HPA Lanolin

Lanolin is a natural substance found in sheep's wool. This medicine is made with manufacturing processes that reduce certain allergens in the lanolin.

Lanolin topical (for the skin) is used to treat or prevent dry skin, itching or other skin irritation caused by conditions such as diaper rash, radiation therapy skin burns, and others.

Lanolin topical is also used to treat sore and cracked nipples caused by breast-feeding.

Lanolin topical may also be used for purposes not listed in this medication guide.

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

You should not use lanolin topical if you are allergic to it.

Ask a doctor or pharmacist if it is safe for you to use this medicine if you have:

• deep wounds or open sores;
• swelling, warmth, redness, oozing, or bleeding;
• large areas of skin irritation; or
• any type of allergy.

Lanolin topical is not expected to harm an unborn baby. Seek a doctor's advice if you are pregnant.

Lanolin topical is often applied to the skin of the nipple area to treat conditions caused by breast-feeding. This medicine is not expected to harm a nursing baby. Use only as directed.

You should not use lanolin topical if you are allergic to it.

Ask a doctor or pharmacist if it is safe for you to use lanolin topical if you have:

• deep wounds or open sores;

• swelling, warmth, redness, oozing, or bleeding;

• large areas of skin irritation; or

• any type of allergy.

Lanolin topical is not expected to harm an unborn baby. Seek a doctor's advice if you are pregnant.

Lanolin topical is often applied to the skin of the nipple area to treat conditions caused by breast-feeding. This product is not expected to harm a nursing baby. Use only as directed.

Since this product is used as needed, it does not have a daily dosing schedule. Seek medical advice if your condition does not improve after using lanolin topical.

Summary of Use during Lactation

Lanolin is a yellow fat obtained from sheep's wool. It has traditionally been used topically to treat sore, cracked nipples during breastfeeding. Highly purified modified lanolin (Lansinoh) has the pesticide and detergent residues removed and the natural free alcohols reduced to below 1.5% to improve safety and reduce the allergic potential.[1] Although lanolin appears to be effective for the prevention and treatment of nipple pain from breastfeeding,[2] studies, most of which used Lansinoh, have not found lanolin to be consistently different in efficacy from application of breastmilk, hydrogel dressings, peppermint gel, aloe vera or warm compresses.[3][4][5][6][7][8][9] A metaanalysis concluded that application of nothing or breastmilk may be superior to lanolin, but good studies are lacking.[10] One small nonblinded study found olive oil to be superior to lanolin for prevention of sore nipples,[11] and another small, single-blinded study found that lanolin application to painful nipples did not decrease nipple pain compared to usual care.[12]

Drug Levels

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

In a randomized, double-bind trial, lanolin was compared to an all-purpose nipple ointment containing mupirocin 1%, betamethasone 0.05%, and miconazole 2% for painful nipples while nursing in the first 2 weeks postpartum. The two treatments were equally effective in reducing nipple pain, nipple healing time, breastfeeding duration, breastfeeding exclusivity rate, mastitis and nipple symptoms, side effects or maternal satisfaction with treatment.[13]

A randomized trial in nursing women with damaged, painful nipples compared lanolin application to usual care, which was a variable mix of education or assistance by health professional, application of warm or cool compresses, analgesics, air drying the nipples or the use of breast shields. A blinded observer assessed healing via telephone calls to the mothers several times after randomization. No differences were found in nipple pain between the groups 4 to 7 days after randomization. No difference was found in breastfeeding self-efficacy at 4 days post-randomization or in the breastfeeding rates of the two groups at 4 and 12 weeks postpartum. Patient satisfaction with care was higher in the women who received lanolin.[12]

References

1. Mohammadzadeh A, Farhat A, Esmaeily H. The effect of breast milk and lanolin on sore nipples. Saudi Med J. 2005;26:1231-4. PMID: 16127520

2. Vieira F, Bachion MM, Mota DD, Munari DB. A systematic review of the interventions for nipple trauma in breastfeeding mothers. J Nurs Scholarsh. 2013;45:116-25. PMID: 23452043

3. Morland-Schultz K, Hill PD. Prevention of and therapies for nipple pain: a systematic review. J Obstet Gynecol Neonatal Nurs. 2005;34:428-37. PMID: 16020410

4. Sayyah Melli M, Rashidi M R, Nokhoodchi A et al. A randomized trial of peppermint gel, lanolin ointment, and placebo gel to prevent nipple crack in primiparous breastfeeding women. Med Sci Monit. 2007;13:CR406-11. PMID: 17767120

5. Abou-Dakn M, Fluhr JW, Mo G, Woeckel A. Positive effect of HPA lanolin versus expressed breastmilk on painful and damaged nipples during lactation. Skin Pharmacol Physiol. 2010;24:27-35. PMID: 20720454

6. Shanazi M, Farshbaf Khalili A, Kamalifard M et al. Comparison of the effects of lanolin, peppermint, and dexpanthenol creams on treatment of traumatic nipples in breastfeeding mothers. J Caring Sci. 2015;4:297-307. PMID: 26744729

7. Dodd V, Chalmers C. Comparing the use of hydrogel dressings to lanolin ointment with lactating mothers. J Obstet Gynecol Neonatal Nurs. 2003;32:486-95. PMID: 12903698

8. Pugh LC, Buchko BL, Bishop BA et al. A comparison of topical agents to relieve nipple pain and enhance breastfeeding. Birth. 1996;23:88-93. PMID: 8826172

9. Saeidi R, Tafazoli M, Gholami M et al. New treatment for nipple soreness in breastfeeding mothers: A clinical trial study. Iran J Neonatol. 2015;6:48-51. http://ijn.mums.ac.ir/issue_626_671_Volume+6%2C+Issue+2%2C+Spring+2015.html

10. Dennis CL, Jackson K, Watson J. Interventions for treating painful nipples among breastfeeding women. Cochrane Database Syst Rev. 2014;12: CD007366. PMID: 25506813

11. Gungor AN, Oguz S, Vurur G, Gencer M, Uysal A, Hacivelioglu S et al. Comparison of olive oil and lanolin in the prevention of sore nipples in nursing mothers. Breastfeed Med. 2013;8:334-5. PMID: 23249138

12. Jackson KT, Dennis CL. Lanolin for the treatment of nipple pain in breastfeeding women: A randomized controlled trial. Matern Child Nutr. 2017;13:e12357. PMID: 27477840

13. Dennis CL, Schottle N, Hodnett E, McQueen K. An all-purpose nipple ointment versus lanolin in treating painful damaged nipples in breastfeeding women: A randomized controlled trial. Breastfeed Med. 2012;7:473-9. PMID: 22428572