What You Need to Know About Milk Blebs, Raynaud’s, and Vasospasms

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 usually come as one (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. A 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 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 also cause 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 Epsom salt can do the trick. Soaking the 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 or All Purpose Nipple Ointment (APNO) in the area will soften the overgrowth of skin causing the bleb. And as always, the magical expressed breast milk is always a wonderful way to help treat and heal any breast or nipple related issue. If the 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 on 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, and one of the most painful experiences a breastfeeding mother can have is 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 restricts blood flow to certain extremities, such as an areola and nipple. Have you ever been outside in the cold and come into the heat only to notice that your fingers 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 area of the breast. Vasospasm happens for quite a few reasons. Often when there is nipple trauma or soreness, vasospasm can happen as a result. Thrush is also a common cause for vasospasm, as is a shallow latch and oral ties.


The pain generally occurs after nursing is over when the nipple is exposed to colder air after a baby’s warm mouth. Moms report their nipples turning white, and a 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 warmness 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 when mom’s take them until they find the pain subsides.


It is most important to find the root cause of the Vasospasm. Baby’s latch should always be looked into by a CLC or IBCLC, and thrush could be ruled out as a cause.


As always, if you are experiencing breast pain, please consult your local lactation professional and a medical professional to rule out any possible infection.