Have you done a suck assessment on the baby?  Have you checked for some
type of frenulum?  Maybe the baby is compressing the tip of the nipple
at the end of the suck and causing a "callus" or a vasoconstriction and
vasodilation effect?  

-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]] On Behalf Of Shaya & Jessica
Billowitz
Sent: Wednesday, September 03, 2008 3:02 PM
Subject: Nipple bleb with complications

I am hoping someone can help.  I have 2 moms in a similar situation.
Mom A has a 6 week old baby who is gaining beautifully.  She has
excruciating stabbing pain AFTER she nurses, sometimes starting 1/2 an
hour later.  It is so bad she is ready to give up.  She does not have
pain while she nurses, and it is only on one side.  She has nursed 4
other children with no problems.  Basically when I saw her, she did not
have one specific white dot like a typical bleb, but a cluster of white
on about 1/4 of the nipple.  You do not feel any clogs in the breast.  I
had sent her to a dermatologist, who tried to pop with no success.  I
had recommended olive oil, and gently trying to rub with a washcloth, in
addition to Dr. trying with needle.  I also told her to take Lecithin.
Nothing has helped.  What now?
Mom B has exact same symptoms.  Her baby is 8 weeks, also gaining very
well, also terrible pain only on one side, and also only after nursing.
Latch fine.  She said she had a bleb although she did not know what it
was. Now there is no visible bleb, and I do not feel any plug of any
duct in the breast.  She does not get the terrible pain after pumping
for some reason.
I am really stumped as to how to precede on these.  We have ruled out
latch or positioning, thrush, etc.  What now?  They are both suffering
terribly.
Thanks,
Jessica Billowitz, IBCLC
Israel 

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email:
set lactnet nomail 2. To start it again: set lactnet mail 3. To
unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules
and directions: get lactnet welcome

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome