Janet, if this bleb is an indicator of a blocked up high in the ductwork,
rather than some localized irritation on the nipple face, then that
tendon-looking thing is no more than a long string of clotted up milk.  I
don't know if Dee Kassing is on lactnet at the moment, but she does a
presentation on recurring blebs, which are often due to a blockage that
never quite gets worked out.  She has moms take a painkiller and then get
into the tub and soak the breast, followed by a deep, most likely quite
painful massage downward on the affected ductwork.  She specifies, with a
really great look on her face, that some weird, gross stuff will probably
come out, enough so that mom needs to be forewarned.

It also sounds like whatever was causing the higher blockage in your client
did not resolve spontaneously after the clotted milk was removed (no
surprise), and she may need to keep massaging and possibly seek other
treatment to resolve the inflammation in there so that the milk can flow
and she can preserve her supply. Something to take acre of, obviously, but
not to panic over.

I did not see the photo, but nothing you wrote strikes me as a cause for
great concern.  There is no tentacled alien living in her breast, all
appearances to the contrary ;)

Lynn Carter OFS LLLL IBCLC
Missouri, USA

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