great round-up article on sore nipples by Marsha Walker, in USLCA's always-useful "Clinical Lactation" (available in print and on-line free to members -- so join if you're not already)
http://www.ingentaconnect.com/search/article?option2=author&value2=Marsha+Walker&pageSize=10&index=1
referenced some research on blebs, with someone analyzing punch-biopsy samples, finding milk solids and inflammatory cells, suggesting that blebs are an inflammatory response, and so may respond to a topical anti-inflammatory. People have pondered whether yeast might be a factor, but there wasn't any evidence of yeast. (Poor yeast! It used to be the cause of everything that made breasts unhappy, but now it's not a star anymore!)
A pediatrician might appreciate your sharing the original research paper. Perhaps the repeated opening with a needle is adding to the insult that the body is mounting the inflammatory defense against.
Often a contributing factor is a baby doing something tight and pinching, stressing the nipple-face with creasing. The "fit" between mother and baby keeps changing, and a big six-month-old, can end up nursing with the chin tucked down, hanging on the end of the nipple. So sometimes it helps to revisit helping the baby get more of a mouthful, moving the baby down toward his/her feet, to get them to reach up toward the breast, and engage that lower jaw, up and in.
Sometimes as a bleb resolves, even though a mother is kind of tired of messing with her breast, it helps to encourage her to stay in "preventative maintenance" mode for a while afterward, with the warm soaks, the oil-soaked cotton ball, and a gentle exfoliation in the shower with a washcloth, to keep it from re-forming.
How wonderful to have a pediatrician with this kind of in-the-trenches understanding and devotion to breastfeeding!
Margaret Wills, IBCLC, Maryland, USA
> Date: Tue, 29 Sep 2015 13:10:54 -0500
> From: "Cecena, Mary, M" <[log in to unmask]>
> Subject: recurring blebs
>
> A pediatrician I work with asked me for help on recurring blebs.
> She is nursing her 4th child (nursed twins for a year) and baby is now about 6 months old.
> She said that for the last 2 -3 months she gets a bleb on one breast "like clockwork every two weeks" is how she described it.
> The bleb causes pain while nursing, and she has read about it, has done the olive oil soak, and warm soaks, always has to resort to using a sterile needle to open.
> I read something last week about dosing with Lecithin, she said she would try that.
> Anyone have experience with blebs that recur like this?
>
>
> Mary Ceceņa, M. A., IBCLC
> Children's Mercy Hospital
> Kansas City, Missouri
>
>
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