Peg writes about a mom with a persistently blocked nipple pore.  She's tried
opening it herself with a needle to no avail.  A surgeon can lance such
blockages with a very sharp needle.  This usually works.  You do have to
keep it clean (gentle daily cleansing in shower with mild soap) and dip and
rinse with normal saline solution after nursing/pumping to keep it from
getting infected.  Topical abx and lanolin to prevent scab formation will
also improve healing.  It's sore afterwards, but this has helped several
moms I've worked with who couldn't keep a bleb from reforming.  My theory is
that the blebs are caluses that form when sub-optimal positioning creates
chronic nipple trauma.  The skin lays down extra layers to protect itself.
If the calus forms over a milk pore opening, the trapped milk underneath
shows white, and then hardens as it dries out, causing the plug under the
dried blister of the calus.  So keeping the nipple skin supple helps (I soak
a cotton ball in olive oil and have mom apply heat over the cotton ball so
the oil is real well absorbed).  Then have her try to peel off the calus and
then keep it clean as above.  It really helps to watch the positioning and
latch.  These older babies can be tough on nipples.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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