Nipple balm: why lanolin is the reference material, and the two constraints that rule out almost everything else
A three-ingredient nipple balm in weight percent and grams, a lanolin-free alternative, the real lanolin allergy numbers, and why latch help beats any product.
This is the most constrained formula on the site. Everywhere else, a longer ingredient list is a design choice. Here it is a liability, because whatever goes into the tin ends up on skin that is often broken and then, in small quantities, in a newborn's mouth. The right instinct is subtraction, and the finished product should look almost embarrassingly plain.
Highly purified anhydrous lanolin is the reference material because it is a bland occlusive that does not need removing before a feed. Two constraints, safe if ingested in tiny amounts and no need to wipe off, eliminate essential oils, herbs and most actives. Persistent pain or damage needs a midwife, lactation consultant or doctor, not a better balm.
Nipples that are cracked, bleeding, blistered, weeping, crusted or increasingly painful need to be looked at by a midwife, health visitor, lactation consultant or doctor. So does a red, hot, wedge-shaped area on the breast, a fever or flu-like symptoms, deep burning pain that continues between feeds, or any pain that begins after weeks of comfortable feeding. These can be infection, thrush, vasospasm or a feeding problem, and a balm treats none of them. It is a comfort product only. Nothing on this page is a treatment for any condition, and describing a balm as one would be a medicinal claim: see cosmetic versus drug claims.
Get help with the feed before you reach for a product
The most useful thing here is this paragraph, not the formula. Nipple pain and damage in early breastfeeding is usually mechanical, and the usual cause is how the baby is attached. Someone experienced watching a whole feed picks up in ten minutes what no amount of reading resolves. A balm keeps damaged skin comfortable and stops a crack drying and reopening between feeds, which is worth having, but it does not change what caused the damage.
It is also worth knowing what the trial evidence says, because it is more modest than the shelves suggest. A Cochrane review of treatments for painful nipples found the studies small and inconsistent, with no clear evidence that lanolin or any other applied treatment outperformed expressed breast milk or simply doing nothing. That is not a reason to avoid a balm. It is a reason to be honest about what it is for: comfort, and keeping damaged skin from drying out.
The two constraints that eliminate almost everything
Every ingredient in a nipple balm has to pass both of these, not one.
- Safe in the trace amounts a newborn might ingest. Not "food grade" in the loose sense, but genuinely benign in a milligram quantity in a newborn's mouth, where the metabolic capacity and the body mass are both small.
- Not requiring removal before a feed. The alternative is wiping a cracked nipple eight to twelve times a day, which is worse than the problem. Anything with pharmacological activity, a strong taste, a fragrance or an unknown ingestion profile fails here.
| Ingredient | Ingestion in trace amounts | Needs wiping off | Verdict |
|---|---|---|---|
| Highly purified anhydrous lanolin | Poorly absorbed, long record in this use | No | Use |
| White soft paraffin, pharmaceutical grade | Inert, not absorbed | No | Use, the lanolin-free default |
| Cocoa butter, food grade | A food | No | Use, in small amounts for body |
| Fractionated coconut oil | A food-grade triglyceride | No | Use, as the softener |
| Any essential oil, including lavender or tea tree | Not established for newborns | Yes | Leave out |
| Menthol, camphor, peppermint | Restricted around infants | Yes | Leave out |
| Calendula, comfrey, chamomile extracts | Pharmacologically active, Compositae allergens | Yes | Leave out |
| Vitamin E above antioxidant levels | Skin-directed dose, not needed here | Yes, in practice | Leave out |
| Honey | Not for infants under 12 months | Yes | Leave out |
| Beeswax | Edible, but a documented contact allergen with propolis | No | Avoidable, use butters instead |
| Olive oil | A food, but see below | No | Avoid, better options exist |
The olive oil entry surprises people. A controlled study applying olive oil and sunflower seed oil to adult forearms found that repeated olive oil application reduced stratum corneum integrity and produced mild erythema, while sunflower seed oil preserved barrier integrity. Whatever the mechanism, there is no reason to choose the oil that performed worse on a barrier that is already compromised. Notes on the fragrance question in general are in essential oils in balms, and the concentration argument for tocopherol is in vitamin E and antioxidants.
Why lanolin is the reference material
Anhydrous lanolin melts at 38-44 C, holds a lot of oil, and forms one of the most effective occlusive films available from any source. Applied to a crack, it slows water loss from the wound surface, which keeps the tissue pliable and stops the scab drying hard and splitting each time the baby latches. In the United States it is a recognised skin protectant active in its own right under the over-the-counter monograph, at 12.5 to 50 percent, which is a useful anchor: this is not an obscure craft ingredient.
The material grade matters more than anything else in this article. Ordinary anhydrous lanolin and "highly purified" or medical grade lanolin are not the same product. Purification removes detergent residues and reduces free lanolin alcohols, and the historical work on lanolin allergy points squarely at those two fractions rather than at lanolin itself. Modern highly purified grades have free alcohols reduced below 1.5 percent. Buy a grade with a specification sheet that states it, and do not substitute a generic craft lanolin on the assumption they are equivalent. Full material notes are in lanolin.
