Milk blebs are a common struggle that many mothers experience during their breastfeeding journey1, that can make the process uncomfortable or painful.
A milk bleb or milk blister occurs when your nipple pore is blocked during breastfeeding, either by a piece of skin or hardened breast milk. This creates a blocked nipple duct which causes milk to back up and harden which blocks or restricts milk flow. This can lead to clogged milk ducts or a breast infection known as mastitis.
Milk blebs can be painful but they usually heal on their own with the help of at-home treatment. However, in rare cases, a healthcare professional may need to drain the milk bleb if your symptoms are severe.1This article will tell you everything you need to know about milk blebs including the symptoms, causes, possible treatment options and when you should see a doctor.
Causes of milk blebs
There are a few different factors that cause milk blebs. This includes:
Incorrect latch and positioning - If your baby is not latched properly, this means milk is not drained efficiently from your breast. This causes milk to back up and clog your nipple ducts.1
Engorgement and blocked milk ducts - If you have an oversupply of breast milk, you will produce more milk than your baby can effectively drain. This can cause milk to back up and cause a clogged duct or milk bleb.1
Friction and pressure on the nipples - Using an improperly fitted breast pump can create friction on your nipple and cause a milk bleb. As well as this, wearing tight-fitted bras or sleepwear and sleeping on your stomach can irritate and put pressure on your breasts and nipples and contribute to the formation of milk blebs and clogged milk ducts.1
Milk blebs can be painful and this pain can travel from your nipple to further back in your breast. The pain is often more intense during breastfeeding or pumping. However, symptoms may vary, with some individuals feeling no pain. .
The most common symptoms of a milk bleb are:
- Small, white or yellow pimple-like spots on your nipple
- Pain in nipples when breastfeeding or pumping
- Inflamed skin around the nipple
Milk bleb spots are often confused with spots caused by thrush. Thrush is a fungal infection that forms on the nipples or breasts and causes a burning or stinging sensation when nursing. Thrush causes nipples to look shiny and red with white patches and requires antifungal medications as treatment.
Management and treatment of milk blebs
Most people do not require treatment for milk blebs as they usually heal themselves within 24 to 48 hours. However, if the milk bleb is very painful and takes a while to heal, there are a few treatment options to speed up the healing process.
Using warm compresses and Epsom salt soaks
You can soothe the affected area by applying a warm washcloth on the milk bleb for 10 to 15 minutes, several times a day. It is ideal to do this right before breastfeeding.
Additionally, you can also soak your nipple in Epsom salt several times a day. To do this, mix one cup of hot water with two tablespoons of Epsom salt. This is effective at drying out the milk bleb which makes it more likely to fall off. The combination of hot water and the magnesium found in Epsom salt is effective at reducing inflammation and encouraging nipple duct emptying.1
Gentle removal techniques for milk blebs
After applying heat, you can soften the hardened skin on your nipple by applying olive oil on the milk bleb. To do this, apply the olive oil with a cotton ball and let it sit for 20 to 30 minutes. Then, use a warm washcloth to gently exfoliate the milk bleb. Using circular motions, gently rub the washcloth over your nipple to remove any skin that is blocking the pore.
Soothing strategies to alleviate discomfort
Although it may be painful, you should not stop breastfeeding or pumping as it can open the nipple pore. You can find relief by positioning your baby so that their chin is against the duct as this is more effective at draining the clogged area.1
You should keep the nipple area moist to reduce pain and discomfort. As well as applying a warm compress, and olive oil and soaking your breasts in Epsom salt, you can also apply vinegar to a breast pad and place it over your nipples.1
With treatment, your milk bleb should heal itself within 24 to 48 hours. You may notice a strand of thickened milk come out of your nipple pore once the skin is loosened which you can pull out with clean hands. Your doctor may recommend applying an antibiotic ointment to keep your nipple clean and dry for a few days and allow the pore to heal.
Potential Complications and Discomfort
Milk blebs can be painful and uncomfortable. If they are left untreated or they cannot heal themselves, milk blebs can lead to further complications, such as:1
- Reduced effectiveness of breastfeeding - you may not be able to express milk as efficiently to your baby
- Prolonged pain and discomfort experienced by the mother
- Risk of infection and mastitis
To prevent future milk blebs or blisters from developing, you should make sure your breasts are fully drained. The main ways to prevent milk blebs include:1
- Proper latch and breastfeeding positioning - your baby should be latched on properly so that their mouth forms a tight seal around your nipple and most of the areola
- Switching breastfeeding positions to reduce pressure on your breasts - you can switch between a football hold and a cradle hold
- Pumping at night - if your baby suddenly starts sleeping through the night, this can lead to clogged ducts so you should pump at least once a night to drain your breasts
- Hand express or pump milk - to remove extra milk and relieve overly full breasts which are prone to clogged ducts and blebs
- Clean your nipples - after breastfeeding, clean your nipples with a wet washcloth to help prevent clogged pores
- Drink plenty of fluids - drinking water during breastfeeding or pumping can help prevent clogged pores
- Eat a healthy, balanced diet - evidence suggests that unhealthy diets high in saturated fats can contribute to the milk blebs
- Take a lecithin supplement - lecithin helps thin breast milk so it is easier for it to flow through the ducts1
Can milk blebs heal themselves?
Yes, milk blebs usually heal themselves within 24 to 48 hours. As you continue breastfeeding your baby, the layer of skin can sometimes come off. Frequent nursing and other home remedies can help release the milk and unclog the blocked pores.
Can I pop a milk bleb?
No, you should not pop a milk bleb as this can lead to infection. A healthcare professional may recommend draining the milk bleb; this is done using a sterile needle and should not be done yourself.
When should I see a doctor?
You should see a doctor if:1
- You are experiencing extreme pain and discomfort and cannot breastfeed
- You have a milk bleb that lasts longer than a few days
- The milk bleb is not improving with treatment
In summary, a milk bleb is a clogged pore in your nipple that occurs as a result of a piece of skin or hardened breast milk. Symptoms include small white or yellow spots on your nipples, painful nipples or pain when breastfeeding and inflamed skin around the nipple. The main causes of milk blebs are poor latch which can cause a build-up of milk, an oversupply of breast milk, tight-fitted bras and pressure on the chest.
Milk blebs are often treated using at-home remedies such as a warm compress, gentle exfoliation and frequent breastfeeding and pumping. To prevent milk blebs, it is important to make sure your breasts are fully drained. As well as this, you should position your baby correctly and switch positions to reduce pressure on your breasts, practice nipple care, stay hydrated by drinking plenty of fluids and eat a healthy, balanced diet. Although most milk blebs go away on their own, you should contact your healthcare provider if you are experiencing severe pain and your milk bleb lasts longer than a few days and is not improving with treatment. You can also contact a lactation consultant to support you in your breastfeeding journey.
Obermeyer S, Shiehzadegan S. Case report of the management of milk blebs. Journal of Obstetric, Gynecologic & Neonatal Nursing [Internet]. 2022 Jan [cited 2023 Jul 21];51(1):83–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S088421752100277X