Hi all
Very envious of all you lucky ones attending LLLI or ILCA conferences, just
too far for me to go from Australia  :(
Plugged ducts, especially with a white spot on the nipple, are fairly well
recognised in Australia, at least amongst NMAA Counsellors. They were
described very well in Maureen Minchin's Book 'Breastfeeding Matters',
where both plugs or strings of a 'fatty material' have been expressed from
the offending duct (and often seen as a white spot on the nipple), and
in other cases a small white 'blister' is seen, which if popped with a
sterile needle allows rapid resolution of the blockage. Sometimes there
seems to be recurrence of these problems, either due to the amount of
saturated fats in the mothers diet (i'm not a dietician, on shaky ground
here), and I have also heard of lecithin as a treatment in these cases.
With the nipple 'blister' it seems as though skin grows over one duct
opening. Sometimes changing feeding position can help this, in other cases
*gently* rubbing the surface of the nipple with a soft cloth will brush off
any excess skin before it has a chance to build up.

Fiona Coombes
NMAA Breastfeeding Counsellor
Family Physician, IBCLC
Mum to Rowan 7, Cameron 4, Linley 20 months, no pets, and one very
tolerant partner!