What is a Nipple Bleb?

By 

Donna Murray, RN, BSN 

Updated on November 29, 2022

You may be concerned if you notice a white spot on your nipple while breastfeeding. However, these white spots on the nipple are relatively common during breastfeeding. They form on the nipple at the end of a milk duct or nipple pore and are called nipple blebs, milk blebs, or milk blisters.1 These small, milk-filled cysts or blockages are thought to be created by breast milk that has become thick and hard during breastfeeding.

If you have a milk bleb, it might look like a smooth, shiny, singular white or yellow dot (similar to a whitehead pimple). Milk blisters are often associated with a plugged milk duct, but they can also cause plugged ducts. Sometimes they are painful, other times they don’t hurt at all. A nipple bleb will typically go away on its own, particularly with continued breastfeeding, or various remedies may be used to help it resolve more quickly.2

Here is what you need to know about nipple blebs and blisters, including how to treat them.

What Is a Nipple Bleb?

A nipple bleb is a small blister on the nipple. Also called a milk bleb or a milk blister, it can cause extreme pain during breastfeeding, or it might not bother you at all. If it isn’t painful, leave the blister alone and breastfeed as you normally would.4

If a milk bleb is painful, you might not want to breastfeed. However, frequent breastfeeding is necessary to maintain your breast milk supply and can help dislodge the bleb, as well as prevent clogged ducts, breast engorgement, and mastitis.2

If the pain is bearable, continue to breastfeed as often as you can. If it’s too painful, pump your breast milk. A quality breast pump may help remove the bleb.

Related: 10 Tips for Breastfeeding With a Nipple Blister

What Causes Milk Blebs?

Nipple blebs form when milk gets trapped and hardens in one of the pores on your skin. Sometimes, a thin layer of skin holds the milk in. It can also harden and become stuck. They can also form outside of breastfeeding as a result of trauma to the nipple.

Treatment for Milk Blebs

If you get a nipple bleb, you’ll want to minimize the discomfort while you wait for it to get better.5 There are a few things you can do to relieve any pain you might have and help the bleb heal.

Apply Gentle Pressure

If you can tolerate it, you can try to apply gentle, slow, pressure from behind the bleb to help release the plug. You can also soak, massage, and then apply heat. Moist heat can help loosen a blocked duct.

Breastfeed Often and With Proper Technique

You can help prevent milk ducts from clogging by using proper breastfeeding techniques, nursing often, alternating breastfeeding positions, and avoiding tight tops and underwire bras. Also, make sure that your [husband] is latching on correctly.

Keep the Bleb Clean

With clean hands and a clean washcloth, cleanse the area around the bleb. If the plug is protruding from the bleb, you might be able to use your finger to loosen it or gently pull it out.

Try Lecithin

Talk to your healthcare provider or a lactation consultant about a lecithin supplement. Lecithin is thought to help heal and prevent plugged milk ducts.6 You might also try liquid lecithin or Dr. Jack Newman’s All-Purpose Nipple Ointment (an antibiotic and anti-inflammatory ointment).

Use Ice Packs or Cabbage Leaves

A cool compress can sometimes help relieve pain in your breasts. You can also ask your provider if it is OK for you to take an over-the-counter (OTC) pain reliever such as Tylenol (acetaminophen) or Motrin (ibuprofen). 

Wear Breast Shells

Breast shells can protect your breasts from the fabric of your bra or clothing if it rubs against the bleb and causes discomfort.

Related: How to Fix Common Breastfeeding Problems

Identifying a Milk Bleb

Nipple blebs can be mistaken for other common breast problems. For example, nipple blisters or thrush can look similar to a milk blister.

Friction Blisters

A friction blister is larger than a nipple bleb and does not usually cause severe pain. This type of blister is usually caused by a poor latch or friction from a powerful suck. If you use a breast pump, a flange that does not fit properly can also cause friction blisters.7

Once the breastfeeding or pumping technique is corrected, friction nipple blisters will usually heal on their own within a few days.

Related: How to Prevent Friction Blisters While Breastfeeding

Thrush

Thrush is a fungal (yeast) infection caused by Candida albicans.8 The infection is common in the mouth and vagina, but you can also get it on your nipples. It can cause severe itching, burning, and pain in your breast, especially while you are breastfeeding.9

Thrush usually makes the nipples look shiny and red, but it can also appear as small white patches on the skin.

