I am sure the more experienced will chime in on this, but I want to share my 2 cents too. 

I have had a number of moms who go on to develop what seems to be a deep breast infection following a blister, esp when the blisters come repeatedly. 

I would talk with the mother about having the blister and the milk cultured and perhaps the baby too - in most of the cases with this scenarion that I have followed it was the baby who had staph in his nasopharynx. Our doctor's explanation is that when the blister pops open it is an open door for the bacteria in baby's nasopharynx to invade the breast and that's why mom's milk and the culture from the blister come up with the staph too. 

Topical mupirocin did the trick for some of the moms but quite a lot of them required an antibiotic treatment (at least 10 days) after everything else failed to help. Some required a candida treatment too. For one of the moms who has had very persistent pain for about 2 months 2 rounds of physioterapy (ultrasound), 5 days each, after the antibiotics helped to clear it in the end. I am not sure this is evidence-based, but it was what the doctor suggested and mom feels it really helped her.

I would be very interested in alternative ways to manage this - I really don't like antibiotic treatment all that much, but the other natural suggestions such as grapefruit seed extract and lactobacilli did not help these moms.

Christina Yaneva
BF Peer Councellor
Bulgaria


--- On Mon, 2/8/10, Mary Ryngaert <[log in to unmask]> wrote:

> From: Mary Ryngaert <[log in to unmask]>
> Subject: Nipple bleb and shooting pain
> To: [log in to unmask]
> Date: Monday, February 8, 2010, 5:07 PM
> Hello all,
> 
> Delurking to ask a question for a patient.  I do have
> permission to post.  Mom is a 31 year old physician
> with history of white nipple bleb for the past 2-3
> weeks.  It seemed to drain last weekend, but that was
> followed by severe shooting pains in the breast.  Heat
> and ibuprofen were only slightly helpful, but now pain and
> nipple bleb are back and this lady is understandably very
> frustrated.  She has been on lecithin for 2 weeks
> now.  This is her second baby.  She was born in
> September and is nursing and growing well.  She did
> have a clogged duct in December that seemed to precipitate
> this issue.
> 
> What now?  Is this developing into a mastitis? 
> She has no fever or malaise.  
> 
> Thanks,
> 
> Mary Ryngaert, ARNP IBCLC
> UF Breastfeeding Clinic
> 
>          
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