All Purpose Nipple Ointment (APNO) or Medihoney for Nipple Damage

All Purpose Nipple Ointment is a combo of antibiotic (bacitracin), anti-inflammatory steroid (hydrocortisone), and anti-fungal (miconazole) that is available via prescription. Medihoney is a medical grade sterile honey with antibacterial and wound healing properties, available OTC.

If there is nipple pain and/or damage, shallow latch and positioning is usually the culprit and should be addressed first. This is very common in the early days of breastfeeding as parent and baby learn how to get a deep latch. Once the latch is improved, the pain and damage should rapidly improve. If pain/damage persists, consult with an IBCLC.

If nipple damage is present, APNO is not recommended as a first-line treatment as the multiple active ingredients can make it more difficult to identify the underlying cause of the damage and determine which intervention is truly effective. It can also cause side effects like allergic reaction from an ingredient that was not helpful to begin with. Instead, a targeted approach is preferred that addresses the root cause while using treatments that are appropriate for the specific type of tissue injury.

Medihoney is a preferred treatment for nipple damage due to its healing properties. If there is no damage but the nipples feel dry or sore, nipple butter, olive, or coconut oil can help.

*Please Note*
Medihoney is currently on recall as of January 2026 due to packaging failure leading to contamination of sterile barrier. First Honey Wound Healing Ointment is a suitable alternative.

Sources:

https://intouchpediatrics.com/in-touch-pediatrics-blog/say-no-to-apno

https://fourthtrimesterdoc.com/general/just-say-no-to-apno/

https://physicianguidetobreastfeeding.org/mythbusters/if-you-feel-silly-doing-it/