What is a milk blister?
A milk blister, or blocked nipple pore, is also called a bleb or nipple blister, or simply “milk under the skin.” It occurs when a tiny bit of skin overgrows a milk duct opening and milk backs up behind it. A milk blister usually shows up as a painful white, clear or yellow dot on the nipple or areola and the pain tends to be focused at that spot and just behind it. If you compress the breast so that milk is forced down the ducts, the blister will typically bulge outward. Milk blisters can be persistent and very painful during feeding, and may remain for several days or weeks and then spontaneously heal when the skin peels away from the affected area.
A white spot on the nipple may also be caused by an obstruction within the milk duct (as opposed to skin covering the milk duct). The obstruction might be a tiny, dry clump of hardened milk or a “string” of fattier, semi-solidified milk. The first type of milk duct obstruction will often pop out from the pressure of nursing or manual expression, or can be gently scraped from the surface of the milk duct with a fingernail. Reducing saturated fats can help to prevent recurrence of this type of obstruction. Both of these types of milk duct obstruction are associated with recurrent mastitis.
What causes a milk blister?
The underlying cause of a milk blister may be oversupply, pressure on that area of the breast, or the other usual causes of plugged ducts. Latch, suck, and or tongue problems may contribute to blisters because of friction on the tip of the nipple.
Thrush (yeast), can also cause milk blisters. If you have more than one blister at the same time, suspect thrush as the cause. Yeast is often accompanied by a “burning” pain, and the pain tends to be worse after nursing or pumping (whereas a plugged duct generally feels better after the breast has been emptied).
There are different methods that can be used to soften the blister
Apply moist heat to soften the blister prior to nursing.
Soak some oil (coconut oil, Vit E oil etc.) on a breast pad and wear that for 1 day or so.
Another option is to use a solution of Epsom salt — 2 teaspoons to 1 cup water. The Epsom salt is first dissolved in a small amount of very hot water, then further water is added to cool it down enough to soak in. Do this at least 4 times per day.
Soak a breast pad with vinegar and wear it against the nipple for a few days, this can break down the milk acids. (be sure to wipe of before feeding)
Nurse or pump with a hospital-grade pump.
Nurse first on the breast with the milk blister, directly after applying heat. Before you nurse, it can be helpful to use breast compression and attempt to hand express back behind and down toward the nipple to release any thickened milk that has backed up in the duct. Sometimes clumps or strings of hardened milk (often of a toothpaste consistency) can be expressed from this duct.
Treat the milk blister after nursing to aid healing.
Lecithin supplements can help to heal and prevent recurrent plugged ducts.
Massaging the breast, areola and nipple with a massage oil containing grapefruit seed extract (GSE) can help to heal recurrent milk blisters. To make the massage oil: mix a few drops of grapefruit seed extract or citrus seed extract into olive oil.