>Yesterday I saw a woman who was breastfeeding uneventfully for 4 months,
>until 3 weeks ago developed a milk blister or "milk under the skin" on one
>nipple. She had a painful blocked duct and so went back to her local
>maternity unit where a midwife used a sterile needle to open the offending
>spot on the nipple. The blockage did not clear spontaneously, but she went
>home and kept feeding and the blockage cleared.
>One week later the process was repeated. And since then she has removed the
>tiny piece of skin herself every 2 days (she ran out of needles given to her
>from the hospital and has started using "horse" needles!).
>Anyway she wanted me to "Fix the problem for good". However, when I saw her
>the spot was tiny and there was no blockage, so I was reluctant to do
>anything. Should I have tried to remove it? Robyn Noble in Breastfeeding
>Review, July 1991, p118 says "In some cass *complete* removal of this
>overgrowth is needed to discourage reoccurence of this condition".
>Does anyone have any other suggestions?
>Thanks,
>Lisa Amir
>GP / LC in Melbourne, Australia

Lisa:  I saw a woman yesterday who it seemed was describing a milk blister
but nothing was apparent or remarkable on examination.  Did your patient's
milk blister look like a milk blister or like nothing at all?  I am trying
to decide whether to take the chance of trying to remove my patient's milk
blister, to refer her to an MD with no knowledge of milk blisters, or to
wait and see.  Does the article you mentioned by Robyn Noble have a
description which matches what I'm seeing?

Arly                [log in to unmask]
MS, CLE, IBCLC