In 2012 in Breastfeeding Medicine they published a short abstract on a poster session that caught my eye:
BREASTFEEDING MEDICINE, Volume 7, Supplement 1, 2012
ª Mary Ann Liebert, Inc.
DOI: 10.1089/bfm.2012.9983
BLEB HISTOLOGY REVEALS INFLAMMATORY INFILTRATE THAT REGRESSES WITH TOPICAL STEROIDS; A CASE SERIES
MaryAnn O’Hara, MD, MPH*
Seattle Breastfeeding Medicine, Seattle, WA
This was a very small study, but an MD Resident and her doctor (an instructor at a local Osteopathic Medicine school who had asked me to present to her medical students some breastfeeding education for various years) came to my La Leche League meeting right after I had read this. The resident had been suffering from repeated blebs during breastfeeding and even when she stopped breastfeeding and was just pumping. She was ready to stop breast milk feeding as well, as she was exhausted and always in pain. I mentioned this study to her doctor, who was able to look it up. She applied the steroids x 5 days - and was cleared up! She was still worried about returning to breastfeeding, but she did continue pumping without repeated blebs forming.
I did try to contact Dr. O'Hara, but believe she has moved on to other research topics and I've not been able to find any other studies on this topic - I sure would like to have more information/studies on this! For now, when these situations of repeated blebs occur, I do give the reference to the moms and SOME doctors to follow through - but many just say "try the corticosteroids in the pharmacy" which is something that was not part of this study. The treatment was with "a short daily course of a very thin layer of a mid-potency steroid under occlusion to enhance penetration into the inflamed and fibrotic tissue."
Jeanette Panchula
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Topics of the day:
1. milk blebs, swollen nipples
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Date: Sat, 16 May 2020 10:42:42 -0400
From: Donna Bruschi <[log in to unmask]>
Subject: Re: milk blebs, swollen nipples
I agree with the previous posts --all of them are what I do and recommend.
This is anecdotal, based on my experience, personal and with clients.
I ask clients with "recurring" plugged ducts and blebs, "How tired are you?" Every single one says they are tired or exhausted.
I don't know what role exhaustion might play with your client, but sleep is important.
We know exhaustion suppresses the immune system. It also causes one to do things like not empty a breast, or work out a plug, or fall into a deep sleep compressing a breast underneath, because one is tired and isn't thinking clearly.
Another idea is a soft and gentle brushing of the tip with a wash cloth after soaking. A baby exfoliates the nipple tip while nursing, but a pump doesn't do this.
Lastly, is learning hand expression an option?
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