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!