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. Yeast was ruled out as well as vasospasm.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 needs 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 for 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 my moms the help they need and not give up their breastfeeding. Thanks,
Molly Shakar RN. IBCLC




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