Breastfeeding and Skin Conditions of the Breast, Areola and Nipple

Tips for Dealing With Eczema, Psoriasis and Dermatitis

Bare Chest, Hand over breast. Breastfeeding and Skin Conditions of the Breasts and Nipples
Can you breastfeed if you have eczema, psoriasis, or dermatitis on your breasts and nipples?. Image Source/Getty Images

Eczema, psoriasis, and dermatitis are skin conditions that can develop on the breast, areola, and nipple. They can show up as dry, red, raised rashes or flaky, scaly patches on the skin that may itch, burn, crack, bleed or ooze. These skin conditions can make it painful to nurse your child, but you do not have to stop breastfeeding if they develop.

Tips For Dealing With Skin Conditions of the Breast:

  • See your doctor or a dermatologist for a true diagnosis, treatment instructions, and pain relief.
  • A common cause of breast irritation that can lead to outbreaks of these types of skin conditions is an incorrect latch. By correcting a poor latch, you can help to prevent further damage to your skin. If you need help with your baby's position and latch, contact your doctor, a lactation consultant or your local La Leche group for assistance.
  • Dermatitis and eczema are sometimes caused by an allergy or irritation. If you can determine the cause, try to eliminate it. Once you remove the irritant, your skin can begin to heal more quickly.
  • Do not wear tight-fitting bras or clothing that can put pressure on your breasts and irritate your skin.
  • Use breast pads without plastic linings and change your breast pads when they get wet.
  • Wearing breast shells inside your bra may be helpful.  Breast shells can prevent your clothing from rubbing against your skin.
  • Warm water compresses or hydrogel breast pads may be useful to soothe irritated breasts.
  • You can try rubbing some freshly expressed breast milk onto the area. Breast milk can help to moisturize your skin and promote healing.
  • UVB light treatments may be helpful, and they are considered safe for breastfeeding women.
  • Many treatment plans for skin conditions include the use of topical steroid ointments or creams that you need to apply directly to the affected area. Use these medications immediately after nursing and gently wash your breasts well before nursing again.
  • If it is too painful to breastfeed from one of your breasts, continue to nurse from the other side.  Pump or hand express your milk from the painful side while it's healing. 
  • If both breasts need time to heal you may need to temporarily wean your child. If you are not putting your baby to the breast, use a breast pump frequently to maintain your milk supply and prevent some of the common problems of breastfeeding. You can also use an alternative feeding method to feed your child until you can return to breastfeeding.
  • Certain options for the treatment of psoriasis including methotrexate, cyclosporine, PUVA and biologic medications are not safe to use while breastfeeding. Make sure your doctor knows that you are breastfeeding before he prescribes any treatments.
  • Call you doctor if your condition does not improve with treatment. Thrush or other forms of dermatitis may look similar to eczema or psoriasis. And, although uncommon, a kind of cancer called Paget's disease of the breast can be misdiagnosed as eczema or dermatitis.

Sources:

American Academy of Pediatrics. New Mother’s Guide To Breastfeeding. Bantam Books. New York. 2011.

Barankin B, Gross MS. Nipple and Areolar Eczema in the Breastfeeding Woman. Journal of Cutaneous Medicine and Surgery: Incorporating Medical and Surgical Dermatology. 2004; 8 (2): 126-130.

Lawrence, Ruth A., MD, Lawrence, Robert M., MD. Breastfeeding A Guide For The Medical Profession Sixth Edition.  Mosby. Philadelphia. 2005.

Newman, Jack, MD, Pitman, Theresa. The Ultimate Breastfeeding Book of Answers. Three Rivers Press. New York. 2006.

Weatherhead S, Robson SC, Reynolds NJ. Management of Psoriasis in Pregnancy. British Medical Journal. 2007; 334 (7605): 1218-1220.

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