Dear Molly, my goodness.
Firstly, there are two basic suggestions on this type of situation. I
always look in my tried and true resources, such as The Breastfeeding
Answer Book, by Stock and our own Nancy Morhbacher. This is the bible,
as far as I am concerned, and we all should own a copy. It is wonderful.
:)
This situation is getting overly complicated when in fact it is really
not. I would suggest going back to basics here. The layer of skin on
top of this area needs to be warmed with wet heat and then removed, ie
peeled away. THEN she can get into a really warm bathtub, and hang her
breast down into the water, expressing milk into the water...and
massaging firmly downward. Probably a plug of toothpaste like material
will come out. I would then recommend Jack Newman MD's nipple ointment
APNO (see www.breastfeedingonline.com) to kill off infection, etc. Does
she have signs of yeast anywhere else? Vaginally? Burning pain in
between feedings? Have the baby NURSE a lot on it after that. I believe
that Nancy Morhbacher's and Julie Stock's Breastfeeding Answer Book has
a treatment plan on this. pp. 484-485. A text I would not be without. :
) They discuss soaking in warm water and then peeling away that first
layer of skin... Or soaking it with a cotton ball soaked in olive oil.
Once the blister is opened, was the nipple with mild soap and rinse well
once a day to prevent infection. Do not use antibacterial soap, as they
usually are strongly scented. (BFAB). She can then also put a thin layer
of a topical antibiotic ointment such as Bactroban or Polysporin to her
nipples after feedings alternating with purified lanolin. I like the
APNO ointment by Newman though. She needs to be checked thoroughly for
yeast/thrush, in any case, and the latch needs to be perfected so that
the baby empties the breast thoroughly. Fixing the latch is always the
first line of defense.
See the FAQ on Blebs at www.medela.com.
This is a clear case of forgetting the simple arts. Dye studies are
OUT.
Kathleen
Kathleen Bruce RN IBCLC
Independent consultant: Breastfeeding Clinic of Vermont, Lactation
Resources of Vermont, Medela, Inc.
Listowner Lactnet listserv
[log in to unmask]
Archives: http://peach.ease.lsoft.com/archives/lactnet.html
-----Original Message-----
From: Molly Shakar [mailto:[log in to unmask]]
Sent: Saturday, October 09, 2004 11:18 PM
To: [log in to unmask]
Subject: milk blister
I am hoping someone can give me some advice as I am very frustrated and
don't know what to do next for this mother.
She presented to me with a sore nipple about 3 weeks ago. After nursing
she had a "white blister at the end of her nipple with a good amount of
pain."She was in so much pain she had taken the baby off the one breast
and pumped for two weeks to see if the pain went away, which it did. I
told her what I thought it appeared to be a milk blister, encouraged her
to put warm compresses on and try to break it open by nursing, etc. It
did get a little better, but never totally resolved.
Again, she came to me this week and said it had never gone away and the
pain is hard to deal with. I referred her to her OB to talk to him
about lancing as it never resolved with compresses, etc.
She called me today in tears because she went to her OB who said he
thought that it was indeed a milk blister, but he had never lanced one
before. He sent her to a surgeon. The surgeon said he didn't know what
it was. He felt it wasn't a plug because he didn't feel anything hard
behind the nipple. He told her to just pump for 2 weeks and see what
would happen. She told him she had already tried that and it didn't go
away. He now wants to inject it with dye and see what if it might be- a
plug or something else. She spent $200 on co-pays yesterday and didn't
get any answers to her problem. She is very frustrated, upset and in
pain. I have had moms in the past presenting with the same symptoms and
after trying to work it out themselves sent them to their primary and
had the milk blisters lanced and had great results and relief of their
symptoms.
Am I off base with this problem? Is the surgeon going overboard with
wanting to inject with dye to study it? Could it be anything else? She
now wants to go to someone else to have them do something for her and
wants my advice. I don't know who else to send her to. She is now
pumping the affected side to get some relief from the pain.
I told her I would ask the wonderful professionals of Lactnet advice
because I am at a loss on what to do to help her with this pain. Any
advice?
I so appreciate all of you out there working so hard to help these moms.
Sometimes it feels like such a uphill battle to get them the right
advice.
Thanks,
Molly Shakar RN. IBCLC
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
