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