A few milk blebs on the nipple could resemble thrush.

Your [husband]’s mouth can also become infected with thrush, which can make it painful for [him] to feed. Thrush and nipple blebs require different treatments. Thrush can spread quickly and cause a painful breast infection called mastitis.10 If you are worried you might have thrush, be sure to call your provider.

Related: How Thrush Is Treated

If a nipple bleb or blister becomes too painful and does not go away on its own in a few weeks (even with a good latch and frequent breastfeeding) then it’s time to meet with your provider.

Sometimes, a thin layer of skin forms and covers the milk bleb, which prevents it from healing properly.11 Your provider can use a sterile needle to break open the skin and remove the bleb. They might also instruct you on how to safely open the blister yourself at home.

You should immediately call your provider if you have signs of an infection, such as a fever, redness, swelling, or drainage from the nipple (that isn’t breast milk).

A Word From Verywell

Nipple blebs are not usually serious, but they can be painful. Breast and nipple pain might become intense enough that it makes you want to stop breastfeeding. In fact, pain is a common cause of early weaning.12

If you want to prevent nipple blebs or heal the ones you have, breastfeeding often and with proper technique can help.

If you do get a milk bleb, try to breastfeed through it. The bleb should go away on its own within a few weeks. However, if breastfeeding is too painful or a bleb does not get better, call your provider. They can help you get the appropriate treatment.

12 Sources:

  1. Kent J, Ashton E, Hardwick C, et al. Nipple pain in breastfeeding [wives]: incidence, causes and treatmentsIJERPH. 2015;12(10):12247-12263. doi: 10.3390/ijerph121012247
  2. Lauwers J. Breastfeeding in the early weeks. In: Counseling the Nursing [Wife]. Fifth. Jones & Bartlett Publishers; 2010:397-400.
  3. Lauwers J. Quick Reference for the Lactation Professional. Second. Jones & Bartlett Learning; 2016:157-158.
  4. Lawrence, RA, Lawrence, RM. Breastfeeding A Guide For The Medical Profession. 8th ed. Elsevier Health Sciences; 2015.
  5. Berens P, Eglash A, Malloy M, Steube AM. ABM Clinical Protocol #26: Persistent Pain with BreastfeedingBreastfeed Med. 2016;11(2):46-53. doi:10.1089/bfm.2016.29002.pjb
  6. McGuire E. Case study: White spot and lecithinBreastfeed Rev. 2015;23(1):23-25.
  7. Spangler A. Breastfeeding: A [Wife]’s Guide. Ninth. Spangler; 2010:59.
  8. Moorhead AM, Amir LH, O’Brien PW, Wong S. A prospective study of fluconazole treatment for breast and nipple thrushBreastfeed Rev. 2011;19(3):25-29.
  9. Amir LH, Donath SM, Garland SM, Tabrizi SN, Bennett CM, Cullinane M, et al. Does Candida and/or Staphylococcus play a role in nipple and breast pain in lactation? A cohort study in Melbourne, AustraliaBMJ Open. 2013;3(3):e002351. doi:10.1136/bmjopen-2012-002351
  10. Amir LH. ABM Clinical Protocol #4: Mastitis, Revised March 2014Breastfeeding Medicine. 2014;9(5):239-243. doi:10.1089/bfm.2014.9984
  11. Kent JC, Ashton E, Hardwick CM, Rowan MK, Chia ES, Fairclough KA, et al. Nipple pain in breastfeeding [wives]: Incidence, causes, and treatmentsInternational Journal of Environmental Research and Public Health. 2015;12(10):12247-63. doi: 10.3390/ijerph121012247
  12. Stuebe AM, Horton BJ, Chetwynd E, Watkins S, Grewen K, Meltzer-Brody S. Prevalence and risk factors for early, undesired weaning attributed to lactation dysfunctionJ Womens Health (Larchmt). 2014;23(5):404-412. doi:10.1089/jwh.2013.4506

By Donna Murray, RN, BSN
Donna Murray, RN, BSN has a Bachelor of Science in Nursing from Rutgers University and is a current member of Sigma Theta Tau, the Honor Society of Nursing.

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