Milk Blisters, Clogs and Mastitis, Oh My!

Before I ever breastfed, I knew that you should call a lactation consultant if your nipples were in pain or your baby didn’t latch. But I had never heard of a milk blister. Fast forward 8 years, and blebs are part of my daily vocabulary. I didn’t get them very often, but I do see them somewhat frequently. Those and other types of blockages in the milk ducts and breast aren’t emergencies, but they should be addressed.

What Are Blebs?

Blebs are milk blisters. They form when a pore on your nipple becomes blocked by an overgrown piece of skin. Because the milk can’t come out, it backs up behind it, forming what looks like a whitehead pimple.

If you have a bleb, it will look like a white, yellow or clear dot. These appear on the nipple or areola.

You know that it’s a bleb because you experience sharp pain on or behind the blister. If you press on your breasts, the milk blister usually protrudes.

Could a Milk Blister Be a Sign of a Clogged Duct?

Sometimes, the milk duct gets blocked internally from dried or fatty clumps of milk. If the milk plug occurs near the skin’s surface, it can resemble a bleb. The difference is that a superficial plug can usually be worked out. A milk blister doesn’t emerge with pressure.

Clogs that are deeper within the breast are harder to deal with. You can’t usually detect them by looking at your breasts, although they can create redness on the skin that overlies the affected area.

While a clogged duct won’t cause a milk blister, a milk blister could lead to clogged ducts. Therefore, it’s important to treat a bleb properly to prevent clogged ducts or, worse, mastitis.

How to Treat a Milk Blister

Blebs are notoriously hard to get rid of. I like soaking a cotton ball with olive oil and applying it on the affected nipple. Be sure to place a disposable nursing pad over it so you don't get oil on your bra. Keep that in place all day to soften the nipple skin. If you’re not persistent with your treatment, they can reoccur.

Follow the steps below for treating a bleb:

Saline soak your nipple. You can use a solution of 1 cup of water and 2 teaspoons Epsom salt. Soak your nipple in the solution for 2-5 minutes. Just make sure to wipe off the solution with plain water before feeding your baby.
Nurse your baby on the side with the bleb immediately after applying heat. You might try hand expressing first to break up any clogs or remove thickened milk from the duct before your baby latches on.
When the skin feels like it has softened, gently rub the bleb with a moist, clean washcloth. You can also try loosening the edge of the bleb with a clean, dry fingernail. This should remove the excess skin that covers the pore. You’ll have to do this frequently to prevent the skin from growing back.

How to Treat a Plugged Duct

If you have a deeper clog, you can treat it as follows:

Nurse frequently—keeping the milk moving is important.
Use ice packs before and after nursing. Ice helps with inflammation.
While you nurse, massage the area where the clog is. Direct your strokes toward the nipple.
Try hands-on pumping to fully empty your breast.
Try using gravity to help empty the breast: Get on your hands and knees and dangle your breasts over your baby while the little one is lying flat on the bed or floor.

Plugged ducts can lead to mastitis, which is an inflammation of the breast. While any of these conditions can be painful, mastitis is usually the most uncomfortable. When you have mastitis, you may feel like you have the flu.

Latching problems, inadequate milk removal, hurried feedings, an oversupply and using nipple shields can contribute to blebs and clogged ducts. Therefore, working with an IBCLC if you have any breastfeeding issues can prevent these conditions from occurring. If you’re not sure why you’re

getting persistent blebs or clogs, contact me for an assessment. Let’s get to the bottom of this so that you’re not in pain and can continue with a beautiful breastfeeding relationship.

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