As u r breast feeding mother..better treat this conservative ly..Use cremaffin syp atleast once for 2days and have smooth passage of stools than straining. High fibre diet advised Avoid nonveg and spicy foods for atleast 3months

Kindly take fibre rich diet & use stool softener Diclofenac is generally safe durning BF

Why It Keeps Coming Back: 1. Anal fissures commonly recur due to: 2. Passing hard or large stools 3. Inconsistent stool habits 4. Poor fluid or fiber intake Long-Term Management: 1.To promote healing and prevent relapse: 2.High-fiber diet: Whole grains, fruits, vegetables 3.Hydration: Aim for 2–3 liters of water/day 4. Regular stool habits: Avoid straining 5. Continue sitz baths: 2–3 times daily, especially after bowel movements 6. Topical treatments: Nitroglycerin or nifedipine ointments (consult a General surgeon  before use during BF) For Pain Relief (BF-safe options): 1. Paracetamol (acetaminophen) – Safe during breastfeeding 2. Ibuprofen – Generally safe during BF and effective for pain/inflammation 3. Diclofenac – Also considered safe by many guidelines, but should be used under medical supervision

Avoid hot ,spicy and fried food. Eat fibre rich diet and plenty of water during day time. Continue your stool softener. Then creamagel ointment used just before going to pass stool and after passing stool. Pain killers generally safe during BF.

Please do following Sits bath warm water bath after stool Polyethylene glycol laxative Take fruits and salad Use xylocaine jelly before you go toilet Use Nitroglycerin jelly after toilet Drink more water about 1.5 lt to 2 Lt per day Dr Sandhu Associate Physician Alberta Canada