APNO for Breastfeeding Moms: Your Top 10 Questions Answered by a Compounding Pharmacist

Introduction

Author: Vishnu Patel PharmD. 4/15/2025

Breastfeeding is beautiful—but when nipple pain enters the picture, it can also feel exhausting and overwhelming. If you’ve been handed a tube of lanolin cream and it hasn’t worked, you may have heard about All-Purpose Nipple Ointment (APNO). But what exactly is it? Is it safe? How does it work?

At Rock Ridge Pharmacy, we specialize in compounding APNO for moms who need targeted relief from cracked, sore, or infected nipples. Here, we answer the top 10 most common questions breastfeeding moms ask about APNO—so you can feel confident, informed, and on your way to healing.

1. What Is APNO And How Is It Different From Regular Nipple Cream?

APNO stands for All-Purpose Nipple Ointment. Unlike over-the-counter lanolin creams, APNO is a prescription-only, compounded medication that combines three key ingredients:

Mupirocin – an antibiotic for bacterial infections
Betamethasone – a corticosteroid that reduces inflammation
Miconazole – an antifungal to treat yeast (thrush)

Regular nipple creams like lanolin only moisturize. APNO treats the root causes of nipple pain when there’s infection, inflammation, or fungal overgrowth.

2. What Is APNO And Why Is It Different?

APNO, or All-Purpose Nipple Ointment, is a compounded medication that contains:

• Mupirocin – an antibiotic to address bacterial infections

• Betamethasone – a corticosteroid that reduces inflammation

• Miconazole – an antifungal to treat Candida (thrush)

This combination makes APNO a more comprehensive option when nipple pain is severe, recurring, or caused by more than just dryness. It’s designed to treat pain that results from infection, inflammation, and fungal overgrowth—which are often interrelated.

Unlike lanolin, APNO requires a prescription and must be made by a compounding pharmacy. At Rock Ridge Pharmacy, we formulate APNO fresh with pharmacist oversight, ensuring safe concentrations and optional customization (lanolin-free, steroid-free, etc.).

3. Is APNO Safe While Breastfeeding?

Yes. When used as prescribed, APNO is safe for both mother and baby. You do not need to wipe it off before nursing. The ingredients are used in such small, localized doses that they are not harmful to infants.

4. How Often Should I Apply APNO?

Apply a small amount (pea-sized) to the entire nipple area after each feeding or pumping session. Most moms use it 3–4 times a day unless directed otherwise by their provider.

5. Do I Need To Wipe Off APNO Before Nursing?

No. If applied properly (thin layer), APNO is fully absorbed into the skin. There is no need to wipe it off between feeds. It’s designed to stay on and continue working while you nurse.

6. How Long Can I Safely Use APNO?

APNO is typically used for up to 14 days. If symptoms haven’t improved by the 7-day mark, or pain returns after stopping, contact your lactation consultant or healthcare provider for reassessment.

7. Can I Use APNO And Lanolin At The Same Time?

Generally, no. Lanolin can create a barrier that prevents APNO from fully absorbing. Stick with APNO alone during your treatment period. If you return to lanolin afterward, do so under provider guidance.

8. What If APNO Stings When I apply It?

A slight sting on first use can happen, especially on broken or cracked skin. If the sensation continues or worsens, stop using and talk to your provider. You may need a steroid-free or lanolin-free version, which Rock Ridge Pharmacy can compound.

9. Will APNO Treat Nipple Thrush?

Yes. Miconazole in APNO treats Candida albicans, the yeast that causes thrush. However, if your baby shows signs of thrush (white patches in the mouth), they will also need treatment from a pediatrician to prevent reinfection.

10. Can I Get APNO Without A Prescription?

No. APNO is a compounded prescription medication, so your OB/GYN, pediatrician, or lactation consultant must write a prescription. We can help guide your provider if they are unfamiliar with the formula.

Where Can I Get APNO Quickly?

Right here at Rock Ridge Pharmacy. We specialize in compounding APNO using Dr. Jack Newman’s clinically proven protocol. We offer:
- Fast turnaround
- Customized formulations (lanolin-free, steroid-free, etc.)
- Pharmacist support to answer your questions
Ask your provider to fax your prescription to (201) 444-2698, or call us directly at (201) 444-4190. We’re here to help you breastfeed more comfortably—without delay.

Final Thoughts: You Deserve Relief

Pain doesn’t have to be part of your breastfeeding story. If you're experiencing burning, cracking, inflammation, or signs of thrush—APNO may be the answer. At Rock Ridge Pharmacy, we’re honored to support you with safe, personalized care that helps you heal, feed, and thrive.