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Subject:
From:
Elizabeth Brooks <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 14 Sep 2014 06:32:31 -0400
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Is the bump on the nipple face?  I'd suspect bleb (plugged nipple pore) and
they can be quite uncomfortable.  Some moms have "repeated blebs" in the
same location.  But ponder the lovely poster abstract from the ABM 2012
conference by O'Hara ("Bleb histiology reveals inflammatory infiltrate that
regresses with topical steroids; a case series"; link here to the published
version which requires BFg Med access:
http://online.liebertpub.com/doi/abs/10.1089/bfm.2012.9983?journalCode=bfm).


In part it says:  "The blebs caused 5 women so much pain that they
requested excision of the lesions, which they tolerated well in an
outpatient clinic using a punch biopsy tool after local anesthesia. Every
woman’s symptoms resolved shortly after removal of the rubbery, scar-like
tissue. Histology consistently revealed 1) lack of any bacteria or fungi,
and 2) histiocytes with foamy cytoplasmic vacuoles and fibrin deposition.
These immune cells indicated a tissue reaction to milk that has leaked from
ducts into surrounding tissue. Based on these findings, subsequent patients
with blebs have been treated effectively 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."

If it is on the nipple shaft, it may be a sebaceous cyst; you can see a
photo in Wilson-Clay & Hoover's BFg Atlas.  After having the site emptied
by a dermatologist, that mom had uneventful BFg going forward.

-- 
Liz Brooks, JD, IBCLC, FILCA
Wyndmoor, PA, USA
Secretary, U. S. Breastfeeding Cmte (2014-16)
IBCLCs empower women and save babies' lives!

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