What You Need to Know About Milk Blebs, Raynaud's, and Vasospasms
What is a Milk Bleb?
Have you ever noticed a small, white or yellow pimple-looking spot on your areola or nipple? If so, you may have what's called a milk bleb.
Milk comes down through the breast through a channel of ducts and flows out to the baby through the nipple. When milk gets stuck or blocked in these ducts due to an overgrowth of skin, a milk bleb is formed.
The area under the skin may bulge or swell with let down or when milk is expressed. Blebs are usually singular (if there is more than one white spot, thrush may be the culprit), but one tiny bleb can cause some significant pain for mom, both when breastfeeding and not.
What causes a milk bleb?
A milk bleb can have many causes. As mentioned above, thrush can cause blebs because of the lack of milk transfer due to pain, which leads to engorgement. An ill-fitting bra can also put pressure on the breast, resulting in a blocked duct. Friction from a shallow latch on the nipple, oversupply, oral ties, or even nursing in an awkward position can cause milk blebs as well.
Treatment of Milk Blebs
Treatment generally is fairly easy and can be done at home, unless otherwise stated by a medical professional or due to thrush. A simple bowl of warm water and 2-3 tablespoons of Epsom salt can do the trick.
Soaking the milk bleb prior to nursing or pumping will help open the duct and allow the bleb to "pop." Gentle breast massage and compressions along with a warm compress, and pumping or nursing can help move the blockage out of the milk duct.
Olive oil, nipple cream, or All Purpose Nipple Ointment (APNO) in the area will soften the overgrowth of the skin causing the bleb. And as always, expressed breast milk is always a wonderful way to help treat and heal any breast or nipple-related issue.
If the milk bleb is causing pain, consult a medical professional to evaluate the area and treat with pain medication, as needed. If you do suspect a bleb, please consult an IBCLC for further evaluation of latch and supply.
Raynaud's Syndrome and Vasospasm
Pain while breastfeeding always needs to be explored. Any type of pain in the breast that includes burning or stinging should be addressed at the first sign. Breast pain can mean an underlying infection, such as thrush or mastitis, or one of the more painful experiences a breastfeeding mother can have: vasospasm.
Before we get into vasospasm, let's first explore a syndrome called Raynaud's, which can be a root cause of vasospasm. Raynaud's is a disorder that constricts the blood vessels, causing them to narrow, which then restricts blood flow to certain extremities, such as the areola and nipple.
What is Vasospasm?
Have you ever been outside in the cold and come into the heat only to notice that your fingertips are white? The external temperature restricts blood vessels and blood flow to the tips of the fingers, turning them white and sometimes causes pain - a burning or stinging sensation.
In breastfeeding, this is a condition called vasospasm of the nipple. The blood flow to the nipple is temporarily cut off, which causes the nipple to turn white. Vasospasm can cause intense and sometimes debilitating pain and burning of the nipple and surrounding breast area. Vasospasm happens for a variety of reasons. Nipple trauma or soreness can result in vasospasm. Thrush is also a common cause for vasospasm, as is a shallow latch and oral ties.
Treatment of Vasospasm
The pain generally occurs after nursing or pumping is finished, when the nipple is exposed to colder air after a baby's warm mouth. Moms report their nipples turning white, and burning pain or sensation after breastfeeding that may last for a few minutes or more.
Some have mentioned they notice a change in nipple color and no pain. If you do find that you have pain after nursing and that your nipple is changing color, try to avoid letting your nipple 'hit' open air.
Cover your breast with a warm breast pad or clean hand as soon as you are done nursing. The heat from the breast pad or hand will limit the temperature exposure to the nipple and will hopefully reduce any pain. A heating pad can also be very helpful in drawing blood back to the nipple and easing any discomfort. It's been noted that vitamin B6, magnesium and calcium may have a positive effect on vasospasm as well. Please consult your Dr. before taking any vitamins or supplements.
What’s most important is to find the root cause of any discomfort. Baby's latch should always be looked into by a CLC or IBCLC, and thrush should be ruled out as a cause. As always, if you are experiencing breast pain, please consult your local lactation professional and a medical professional.