Anne Andrianos writes: "In my experience, milk blisters are closely linked
with an obstruction or milk plug of some sort....Warm (NOT HOT) wet
compresses to the nipple help. Frequent nursing, careful positioning,
sometimes additional pumping to completely drain
the breast  and remove the obstruction  is essential."

The situation about which WInnie posted involved a mother nursing twins
(right, or is my brain addled by a build-up of toxins?), and Anne's response
is entirely consistent with my own experience of nursing twins, as well as
my professional observations. I had a real tendency to plugged ducts all the
while I was nsg. my twins - they were big nursers, and I had a really good
supply, and it was being constantly stimulated by so much nursing. Which is
how it's supposed to work, but I always was right on the edge of having
obstructed areas, mild engorgement, blebs, even mastitis, etc. I didn't know
beans about BFing then, but I found exactly the measures that Anne mentions
above kept it all manageable. ANY lengthening of the time between feeds, a
baby that fell asleep on the job, anything that interfered with very
complete and frequent drainage would cause these things to flare up.

The good news is, out of unenlightened but fortuitous self-interest, those
were well-fed babes!

Cathy Bargar RN IBCLC Ithaca NY

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