Okay…need to get this off my chest: *&^&%#$%#%^%^&&**)()_)_*(^^&$%@#$@$##$%

 

Thank you.

 

Now then, client has developed a blood blister on the face of the nipple,
between centre and 2/3 o’clock.  It’s about 1/8th of the size of mom’s
nipple.  

 

I know via oral exam of 9 pound baby that baby has a VERY strong suck.  I’m
talking VERY strong.  

 

Mom and baby were breastfeeding fairly well (36 hours post partum) up to
this point, with some challenges latching, but no major concerns.  LC in
hospital was with mom, mom latched but told LC that it hurt and felt
‘pinched’.  LC commented that latch looked good and encouraged the mom to
continue with the feed anyway, even though mom still complained of pain.
When the feed was done, there was a fairly large blood blister on mom
nipple, and mom was in pain.

 

I attended mom about 4 hours post this occurance.  She had just fed on the
affected side again, with some discomfort, and more swelling of the blister.
We applied a warm compress, which mom said felt good.  I did observe that
the blister became a little bit smaller in the hour post feed, but was still
very obvious.  At times during my visit, mom complained of minor pain on
that side.  I hand expressed for her (both sides) – mom felt a little bit of
pain or irritation when I hand expressed on the affected side.

 

I examined the nipple thoroughly.  The blister is a true bubble, not just a
smooth raised area.  My guess is that baby did NOT have the tissue in her
mouth far enough (pinched feeling that mom talked about), and so was causing
friction on the face of the nipple, stretching some of the skin on the
nipple.  Not breaking the latch at this time caused baby’s very strong suck
to break a capillary at the same time as stretching the skin, and milk
flowed into the newly formed blister.  

 

I suggested to mom that the blister may have to be popped.  She informed me
that hospital LC told her not to pop it.  I will admit to not ever having
this happen with a client before, but I do know that blebs are often popped
(under sterile conditions, of course), and my feeling was that this was more
like a bleb.  It looks like a bleb, only filled with milk.  My feeling was
that if it is not popped, and the blood does not dissipate, it will just
cause the mother more pain and/or get worse.  I did tell her that the baby
might pop it when nursing, and she could help that by using a warm compress
before feeds…but…I dunno…I’m just the private practice LC…who am I to say?
What do you all think?

 

Blessings.

 

Karyn-grace Clarke, IBCLC, LLLL

Gulf Islands, BC, Canada


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