Bleb: It's the Breastfeeding Problem No One Talks About


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I struggled with breastfeeding from the very first hour after my son was born. Nursing was extremely painful, despite the nurses and lactation consultants helping me at the hospital. They assured me that his latch was good, he did not have a tongue-tie, and it was too early to worry about milk flow. Unfortunately, my sensitive skin and my baby's strong suck were not issues that could be fixed. But a few weeks after I left the hospital with my newborn, one breast was especially sore. It felt like sharp, stabbing pains whenever I fed my son from that side. I did not worry much at first because painful breastfeeding seemed like the norm for me, but then I noticed a raised white spot on my nipple that hurt to touch.

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I vaguely remembered reading something about white spots in a pregnancy book. I could not recall any of the details, except that it was a bad sign. It was late at night, so I turned to the Internet for answers. After searching online, I came to the conclusion that I had thrush because many of the symptoms were similar. It seemed serious, and according to Google, it had the potential to get much worse. The more I read, the more scared I became.

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After a panicked phone call to my lactation consultant the next morning, I learned that what I had wasn't thrush; it was actually a bleb. Yes, you read that right. I was confused, too. I actually asked my lactation consultant to spell the word for me, because I had no idea what she was talking about. 

Apparently, a bleb is a white or yellowish blister on the nipple that blocks the milk from coming out of that pore. These milk blisters can cause breast pain, nipple soreness, and low milk flow. According to lactation consultant Laurie Barbalinardo, RN, IBCLC, at Hackensack UMC Mountainside, blebs don't have to be painful but "almost always are." I can certainly attest to the truth of that statement.

I developed my bleb in the first month of breastfeeding, and then again when I was weaning my son a few months later, and Barbalinardo says that's not uncommon. “Blebs can occur at any point during breastfeeding," she told me. "In my experience, I usually see blebs early on [in the breastfeeding relationship]."

So, how can you tell if you have a bleb? A small white bump on only one nipple is the telltale sign. You might also have pain and notice changes in your milk flow. You might mistake it for thrush, like I did, but that usually occurs on both breasts, so having blisters on only one side means it is unlikely that thrush is the problem. But, even if you're pretty sure you have a bleb, Barbalinardo warns against diagnosing yourself. 

"It's always better to talk to an expert than to self-diagnose because there is potential harm in not knowing what you're treating," she explains. If you are having trouble getting an appointment with your very busy doctor, many hospitals have free breastfeeding support groups where you can speak to a professional. "If you can't see a doctor or lactation consultant in person, then just call. There is really no substitute for talking to a professional," Barbalinardo says.

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The good news is, if you find out that you do have a bleb, you can most likely remove it yourself at home. "A mom can attempt to unroof the bleb in the shower, and if successful, Mom should follow up with her health care provider, as it is advised to use a topical antibacterial cream to prevent infection," Barbalinardo says. She recommends using a rough washcloth while in the shower to open the blister. I made the mistake of first trying to remove the bleb outside the shower (ouch!). I found out that gently scraping open the blister after standing in the hot water for a while was much less painful. If you are unable to remove the blister yourself, then the next step is to make a trip to your doctor, who will use a sterile needle to open the bleb for you.

I am going to be honest and warn you that removing my bleb hurt a lot, even in the shower. It is necessary to get better, though, so the sooner you get it over with, the better. Waiting will just make the situation worse. In addition to the pain, Barbalinardo says the risks of ignoring a bleb are that the baby could reject the breast because of slow milk flow and the mother could develop a plugged duct and then possibly mastitis.

Luckily, once the bleb is opened, you will get better fast. My milk that was blocked behind the blister came out at the very next feeding, and then the painful spot in my breast faded. The site of the blister was a bit sore for two days afterward, but that awful stabbing pain was gone. It was such a relief, and I felt surprised at how much pain a small white dot had caused.

When I told this story to some mom friends, none of them had ever even heard the term bleb before. Unfortunately, it's something most breastfeeding moms don't know about until it happens to them. And that's why I decided to share my experience, so if other moms ever see that telltale little white dot, they won't spend the night panicking and frantically Googling like I did.

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