Norma, We have an epidemic of late onset persistantly sore---rather,
MISERABLE---nipples in our town! Aargh! I have noticed many cases of
milk blisters, AKA milk blebs, which are causing basically the same
constellation of symptoms as ductal yeast---shooting pain, aching
after nursing, pain during nursing even with good latch, red but not
awful looking nipples, except for the small white or yellow "spots" on
the nipples. Today I saw one mom of a newborn at home and talked to
the mom of a toddler on the phone, both very committed to nursing
their babies, and both ready to quit because of the pain of milk
blisters/plugged ducts! Another mom, a doctor's wife, thought she
might have yeast because of the persistant pain. She mentioned
"spots", and I took Riordan and Auerbach's book with the photos in the
front cover to show her. The mom said, "Yup! that's me!" (Not yeast,
but milk blisters, with the shooting pains, pain between feeds, aching
after feeds, etc.) I recently worked with a woman (baby 9 months old,
onset of soreness at 2 months, worsening with time, despite treatment)
who was determined to nurse, but the severe pain was wearing her down.
Latch and milk supply good. Mom alternating between lansinoh and
steroids on nipples, s/p treatment for yeast. She was so miserable.
Family Practice and OB docs had not been helpful. The dermatologist
had told her to wean! (We had explored the ideas of eczema and
psoriasis.)  While going over her history yet again so I could post to
lactnet and get help from my LLL APL she mentioned the white spots.
AHA! So I explained the treatment for milk blisters, which she
followed to the letter. In four days she felt "much better". In ten
days she was "85% better" and smiling. Now the mom and baby are happy
campers! (Baby has many food allergies so they were working on those,
too.)  I recognize the symptoms and natural history of these problems
because I had them myself, lo those many years ago! Norma, maybe the
yeast is gone, but a few ducts are covered by epithelium which has
"lost its way". Just a thought.
Regards, Rowena Tucker PA,LLLL,IBCLC
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