If you are a breastfeeding mother who has experienced sore nipples and treated them (or sought to prevent them) by using a nipple cream, you may want to listen up. The Food and Drug Administration (FDA) has issued a warning about one such popular topical agent: Mommy’s Bliss Nipple Cream. According to the FDA’s statement, two ingredients in the cream can cause “respiratory distress or vomiting and diarrhea in infants.”

The ingredients, chlorphenesin and phenoxyethanol, are cosmetic preservatives. According to the FDA, the former “relaxes skeletal muscle and can depress the central nervous system and cause respiratory distress in infants.” The latter can cause respiratory distress, too; it can also cause “vomiting and diarrhea, which can lead to dehydration.”

Signs the FDA urges mothers and caregivers to look for include:

• decrease in the infant’s appetite
• difficulty awakening the infant
• limpness in infant’s extremities or reduction in strength
• change in infant’s skin color
• dermatitis in the mother—worsening of the drying and cracking of the skin where cream has been applied
  

The manufacturer, MOM Enterprises, responds to the FDA on its website. According to the company, although the FDA conducted its assessment of the cream in October 2007, the agency failed to inform the company of their findings until about six months later. Although the company disputes the FDA’s findings and cites positive customer response to the cream, it has nevertheless withdrawn the product from the market. Full refunds are being offered to consumers who have the product.

I am not a scientist, and I don’t know the merits or problems of these particular preservatives. Nor do I pretend to understand why the FDA waited so long before reporting its findings to the company and the general public.

But what I do know is that several studies have confirmed that the leading cause of sore nipples is poor positioning of the infant at the breast. That’s not something that a cream can correct, anyway. (There are other causes, of course. But that’s the leader.)

As a new mother, I did use a nipple cream for a brief time. It soothed the tender skin and enabled it to heal while I “learned the ropes” of positioning my son during breastfeeding. But rubbing a few drops of my milk into the nipple at the end of the feeding worked just as well. (I don’t remember where I got this idea, but I was heartened to see an article about a study comparing lanolin and breastmilk. Breastmilk “won” in terms of its effectiveness for sore nipples.)

So, mothers, here’s what I think: Maybe we should try to breastfeed without all of the trendy products available. If you’re experiencing pain, a knowledgeable health care provider or lactation consultant who can provide some positioning help just might be the best “breastfeeding aid” of all.