By Catherine Genna Watson, BS, IBCLC
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A bleb is a small white spot on the tip of the nipple that looks like a tiny, milk-filled blister. The bleb only seems to cover one nipple opening or pore. It can be very painful to the touch and while breastfeeding or pumping. A sucking blister is usually larger and is caused by the baby taking only the nipple into his mouth during sucking, putting too much pressure on the tip of the nipple. Sucking blisters usually go away by themselves within a day or two when baby is latched on better. Blebs often need to be treated before they disappear. Professional help with latch-on technique from an IBCLC can often help solve these problems.
You can try to open up or remove the bleb at home. First, soak the nipple in warm water to soften the bleb. Then try rubbing it gently with a clean, damp washcloth until it opens or loosens. Next, feed the baby or express some milk to make sure any thickened milk is removed. You may see a small strand of hardened milk come out from the tiny duct opening. This is normal, and will help the healing. Finally, some antibiotic ointment can be used on the sore area until it heals. Ask your doctor to recommend an ointment that will let you keep breastfeeding. Avoid any over-the-counter ointment that contains neomycin. Usually feeding is more comfortable as soon as the bleb is broken.
If the bleb does not break easily, your doctor or midwife can break it with a sterile needle. This usually works better right after feeding the baby, when the blister is larger. You should continue to breastfeed often to drain the breast and let any thickened milk come out. If breastfeeding is too painful, using a hospital grade rental breast pump for 10 minutes at each feeding time will help maintain your milk supply and prevent mastitis.
Better positioning should prevent both blisters and blebs. An IBCLC and your doctor can help if you have either problem, or if they come back after treatment.
Kathleen B. Bruce BSN IBCLC
Barbara Wilson Clay, BSEd, IBCLC
Mary Bibb BA, IBCLC
Lawrence R and Lawrence R. Breastfeeding A Guide for the Medical Profession, 5th edition. Mosby, 1999.
Newman, J and Pitman, T. The Ultimate Breastfeeding Book of Answers, Prima Publishing, 2000.
Riordan, J and Auerbach, K. Breastfeeding and Human Lactation, 2nd edition. Jones and Bartlett, 1999.