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Blebs, Nipple Blisters and Plugged Ducts

Certain breastfeeding conditions, such as blebs, nipple blisters and plugged ducts, can occur anytime during breastfeeding. These conditions can occur simultaneously and be confused with each other. However, these uncomfortable and annoying problems can be relieved with careful diagnosis and treatment.

Blebs

A bleb is a pressure cyst that occurs when a tiny amount of milk has seeped into the nipple tissue at a duct outlet. Blebs are typically caused by an improper latch. Blebs usually have an irregular shape and stay flat when pressure is applied to the nipple stem. Although blebs are generally painless, some women experience pinpoint pain when they breastfeed.

Treatment

First correct your baby's latch. Try changing the angle at which the baby approaches the breast, or switching from cradle to football hold or lying on the side. Changing positions will prevent the baby from putting pressure on the same spot at each feed.

Warm compresses can be soothing. Some women find that applying Lansinoh or Pure-Lan after breastfeeding keeps the bleb moist and reduces latch-on pain.

Plugged Nipple Pore and Plugged Ducts

A plugged nipple pore is similar in appearance to a bleb, except the plug is generally tiny and round, and is often an oily, waxy substance. If you squeeze upward on the nipple base, the plug will generally raise up like the lead in a mechanical pencil. If a nipple pore is plugged, there is almost always a corresponding hard, painful area in the breast where the milk is accumulating - a plugged duct. The swollen duct may press on neighboring ducts and prevent them from draining. Therefore, the hardened area can appear to spread.

Treatment
Make sure to get plenty of rest and breastfeed frequently.

Increase your fluid intake and, if well tolerated, take ibuprofen 200 to 600mg every eight hours with food or fluid to reduce inflammation and pain. You may substitute acetaminophen for ibuprofen for pain relief. If you do so, please follow the manufacturer's dosage instructions.

Apply heat to your breast often and massage the blocked area when breastfeeding or pumping. To soften the plug you may put olive oil on a cotton ball and use a nursing pad to hold this in place against your nipple.

If the previous steps do not help, take a warm bath with the affected breast submerged and massage behind the nipple and areola to try to loosen the plug. It may also help to gently rub the tip of your nipple with a wet wash cloth or other soft cloth. Next, firmly massage across the hardened area starting at your chest wall and working toward your nipple. Breastfeed or pump immediately after leaving the bath.

To prevent recurrence, consider changing your baby's position on the breast; insure that your bra fits well (no underwire); and that your purse, diaper bag and baby-wearing items are not digging into your breast, causing further blockage.

Milk Blisters

A milk blister results when skin grows across a nipple pore or opening and blocks it. The blister is usually raised with visible fluid below.

Treatment

Gently wash the nipple.

Very carefully with a gentle lifting motion, open the blister with a sterile needle to drain any trapped fluid. Consult your health care provider if you are nervous or need assistance.

Apply a small amount of Bacitracin to your nipple immediately after breaking the blister.

Until it is fully healed, keep the nipple tip moist with nipple ointment, such as Lansinoh. This may help prevent the blister from forming again.