I'm venturing out of lurkdom with my first post so please be gentle with me. (TIC)

I have been working with a mom for about 3 months who initially was concerned about recurring plugged ducts.  About a month ago we realized she had what appeared to be a bleb on the end of her nipple.  It wasn't so much a white spot but a very thin layer of skin covering at least one nipple pore with what looked like a plug of milk behind it.  Being a nurse she felt pretty comfortable with lancing it herself with a sterile needle and nursing her baby immediately after.  She also soaked her breast, massaged and expressed what she could manually.  She also used a little triple antibiotic cream on her nipple also.  It worked and her plugged duct did resolve.   She is also watching her saturated fats and taking lecithin.

The problem is the skin keeps growing back.  She has broken it at least twice herself and even went to her doctor who was kind enough to do it for her but then told her to wrap her breast afterwards.  She didn't.  She seems to think that the doctor's attempt was the most successful because she said the milk flowed easily from where he broke the skin.  Again though, it grew back and now it seems to be getting thicker.  This makes sense to me that the skin would "callous" after repeated poking but what to do about it? 

She called me last night very frustrated because the plugged duct had reappeared and she had spent the night attempting to fend off a bout of mastitis.  She has had at least two infections that I know of.

Her baby is 10 months old, eating some solids and thriving in every way.  It was suggested to me by another LC that there was probably something going on with the latch on that breast.  Mom reports no soreness other than the bleb and associated plugged duct.

I would imagine that if this continues she could simply nurse on one side but she is planning to get pregnant again in the next few months.  She wants to avoid this happening again if at all possible.

So I am looking to your collective wisdom to help me help this mom. TIA.

Christine Young
Aspiring IBCLC- July's coming fast!

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