In the discussion of the case of the mother of twins who fractured her elbow, and has subsequently had what was initially called "blisters" on her nipple (three situations which may well be unrelated), one fo the problems seems to be the *terminology*.
    Later contributors are assuming it is a white bleb, or blocked milk pore.  If it is, this is certainly a different situation from a "blister".  Yet, out there in the community the term "blister", or "milk blister", is loosely used for this condition, inappropriate though the term is.  Chances are, mothers will use teh term "blister" through not knowing any other term for bleb.  This is where good questioning of the Mum is necessary, if she can't be seen, to ascertain which it is.
    As for blisters, some years ago a colleague told me about two mothers who had blisters and very raw skin on the very tips of their nipples.  What do you think these were?  They were actually acid burns - one baby had severe gastro-oesophageal reflux (GOR) and the other had pyloric stenosis and was sent for surgery.  Resolution of the nipple problem (burn) came for one mother after she weaned and the other after her baby was treated.  Not something I've seen myself, but an interesting possibility that is worth sharing.
                        Virginia
                         Virginia Thorley, OAM, IBCLC
                         Brisbane, Queensland, Australia

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