Dealing With Blebs

A bleb is a white spot on your nipple that looks as if milk has collected in a small blister under a thin layer of skin.  It is often, but not always, associated with a plugged duct higher up in your breast.  We don’t really know what causes blebs, so there are lots of ideas about how to resolve or prevent them.  Usually, when the bleb disappears, the plugged area of your breast softens rapidly.  The material in the bleb may come out like toothpaste or spaghetti, it may have hardened into tiny granules that you can feel between your fingers as they come out, or you may simply find that the pain, bleb, and plug disappear during a particular nursing.

The ideas listed here on dealing with blebs and their associated plugged ducts are from breastfeeding specialists in several countries.  Perhaps some of them will fit your situation.  The ideas in bold may be especially helpful suggestions.

Nursing ideas

• Nurse as often as possible, keeping that breast as soft as possible.
  
• Lay your baby on his back on the floor or bed, perhaps on a folded blanket so that the back of his head can drop off the edge and he can lie with his face toward the ceiling.  Loom over him on your hands and knees so that your breast dangles, and nurse in that position.
• Nurse your baby with his chin pointed in the direction of the plug.

Manual ideas

• Use hand expression and gentle nipple manipulation to work the bleb out.
• After showering or soaking, gently rub the surface of the nipple to release the bleb.
• Using a sterilized needle, gently lift and open the skin over the bleb, teasing away a bit of skin with tweezers if needed.  Apply a topical antibiotic several times a day after nursing, for several days.  Some mothers prefer to have a physician open the bleb, others prefer to be in control of the needle themselves.  It’s similar to pricking a heel blister. 
• Apply positive pressure behind the nipple, or perhaps behind the plugged duct itself, along with gentle massage and manipulation of the nipple.

Ointment/lotion ideas

• Rub a small amount of topical antibiotic like bactroban or polysporin on your nipple after nursing, especially for a day or two after the bleb disappears or opens.
• Apply calendula oil after nursing, several times a day.
• Use a mixture of olive oil and a couple drops of grapefruit seed extract (GSE) or citrus seed extract to massage the breast, areola, and nipple.
• Use Jack Newman’s recipe for All-Purpose nipple Ointment (APNO).
• To prevent recurrences, spray the breast and nipple with a dilute acidified solution (1/4 cup vinegar in 2 cups water with 5 drops GSE) after showering.

Soaking ideas

• Olive oil on a cotton ball over your nipple inside a bra
• Vinegar (which dissolves calcium deposits), or diluted vinegar on a breast pad
• Epsom salts (2 teaspoons in a cup of warm water) 4 times per day
• Warm, moist compresses

Breast ideas

• Stop wearing a bra.
• Stop wearing an underwire bra.
• See a physiotherapist for ultrasound treatment of the breast.  According to some Australian breastfeeding specialists, one treatment is usually adequate.  Not commonly tried in the US.
• Use a vibrator on the plugged area.  Some possible substitutes for a vibrator: an electric razor, or leaning against a washing machine during the spin cycle.
• Lay cabbage leaves or raw potato slices over any area of engorgement.
• Wear a bra with push-up pads to reduce pressure points on ducts.

Diet ideas

• Increase fluids.
• Avoid some or all of the following, especially the ones that you normally tend to overdo: dairy products, sugar, peanuts, chocolate, fats (especially saturated fats), caffeine, antiperspirants, decaffeinated products.
• Increase salt.  If you already use “too much” salt, try decreasing it.
• Increase immune system boosters like vitamin C.
• Take one tablespoon of lecithin daily (available at health, drug, and vitamin stores).

Other ideas

• Take ibuprofen to reduce inflammation.
• Check for anemia, and treat if necessary.
• Be tested for Herpes simplex, which can cause nipple blisters.
• Decrease stress.
• Call a breastfeeding specialist for help.  Why go it alone?
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For additional ideas, check kellymom.

©2006 Diane Wiessinger, MS, IBCLC    www.normalfed.com