Mary,  Do a lactnet search on "bleb" and you will get quite a few posts on
this topic.  I'm wondering if that is not what your daughter is suffering
from.   These are dryer than normal milk secretions that fill the duct and
seem to be visable from the nipple pore as a white spot, bulge or dry
matter.   They are sometimes hand expressed out, worked loose with streches
of the nipple face in opposite directions, soaked loose with warm water
(plain, saline or with epsom salts.  They tend to reoccur and respond well
to local antibiotic ointments.  Sometimes they are lanced, poked with a
needle or have the surface rubbed off with a cloth or maternal finger.  Lots
of stuff out there, little consensus.  I've had best luck cleaning nipple
with alcohol, lancing with a sterile needle, removing loose dead blister
like skin, hand expressing thickened milk secretions, pumping and/or nursing
and following up with an antibiotic ointment while healing.  Some of this is
"out of the range of LC normal practice" but in the range of RN/MD practice
with whom I've consulted or sent mom to.   The antibiotic locally was the
thing that stopped the constant reoccurances that my last client with this
suffered from.   A breastfeeding friendly dermotologist is a good referral
if you aren't comfortable with this.   This is the specialist type that
started my last client on antibiotic after we did several lancings and it
kept reoccuring.  I'm seeing more and more common sense recommendations for
topical antibiotic on nipples that won't heal.  Also a daily bit of soap and
water washing might help keep bacterial counts down although this flys in
the face of our LC mythology that nipples and soap shall never meet.  Dr.
Jack says no need to rinse off his APNO  as the amount absorbed is minimal.
APNO might be even better than plain anitibiotic ointment/cream.  I think
the reoccurance if there is an infection is because of inflamation.   I
agree with the use of lethicin for prevention of reoccurances too.  If not
familiar with APNO do a search on that too, it is an antibiotic,
antiinflamatory and anti yeast combo.   See Dr. Jack's web pages on
www.bflrc.com.

Sorry for typos and poor formatting.  I'm working on a very old and
uncomfortable computer while mine is being repaired and I can't figure out
spell check or expand the windows or go up or down to check what I've
written.  YUK!!

Carla

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html