Bettina, You wrote:
<Through the pregnancy she has developed about 12 milk blisters (or so
they appear) that are not painful and are clustered on
each of her nipples.  After a hot shower she can pick them off, but they
recur.  She has no breast tenderness or lumpiness and has not noticed
leaking.  When she tried to hand express they came out a bit and
probably could have been plucked off like little plugs.  Anyone seen
this?>

Have you yourself inspected the nipples, or is this choice of words the
mother's description? I have pictures of a mom who by 28 weeks gestation,
when we did a routine nipple assessment, had a buildup of little,
somewhat shiny mounds of keratin just on the face of the nipple in a
circle area about 3/8 " in diameter. She had not "picked" them off per
se.

But to avoid any adverse reactions on the part of hospital personnel when
it was time to put the baby to breast, we had her soak them at bath time
and remove some of the waterlogged material with a q-tip for microscopic
identification by a pathologist. We had her gently towel the nipples just
as she would her back or other body area, and put a lanolin preparation
on after each bath, and within a month, they were all cleared away.

Some references say that the nipple pores before delivery are occluded
with a mixture of sloughed off epithelial cells and dried colostrum,
which eventually gets moistened and goes into baby as part of early
feedings.

I would recommend that whatever the nature of this, that she be
discouraged from picking them off for fear of damaging the skin barrier
and risking introduction of germs capable of producing mastitis. I have
seen mastitis occur during pregnancy.

Jean
**********************************************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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