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Jack Newman's All Purpose Nipple Ointment

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  • Jack Newman's All Purpose Nipple Ointment

    Does anyone know if there are published clinical data to support the use of this combination ointment (mupirocin plus miconazole plus betamethasone)? If so, would you mind please posting the citation(s). Thanks!

  • #2

    As far as I know, there are no published trials as to the efficacy of this product. Let me know if you find one.

    Tom Hale Ph.D.


    • #3
      I moderate a mother-to-mother breastfeeding support forum, and I've noticed that many of the mothers routinely use APNO or an APNO-like mixture for nipple pain.

      I was reading about recurrent mastitis in Breastfeeding: A Guide for the Medical Profession by Dr. Ruth Lawrence, and I came across this statement:

      "Therapies that include antifungals, antibiotics, and antiinflammatories in one preparation serve to sensitize the flora, [and] diminish effectiveness..."

      Is something mothers should be concerned about? Could frequent use of APNO actually cause more problems?


      • #4

        I think the APNO used appropriately short term is very effective. As I do not believe in the Candida infection of the nipple or ductal regions of the breast, I do not think miconazole is necessary at all. Further, remember the azole antifungals are hepatotoxic and the amount an infant might receive following long-term therapy is significant. Mupirocin is quite effective because this problem is probably due to a staph infection, and mupirocin is quite effective for staphylococcal infections.

        Further, betamethasone is a HIGH potency corticosteroid. After prolonged use, you might see some steroid effects in an infant, but this is only theoretical.

        Thus, my problem with APNO, is that it a highly potent mixture and should not be used routinely, long term, or without close supervision by a physician.

        Tom Hale Ph.D.