Brenda, You may have already heard about this, but I will send it just in case you haven't. 
For some reason we don't know, the body decided to grow skin over a nipple pore. Also, for some reason, that is VERY irritating to the nipple pore! The ones I've seen look like tiny, swollen  donuts. The history of the literature of recommendations is as follows:
First, people recommended to use a warm compress on the affected breast then nurse the baby and all would be well. Nope.
Then, some said to use mild abrasion with a washcloth to open the pores. Nope again.
Then the recommendation was to go to the doctor and ask him/her to lift the top off of the blister. Many doctors would not do it, and many moms would not ask. This is from my own wexperience and that of  the moms I've counselled with milk blisters: They do not go away without strict, daily attention for about *three* weeks. Mom can sterilize a needle, cool it, and lift the top skin off the blister herself, from the side, with no pain. The skin must *not* be pulled off, but it may be trimmed off with the sterilized tip of a pair of cuticle scissors. If the skin is not trimmed off, mom must be prepared to lift the skin before nursings, and then after nursing, apply a barrier ointment such as lanolin or triple antibiotic ointment (no neosporin), to keep the skin frm reattaching where it was before. The mom may want to consider Dr. Ruth Lawrence's recommendation about taking lecithin; I found sunflower seed lecithen instead of soy. The mom may need to take skin health-supporting supplements such as vitamin A (or better, beta carotene-containing veggies), vitamin C, omega 3's, and zinc. I hope that helps. Rowena
Rowena Tucker IBCLC
Bryan, Texas

previous post:
Date:    Mon, 11 Jun 2012 18:46:32 -0500
From:    Brenda Enfield <[log in to unmask]>
Subject: Nipple blebs

PTP:
I am working with a lady G2P2 who is having trouble with nipple blebs at 3 and 9 o'clock positions on Rt nipple only.  Went to MD with information to to treat bleb that she pulled from google search, and they told her they could not do it.  Very frustrated.  Describes discomfort as "pins and needles" in that area when baby on breast.  Had issues with extreme edema, so much so that she needed a few days of Lasix to treat.  Initial call last Tues/Wed around midnight for burning, swollen breasts and not being able to get milk out even with pumping.  Instructed to use RPS prior to latching and laid-back positioing, and to also use RPS with pumping.  She was reporting baby back arching, not satisfied during day, eating all the time, and would only sleep at night after some formula.  During day baby was only on for 5-10 min, then want to eat again shortly.  She actually called me back later to tell me "thank you" because baby had a very good feeding and was sleeping!  Went to emergency room later Wed for swelling, still having some burning in breast.  When she told the LC at this hospital about doing RPS she was told "that doesn't work!" to which she replied "Oh yeah? Then why was I getting relief then huh?"  I know that discussions on nipple blebs are in the archives, but for some reason I have never had any luck in looking there for information.  Must be doing something wrong.  Any suggestions for this lady?  Thanks for the help!!!!

Brenda Enfield RN, IBCLC
Cedar Rapids,IA

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