How to Treat a Milk Blister When You're Exclusively Pumping

Milk blisters (also called blebs or nipple blisters) are sort of like a blocked duct right on the tip of your nipple, and they can be very painful. How do you know if you have one, and how do you treat it? Here’s everything you need to know about identifying, treating, and preventing milk blisters when you’re exclusively pumping.

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What is a Milk Blister, and How Do I Know if I Have One?

A milk blister occurs when skin on your nipple closes over a milk duct opening, becomes inflamed, and milk fills up in the area behind it.

Milk blisters look like a small raised bump on your nipple, and are usually white or yellow. It can look like a pimple or a blister with milk stuck inside of it. Milk blisters sometimes feel hard, and the area around it may be swollen. They are painful in the immediate area and right behind it.

If you do a breast compression on your breast, a milk blister will normally puff out a bit.

You can see photos of milk blisters below:

What Causes Milk Blisters?

Many different things can cause blebs, including thrush, oversupply, pressure on the breast (possibly from sleeping on your stomach or from an underwire bra), and engorgement. If you are nursing at all, friction on the tip of the nipple due to issues with latch can also be a contributing factor.

Thrush is more likely to be the issue if you have more than one milk blister at once. It’s a good idea to check the list of thrush symptoms to see if this might be the underlying cause so that you can get it resolved. (A doctor will have to diagnose thrush and provide treatment.)

How Should I Treat a Milk Blister While Exclusively Pumping?

The goal is to soften the skin on the top of the bleb, and try to work the milk behind it out. Warm compresses, epsom salts, and olive oil can help with the softening, and breast compressions and your pump can help push milk that’s stuck out of the duct. Here are some ways to do this:

When it’s time to pump, apply a hot washcloth – be careful not to burn yourself – to the milk blister, and then pump using breast compressions to try to work out the bleb. If pumping is painful, consider using a pain medication like Motrin that is compatible with breastfeeding. It may be easier to pump the side that’s not affected first, and then hook yourself up to pump on the affected side after your milk lets down.
If your baby will nurse, trying that (along with the hot compress and breast compressions mentioned above) might work better than a pump.
Apply olive oil to a cotton ball and put it in your bra on top of the nipple blister. This can soften the skin on your nipple and help you work it out.
Soaking your breast in epsom salts may also help soften your nipple. (More details on how to do an epsom soak for your breasts here.)
You can also try putting some 1-2 tablespoons of epsom salts into a Haakaa pump. Put the epsom salt into the pump, fill it about halfway will warm to hot water. Suction it on for 5-10 minutes, making sure that your nipple is submerged.
If none of this works, you can ask a health care provider to open the milk blister using a sterile needle. Make sure to ask if an antibiotic ointment is needed afterwards.

Once the milk blister has been cleared, you still may experience some pain from the exposed nipple pore, so again, consider pain medication if necessary. From Breastfeeding USA:

I remember lying in bed with an open nipple pore (after I had wiped away a bleb) trying to sleep and feeling excruciating pain. I remember being confused by that because I had expected the pain to go away once the bleb had been removed. A lactation consultant told me the pain was nerves responding to air entering the nipple pore.

Finally, when the bleb is opened, the milk that comes out may be an odd consistency – like toothpaste, or sometimes stringy. This is normal and nothing to be concerned about.

How Can I Prevent Milk Blisters?

Depending on what is causing your blebs, here are some suggestions for preventing them in the future.

If you think you may have thrush, see a physician for a diagnosis and to get medication to treat it.
Regular epsom soaks (once per day) may help prevent recurrence.
Make sure that your bras are comfortable, fit well, and wires are not an issue. Consider whether anything else (sleep position, a backpack strap, etc.) may putting pressure on your breast(s) that could cause breast pain or blocked ducts.
Lecithin is often used to prevent clogged ducts and may be helpful for preventing blebs, too. Per Dr. Jack Newman, the recommended dose is 1200 mg, taken four times per day.

(Legendairy Milk reached out and gave me a discount code for their sunflower lecithin. Take 15% off with the code EPUMP!)

Have you dealt with a milk blister? Tell us your experience and how you resolved it in the comments!

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