The lanolin allergy numbers, honestly
Lanolin has a reputation as a major allergen that the data does not support, and an under-appreciated risk on broken skin that the data does support. Both halves matter here, because this is a broken-skin application.
| Population | Positive rate | Note |
|---|---|---|
| General population sample | about 0.4% | Random sampling, not a clinic |
| Patch-test referral clinics | 2.5 to 4.6% | People already suspected of contact allergy |
| Dermatitis clinic range across studies | 1.2 to 6.9% | Wide, and method dependent |
| Lower-leg dermatitis | 6.0% | Against 1.7% overall in the same series |
| Stasis dermatitis and leg ulcers | 24.7% | The clearest signal that broken skin is different |
Two further findings keep this in proportion. A repeated open application test in patch-test positive subjects found no reactions on intact skin over four weeks, and all participants healed during application to deliberately damaged skin. But 83 to 87 percent of positive lanolin reactions in the North American data were judged currently clinically relevant, so they are not testing artefacts. The practical rule for this product: lanolin is a reasonable first choice, and if the area becomes itchier, bumpier or more inflamed with use rather than less, stop and switch to a paraffin-based alternative.
The formula: minimal lanolin balm
Percentages are by weight and total exactly 100. The grams column is for a 60 g batch, which fills two 1 oz (30 mL) tins at 27 g each (54 g) with 6 g of overage, 10 percent. The batch is small on purpose: this should be made fresh and used up, not stockpiled.
| Ingredient | % | g for 60 g | What it does |
|---|---|---|---|
| Highly purified anhydrous lanolin | 80 | 48.0 | The occlusive film. Everything else here is a spreadability adjustment |
| Fractionated coconut oil | 15 | 9.0 | Softens neat lanolin, which is too stiff and tacky to apply to a sore area |
| Cocoa butter, food grade | 5 | 3.0 | A little body back, so the balm is not runny in a warm room |
| Total | 100 | 60.0 |
- Sanitise everything. Wash and dry the jug, spatula, thermometer and tins, then wipe with 70 percent alcohol and let it evaporate. This matters more here than on any other formula: see workshop hygiene.
- Melt lanolin and cocoa butter in a water bath at 70-75 C (158-167 F) for ten minutes. Cocoa butter is polymorphic and a partial melt sets with pale streaks.
- Stir in the fractionated coconut oil. Lanolin disperses slowly. Keep stirring until there is no separate glossy layer.
- Cool to 55-60 C (131-140 F) off the heat, stirring slowly so you do not fold in air.
- Pour at 55-60 C to 27 g per 1 oz tin.
- Chill 20 minutes, in the fridge and not the freezer, then leave 24 hours at room temperature before judging the texture.
- Label with the full ingredient list and the date, and tell anyone you give it to exactly what is in it.
How to adjust it
Adjust texture only. Do not add functions. Rebalance against the fractionated coconut oil so the total stays at exactly 100.
- Too stiff to spread on tender skin: lanolin 80 to 72, fractionated coconut 15 to 23. This is the change most people need.
- Too soft in a warm room: cocoa butter 5 to 9, fractionated coconut 15 to 11.
- Maximum occlusion, for skin that keeps cracking: lanolin 90, fractionated coconut 10, no cocoa butter. Very tacky, and effective.
- Less tacky: lanolin 65, fractionated coconut 25, cocoa butter 10. Weaker seal, easier to apply one-handed.
- What not to adjust: do not add wax for firmness, do not add fragrance, do not add a botanical, do not add a preservative. An anhydrous balm does not need one, and the reasoning is in do balms need preservatives.
The lanolin-free alternative
Two options, and they are not equivalent. The simplest is pharmaceutical white soft paraffin used straight from the tube, which is inert, unabsorbed, bland and the evidence-backed choice for anyone with a confirmed lanolin allergy: see petrolatum and mineral oil. The second is a plant-only balm, for people who want that, with the honest caveat that it seals less well.
| Ingredient | % | g for 60 g | What it does |
|---|---|---|---|
| Cocoa butter, food grade | 28 | 16.8 | The main structurant. Sets firm, and it is a food |
| Kokum butter | 17 | 10.2 | Very stearic rich and the least grain-prone butter: mango and kokum butter |
| Fractionated coconut oil | 35 | 21.0 | Carries the butters and keeps it spreadable |
| High-oleic sunflower oil | 20 | 12.0 | Chosen over olive on the barrier evidence above |
| Total | 100 | 60.0 |
There is deliberately no wax in it. Wax adds drag, and dragging a balm across a cracked nipple is exactly what you are trying to avoid. Beeswax also carries propolis residues, which are a documented contact allergen cluster. Forty-five percent hard butter sets this firmly enough on its own. The general vocabulary for why one film seals better than another is in occlusives, emollients and humectants.
Do not use any balm from this page on a nipple that is infected, and do not use it alongside a prescribed cream unless the prescriber says so: an occlusive layer changes how a medicine behaves. Stop if the skin gets worse rather than better. If your baby develops a rash, oral thrush, unexplained irritability or feeding refusal after you start using a product, stop the product and speak to a health professional.
