Effectiveness of Highly Purified Anhydrous (HPA) Lanolin Versus Extra-Virgin Coconut Oil in Preventing Subacute Lactation Mastitis

Lanolin is the standard of care in many healthcare institutions. However, lanolin is not supported by the literature as a gold standard of treatment and care. Frequent dermatoses reactions as well as the lack of wound healing and its use as a protective barrier was not found sufficient to promote effective breastfeeding. The origin of lanolin as an animal by product is not ideal supplement for baby's first exposure to a supplement. Furthermore, there is lack of evidential support that lanolin can in fact promote wound healing.

Several studies have been conducted comparing lanolin to other treatments. A representative selection of these studies is presented here. A 2012 study of 100 breastfeeding women was conducted by Dennis et al., 2012, Lanolin was compared to an All-Purpose Nipple Ointment (combination of Mupirocin Ointment 2%, Betamethasone ointment 0.1%, Miconazole 2%) The researchers hypothesized that the combination of creams would target all the known causes of subacute clinical mastitis including fungal infection, atopic dermatitis reactions, staphylococcus aureus infections. The attention control in the double blinded randomized control trial was HPA purified Lanolin. Participants in both the lanolin group and the all-purpose nipple ointment group experienced severe dermal reactions from the topical application. It was concluded that both products were not effective for preventing complications during lactation but rather contributing to the complication of dermatoses.

Another study conducted by Niazi on a sample of 100 breastfeeding women tested the effects of Purslane cream with an attention control of Lanolin which is current practice and found that lanolin in fact doesn't possess wound healing properties but rather has protective barrier properties that are not necessarily intended for promotion of wound healing. Study participants in the purslane group had rapid repair of the nipple and were able to feed more frequently which maintained adequate milk supply and had a more fulfilling experience. Whereas the Lanolin group experiences less frequent feedings, more pain, and often decreased their duration of breastfeeding.

Jackson conducted a study in Ontario Canada of 186 breastfeeding women using a randomized control design to assess the effects of lanolin on nipple pain. No studies to date had assessed HPA Lanolin effects on nipple pain. Group assignment was randomized. An attention control group received latch education as an intervention while the experimental group used Lanolin on their breasts. Breastfeeding self-efficacy, pain rating and maternal satisfaction with lanolin was measured within the study. Lanolin was found to be no more effective than latch treatment group. The lanolin had short-term protective factors but did not promote wound healing. However, women in the study did report high satisfaction with the ease of use of HPA Lanolin.

Hildebrandt conducted a study of 50 postpartum women where the women were their own control nothing was applied to one nipple and HPA Lanolin was applied to the other. The women were monitored for 10 days postpartum, and they were asked to measure or report their pain twice a day using the nipple tenderness scale. The women in this study reported less nipple pain on the lanolin treated breast than on the breast that received no treatment. Similar to the study published by Jackson et al., (2017) Lanolin has some protective factors for short periods of time. Neither study went beyond 10 days of breastfeeding which makes it difficult to assess the long-term effects over the ideal breastfeeding time period.