12/03/2026
Most people reach for ni**le cream immediately, but the evidence says that may not be necessary (or even the best option).
The cause of ni**le pain is what needs fixing first. Cracked or sore ni**les are almost always a latch/positioning issue. No cream will fix a poor latch; correcting positioning and attachment is the most effective way to allow a damaged ni**le to heal.
Sore (unbroken skin) may not need any product at all; fixing the latch is usually enough
Cracked (broken skin) may benefit from keeping the wound moist to prevent scab formation
What does the evidence actually say about creams? A 2014 Cochrane review found that applying nothing, or just expressed breast milk, may be equally or more beneficial in the short-term for ni**le pain than applying a lanolin ointment. https://www.breastfeedingnetwork.org.uk/factsheet/moist-wound-healing/ That’s a significant finding given how heavily lanolin creams are marketed.
What actually works:
Expressed breast milk contains antibodies and epidermal growth factor, which may promote skin repair, and carries no risk of allergy.
Vaseline (white soft paraffin) is a cheap, widely used option that helps prevent scab formation
Purified lanolin (e.g. Lansinoh) is semi-occlusive and widely marketed, but no study comparing it directly to soft paraffin has been found, and the evidence base has design shortcomings.
Sprays with an alcohol base can actually dry out the skin and make things worse
The moist wound healing principle: Research shows wounds heal around 50% faster when the skin’s internal moisture is maintained. Keeping a cracked ni**le moist prevents hard scab formation, which can be ripped off during feeds and cause fresh damage.
Apply any cream after feeds, not before
Most creams don’t need to be washed off before feeding
Only use water to clean the area; soap dries the skin further
Feed from the less painful side first
Seek support if things aren’t improving!
