Joanna, you stated in your post that mom has a white spot on nipple tip after 
nursing or pumping.  I would suggest she follow treatment guidelines for a 
nipple bleb.  Soaking her nipple in a cup of chamomille tea (warm, not hot, 
obviously) or salt water (1/4 teas in cup of warm water) before breastfeeding or 
pumping several times per day (at least 4).  She could isolate the white spot 
and gently abrade with a washcloth or her fingernail to try to open it, and if 
that doesn't work or is too painful, have her doc open bleb with a sterile 
needle.  Application of Jack's APNO or similar antibiotic/antfungal ointment with 
hydrocortisone ointment is necessary to prevent infection and reduce 
inflammation once her nipple bleb is open; this can also help it from closing up 
again.  She could also take ibuprofen for the pain and inflammation.  It may take 
several "openings" to treat.

Awhile ago worked with mom with similar bleb who followed these steps and 
finally relieved the bleb and pain; it did take over a week if I recall.  It 
would get better and then return.

Barbara Latterner, BSN, RN, IBCLC

~Mom states that after pumping or breastfeeding she will see a 1-2mm white 
spot appear on nipple tip.  Disappears soon after.  Problem started about 2 
months ago.  Now complicated by persistent plugged duct same breast - presumably 
blockage is
in nipple.  ~






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