. Nipple pain is very common; however, nipple pain is NOT normal!

That’s why it is so critical to correct the root cause of your pain, while supporting this sensitive tissue in the healing process.

So, let’s talk about a lesser known nipple cream that you CAN’T find on the shelves of your local baby store... All-Purpose Nipple Ointment, or APNO.

All-Purpose Nipple Ointment was created by Dr. Jack Newman. That’s why it is often called, Newman or Newman’s Cream, here in the U.S. But, I’d like to point out, ointments and creams are not the same thing (a bit more on that later).

So, for the remainder of this blog, I’ll refer to it as APNO. Jack Newman is a leading breastfeeding researcher and founder of the International Breastfeeding Centre in Canada.

I was fortunate to meet him in person at a local breastfeeding conference and loved hearing him talk about his research in late-onset decreased milk supply.

He has some amazing videos/resources on his website so I’m leaving a link HERE. Because our neighbors to the north have AMAZING maternity/parental leave benefits, their issues sometimes present differently than ours.

Moms definitely aren’t returning to work 2-8 weeks postpartum like many of us here in the U.S.

However, nipple pain affects moms on both sides of the border and he created a “one size fits MOST” ointment to address nipple pain from three common causes: bacterial infection, inflammation, and/or fungal infection.

Here is the recipe Dr. Newman created…

1. Mupirocin ointment 2%: 15 grams  

2. Betamethasone ointment 0.1%: 15 grams  

3. To which is added miconazole powder to a concentration of 2% miconazole  

Total: about 30 grams combined.

Apply sparingly after each feeding. Do not wash or wipe off. (more info HERE)

So, let’s break down the ingredients a bit further…

1. Mupirocin (or Bactroban) is an antibiotic that is effective against many bacteria, particularly Staphylococcus aureus (including MRSA). Once there is a blister, crack, or abrasion on your nipple, bacteria can grow in these areas and cause an infection, prolonging your pain and worsening your situation.

2. Betamethasone is a corticosteroid, which like all corticosteroids, decreases inflammation. If your nipples appear pink, red, or inflamed, this ingredient treats the inflammation, and in turn decreases your nipple pain.

3. Miconazole is an antifungal agent that is effective against Candida albicans. Because this ingredient is in powder form, the compounding pharmacist will add it to the above- mentioned ointments to reach a concentration of 2%.

Now, for the tricky part… Since some compounding pharmacies in the U.S. do not carry these ingredients, getting an order from your provider for this EXACT recipe may be difficult for some of you.

HERE is a link to search for compounding pharmacies in your area. I’d recommend calling ahead of time to see what ingredients they carry and if this exact recipe could be compounded.

You’ll want to be sure your provider sends the order to the correct pharmacy, especially if it’s not the same pharmacy you normally fill all your prescriptions. Fluconazole powder or clotrimazole powder could be substituted for the miconazole powder, as long as the concentration remains 2%.

In Dr. Newman’s experience, he has seen clotrimazole (or canesten) cause more irritation than other drugs in this antifungal family. So be mindful of this if it’s the only powdered antifungal option at your local compounding pharmacy.

If you live somewhere where miconazole powder or any of the powder substitutions (fluconazole or clotrimazole) are not available, it is probably best to use the mupirocin and betamethasone compound and then a SEPARATE antifungal cream or gel. Miconazole cream or gel cannot be substituted for the miconazole powder since it can cause the compound to separate.

So, let’s say you are able to get your hands on some APNO, now what?

It’s recommended to apply a very small amount after each breastfeed/pumping session (just enough to make the skin glossy).

Because APNO is an OINTMENT, it will not absorb the same way as a nipple cream. IT FEELS AMAZING and a little bit goes a long way! Thankfully, nipples begin to heal incredibly fast with the right treatment, much like a baby’s bum with a rash.

If you don’t notice improvement within 3-5 days, I encourage you get your nipples reassessed by an IBCLC or another provider experienced in healing sore/painful nipples. Although, APNO can be used for weeks at a time, this is where the “one size fits MOST” approach has its limitations.

It could be that baby’s latch still needs some adjusting, a tongue-tie was missed, or an underlying skin condition or more serious infection is still causing you pain.

I hope this information makes your mothering journey a bit easier and you feel empowered to advocate for yourself during this vulnerable time.

Sending all the motherly love your way, Amanda P.S. I love to see you over in my Instagram community! @midwest.momma.collective.