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Nipple blebs are basically milk blisters which form when milk gets trapped under a layer of skin. It can happen when your skin grows over a milk duct opening and forms a seal that keeps the milk from draining out.
The blisters look like a whitehead pimple on the nipple area (like this). Since the milk is trapped in that area, it will cause a sharp pain stabbing pain in that area. The milk will eventually cause swelling and firmness and ultimately mastitis unless you unclog the blister and relieve the pressure.
You will need to take action to unclog the blockage. When they are left alone, milk blisters can take days to weeks to heal on their own. Until you remove the skin covering the blister, it will hurt every time you nurse or pump.
Do not confuse nipple blebs with blisters caused by friction from improper latching or thrush. Nipple blebs usually only form on one breast and it is clear that there is milk backed up in that area of your breast when you press down with your fingers.
In the case of friction blisters, the inside will be filled with clear fluid or blood. You will need to cease nursing or pumping until the blister is healed or you will risk damage to your nipple area.
In the case of thrush which is a yeast infection, you will have multiple yellowish-white blisters on both of your breasts. Please see your doctor for antifungals as soon as possible as thrush can be spread to your baby’s mouth and throat.
The formation of skin that causes nipple blebs is similar to the cause of clogged pores in acne and keratosis pilaris. Some women are just prone to skin overgrowth and have trouble shedding their top layer of skin.
Just as with acne, the buildup of milk inside the duct leads to inflammation and infection.
Some known triggers that cause milk blisters are tight bras or pressure on the breast, milk oversupply, and inadequate milk removal and drainage of your breast during feeding.
Don’t pop it! OUCH!!!!
Use heat and steam to soften and loosen the skin. A towel soaked in hot epsom salt water (2 tsp epsom salts to 1 cup water) works well. The epsom salts will soften your skin and help it fall off.
Try to wipe the skin off with the towel, or gently (gently!) loosen the skin with your nails.
Then nurse your baby or use a pump to see if you can drain the milk out.
If this fails, repeat the process again at the next feeding. You might need to do this for a couple days, but the skin will eventually peel away.
If your skin gets dry between feedings, use olive oil or a nipple balm to keep the skin soft and supple. You do not want your skin to dry too much as dry skin turns tough and hard, making it even more difficult to get rid of the layer of skin over your blister.
If you succeed in getting the skin off, make sure you apply some neosporin (or other antibiotic cream) to the wound after you’re finished nursing. The drained blister is still an open wound and it is prone to infection because of the moist environment caused by your milk and your baby’s mouth.
You might notice that the milk you get after you drain the blister is thick and stringy. This is due to the milk being backed up in your breast for so long.
While the stringy and lumpy milk might look gross, it’s not going to harm your baby.
Some moms will still prefer to strain out these lumps before feeding.
Once the blister is drained, your wound should heal within a couple days.
The important part is to drain the blister without causing any more pain or introducing an infection. Aftercare is very very important as you’ll have an open wound in your nipple while you continue to nurse and pump.
If you get a lot of nipple blebs, then you may need to take some supplements to thin out your milk and soften your skin. Lecithin is known to thin out breastmilk and omega 3 fatty acids are good ways to soften your skin.
Some people report success with vitamin E supplements, but use these sparingly as too much vitamin E will end up in your breastmilk and this can be toxic to your baby.
You can also try massaging your breasts with oil everyday. The massage will help clear out your blocked ducts and the oil will keep your skin soft and moisturized.
You can try to exfoliate and soften your skin with daily epsom salt soaks (2 tsp epsom salts to 1 cup warm water). Use a wash basin and dip your breasts in for 10-15 minutes.
Minimize pressure against your breasts. That means a properly fitted nursing bra (or no bra at all!).
If your nipples hurt from current blisters or healing blisters, use breast shells to provide a layer of protection against rubbing and friction against your clothes.
Keep your breasts and nipples dry when you are not nursing. Be sure to wipe your nipple area well after nursing or pumping and use a nipple cream to protect your wounds.
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