What is a milk blister?
A milk blister, or blocked nipple pore, happens when a tiny bit of skin overgrows and clogs a milk duct opening causing milk to back up It usually shows up as a painful white, clear or yellow dot on the nipple or areola, and the pain tends to be focused at that spot and just behind it. If you compress the breast /chest so that milk is forced down the ducts, the blister will typically bulge outward. Milk blisters can be persistent and very painful during feeding/pumping and may remain for several days or weeks and then spontaneously heal when the skin peels away from the affected area. This type of milk blister often pops out from the pressure of nursing or milk expression but oftentimes it has to be gently exfoliated from the surface of the milk duct because of the pain it causes.
A second type of milk blister appearing as a white spot on the nipple may be caused by a blockage within the milk duct, as opposed to the skin covering the milk duct. The blockage is typically due to inflammation that causes constriction on the duct and can feel like “hardened” milk. The inflammation is almost always brought on by a change in milk removal intervals or duration. This type of occurrence requires a cold compress for ten minutes after every milk removal session to resolve the inflammation and in some more advanced cases it may additionally require taking an anti-inflammatory. This is NOT a prescription to take an anti-inflammatory. This and all the content on this post, our blog, and our website is educational. You must consult with your healthcare provider before taking any OTC, supplement or medication. This type of milk blister can also, at times, be caused by a “string” of fattier, semi-solidified milk but the cause is more likely to be inflammation. This second type caused by a string of fattier milk can often times be manually expressed from the milk duct. If you have recurring clogs due to fattier milk, reducing saturated fats can help to prevent the recurrence of this type of obstruction.
Both of these types of milk duct obstructions are associated with recurrent mastitis.
A completely different type of blister is caused by friction from a baby’s improper latch or from the use of an ill-fitting nipple shield or flange. This is NOT the same as a blister on the nipple caused by friction. This type of blister may sometimes be red or brown, or a “blood blister.” For this type of blister, the problem is nipple damage due to friction, rather than a milk duct opening being blocked due to inflammation and requires correcting an ineffective latch and or proper flange fitting.
Treatment for Milk Blisters Caused by Obstructed Ducts
Feed first on the side with the milk blister.
Three to four times per day, do a saline soak prior to direct feeding or pumping. Dissolve about one and a half to two teaspoons of epsom salt into one cup of warm water. You can use a bowl or a silicone pump like the Haakaa. Submerge your affected nipple(s) into the water for about 8 to 10 minutes. This soak helps to open the milk duct and can also aid healing.
In the shower after allowing warm water to run over your chest/breasts for a few minutes, gently rub the blister area with a moist washcloth in a circular motion in both directions to help exfoliate the blockage.
If the blister is caused by a clogged duct due to inflammation, you must apply a cold compress for 10 minutes after every milk removal session and if needed consider taking an anti-inflammatory until the clog is resolved. This is NOT a prescription. This is solely educational. You MUST consult with your licensed medical provider before taking any supplement, OTC or other medication.
If after several days of consistently doing the previously noted steps, the blister does not resolve or if at any point it becomes painful, ask your licensed medical provider to treat it by puncture and aspiration. Do NOT do this on your own, there is a much greater risk of infection if you do it yourself. A sterile needle MUST be used, and be sure to discuss with your healthcare provider using an antibiotic ointment after direct feeding or pumping to prevent infection.
You can continue gently exfoliating in the shower a once a week after the bleb resolves, to prevent a recurrence. Make sure to be gentle with any exfoliation.
If you experience pain from the blister or bleb, you can, after direct feeding or pumping, apply expressed breastmilk, an organic, natural nipple ointment, or a hydrogel pad Ilke Lansinoh’ Soothies or Medela) to the nipples to promote healing.
Between feedings, you can use a cold compress and or pain relievers, as needed. This is NOT a prescription. This is solely educational. You MUST consult with your licensed medical provider before taking any supplement, OTC or other medication.
Wearing breast shells, which will relieve the pressure from clothing, can also help with any pain or discomfort in between pumping and or feeding sessions.
If the blister is caused by friction, in order to avoid future recurrences you must address latch and or flange fitting.
Recurring Milk Blisters
To avoid recurrence, it is important to treat the underlying cause of the milk blister so make sure that you work with an IBCLC to help you optimize latch depth and to help you figure out the best fitting flange.
New research illustrates that you should not use heat nor lecithin, of any kind, to treat inflammation.
Call your doctor if you experience a fever, inflammation (swelling), redness, oozing, pus, or any other significant symptoms.
Disclaimer
The Lactation Place does not dispense medical advice nor prescribe the use of any technique as a form of treatment for physical, emotional or medical problems without the advice of a physician, either directly or indirectly. In the event that you use any of the information provided to you, The Lactation Place and all of its representatives and employees assume no responsibility for your choices.
About The Author
Rebeca Four has been helping parents meet their infant feeding goals for 16 years by providing education and support to families in Northern New Jersey and NYC as a lactation care consultant. She is a go-to lactation trainer for healthcare professionals like WIC of Hudson County, nurse-family partnership programs, and community doula programs. She works with clients in her private practice—both in-person and virtually.