Troubleshooting
| Symptom | Most likely cause | First fix |
|---|---|---|
| Too stiff to apply without pressing | Neat lanolin is very firm at room temperature | Take lanolin to 72 percent, or warm a pea between fingers first |
| Stings on application | An added ingredient, or an alcohol residue on the tin | Strip the formula back to three ingredients: balm stings or burns |
| Gritty on the fingertip | Cocoa butter not fully melted, or slow cooling | Full melt at 70-75 C then chill fast: grainy shea butter |
| Skin more irritated after a week of use | Possible contact allergy, lanolin or otherwise | Stop, switch to plain white soft paraffin, ask for a patch test if it recurs |
| Balm smells different after two months | Oxidation of the liquid oil fraction | Discard it. Make 60 g batches and use them within three months |
| Visible mould or a musty smell | Water introduced by wet fingers or a wet spatula | Discard the tin, use a dry spatula: the same failure as in nappy rash balm |
- 1 oz (30 mL) tin: 26-28 g fill. Working density of a finished balm: 0.92 g/mL.
- Highly purified lanolin: free lanolin alcohols below 1.5 percent.
- US skin protectant monograph band for lanolin: 12.5 to 50 percent.
- Batch overage allowed here: 10 percent.
What to do next
If you are in pain now, do two things in this order. Arrange for someone qualified to watch a feed, and put a bland occlusive on the damaged skin in the meantime. If you have a tube of highly purified lanolin, that is already the formula on this page with one ingredient instead of three, and there is no reason to make anything. Make the balm because you want a slightly softer version, or because you cannot get the commercial product, and make it plain. The temptation to add something soothing is the strongest and the most wrong instinct in this whole category.
Frequently asked questions
Does nipple balm need wiping off before a feed?
Highly purified anhydrous lanolin does not, which is the main reason it is the standard material. It is a mixture of wax esters and sterols, poorly absorbed, and the quantity that could transfer to a baby is very small. Anything you add changes that calculation. A balm containing essential oils, herbal extracts or menthol has to be removed, and removing it means wiping a sore nipple repeatedly.
Is lanolin allergy a real concern?
Less than its reputation on intact skin, and more on damaged skin. Positive patch tests run at about 0.4 percent in general population sampling and 2.5 to 4.6 percent in patch-test referral clinics, well below nickel or fragrance. Rates are higher where skin is broken, which is exactly the situation here, so stop if the area becomes itchier, bumpier or more inflamed after use.
Can I add vitamin E, calendula or chamomile?
Better not. Every addition has to clear two bars: safe for a newborn to ingest in small amounts, and not needing removal before a feed. Vitamin E at skin-treatment levels, botanical extracts with pharmacological activity and anything untested on newborns clear neither. The value of this product is in what it leaves out.
What actually fixes nipple pain?
Usually a change to positioning and attachment, assessed by someone who watches a feed. Pain that persists through a feed, damage that keeps recurring, and pain that starts after weeks of comfortable feeding all point to a cause a balm cannot address, including tongue tie, vasospasm, thrush or infection. A balm keeps damaged skin comfortable while the underlying cause is sorted out.
Is a lanolin-free version as good?
As an emollient, yes. As an occlusive, no. Nothing plant based matches lanolin gram for gram at slowing water loss from damaged skin, and no plant butter has lanolin's long record in this specific use. White soft paraffin is the alternative with the most evidence behind it for people with confirmed lanolin allergy, and it is also bland enough not to need removing.
How long does a homemade nipple balm keep?
An anhydrous balm has no water for microbes to grow in, so it does not need a preservative, but it is not sterile and it will pick up whatever your fingers bring to it. Make 60 g at a time, use a clean fingertip or a small spatula, keep it capped and cool, and discard it after three months or if the smell changes.
Can I put honey in it?
No. Infants under twelve months should not be given honey because of the risk of intestinal colonisation by Clostridium botulinum spores, and honey in an anhydrous balm can still carry viable spores even though nothing can grow there. There is no documented case from a cosmetic and no authority addresses topical honey, so treat this as a precaution by analogy, and keep honey out.
Sources and further reading
- Dennis CL, Jackson K and Watson J, Interventions for treating painful nipples among breastfeeding women, Cochrane Database of Systematic Reviews, 2014.
- US Food and Drug Administration, 21 CFR Part 347, Skin protectant drug products for over-the-counter human use, eCFR.
- Diepgen TL and colleagues, prevalence of contact allergy in the general population, British Journal of Dermatology, 2016;174:319. PMID 26370659.
- Silverberg JI and colleagues, North American Contact Dermatitis Group patch test results 2001 to 2018, Dermatitis, 2022;33:193. PMID 35481824.
- Uldahl A, Engfeldt M and Svedman C, repeated open application testing with lanolin in patch-test positive subjects, Contact Dermatitis, 2021;84:41. PMID 32844454.
- Danby SG and colleagues, effect of olive and sunflower seed oil on the adult skin barrier, Pediatric Dermatology, 2013;30:42.
Reviewed and updated 6 September 2026. Spotted an error? Tell us and we will fix and log it.