Sometimes a small white plug can be seen at the opening of the duct on the nipple. This is probably a white bleb, also known as a blocked nipple pore. The milk cannot drain properly when a pore is plugged and inflammation can occur from the pressure.
Characteristics of a blocked nipple pore are as follows:
- May look like a small white milk blister over the nipple pore opening, or like little bits of a hard white substance that is just below the surface of the milk duct outlet.
- May be white or yellow, depending on how long the blockage has been present.
- The skin on and around the blockage may be reddened.
- Can be very painful, especially during feeding.
- Can remain for several days or weeks and then spontaneously heal by a peeling away of the thin layer of skin tissue over the affected area.
A blocked nipple pore may be caused by the remnants of a plug being expelled from the breast.
To open the nipple pore, prior to breast-feeding, soften the skin of the effected breast by immersing the breast in warm water. Then gently rub the affected nipple area with a moist warm cloth. This will help remove the thin layer of skin covering the pore.
Continue to breast feed often, unless it is just too painful to do so; breastfeeding can help to resolve the plug more quickly, and it will not harm the baby to swallow a plug during breastfeeding.
If you cannot breastfeed, at least express your milk as best you can in the meantime; a hospital-grade, internal-piston, double-electric breast pump is our best choice. Pump regularly--every 3 hours, or at least 8 times each day, pumping both breasts at the same time, for 10 to 15 minutes each time, with careful attention to adequately emptying of the entire breast. Be sure to return to breastfeeding as soon as possible. Gently massaging above and behind the area of tenderness during feeding and/or milk expression may also help to expel the plug.
Breast shells may be worn in between feedings to relieve the pressure from clothing on the nipples, relieve discomfort, and possibly aid healing. If your doctor has no objections, the use of a topical antibiotic ointment, used sparingly on the nipple after feedings, may aid in healing and help to prevent infection.
Taking medication such as ibuprofen for pain and inflammation is usually helpful. Cold compresses applied to the breasts between feedings or pumping for 20 to 30 minutes at a time may be used to relieve discomfort.
In chronic situations, some physicians elect to open the duct with a sterile needle to give the mother relief. However, in a few instances this procedure has been followed by recurring pain in the affected area, and therefore is recommended only in extreme cases.