Breastfeeding: How to Help Sore Nipples & Blebs

Hi Mamas! Are you experiencing any discomfort while or right after breastfeeding? Do you have a white painful dot on your nipple and you’re wondering, what the heck is this!? Keep reading and we will help you through it!

First off, it is normal and fairly common to experience discomfort (maybe even toe curling pain the first 10 seconds of the first few latches…just me?) during your initial breastfeeding journey. However, it is NOT normal for breastfeeding to continue to be painful. And you should not have to live in pain and not enjoy your experience.

Proper Latch & Delatching

If nipple pain continues or worsens after the first few days of breastfeeding, the first thing to check is that your baby has a proper latch! A good latch means the nipple and a large mouthful of the breast needs to be pulled deeply into the baby’s mouth. Remember: it's BREASTfeeding, not NIPPLEfeeding!

Baby should have your nipple deep in her mouth. In order for this to happen, she should open her mouth wide, almost like a big yawn. Then his tongue should be over his lower gum line, not tucked back. Babies can slide down during their feeding session, so keep watch to see if the distance between his nose and your breast grows. If so, it’s okay, just break off the feeding gently with your finger, and re-latch.

If baby is latching on well and sucking well, then she will naturally end the session on her own by letting go, usually as she falls asleep. If you decide to delatch and try again for a deeper latch, make sure you are not just pulling baby off, this will hurt! Break off the suction by pressing down on your breast near baby’s mouth, pulling down on her chin, or inserting your finger into the corner of her mouth.

In a previous blog we talked about Foremilk and Hindmilk, which is helpful to know because it can keep you from ending the session too early. A misconception about sore nipples is that having a shorter nursing session might alleviate soreness, but this is not true. It will only prevent your baby from getting the creamy, high calorie hindmilk. So, if you do need to delatch, make sure to relatch.

Keep in Mind…

Nipple pain can come from other causes like thrush, bacterial infection, tongue-tie or flat or inverted nipples. Tongue-tie is a common cause for sore nipples. Check to see if her tongue can reach past her lower lip when she cries. If not, this could indicate tongue tie. Flat or inverted nipples can be drawn out by gentle pumping or baby sucking. For additional help, contact a lactation consultant in your area or contact our lactation consultants here!

How to relieve sore nipples:

• Rub coconut oil or your own breast milk on your nipples
• Wear a loose-fitting bra and clothes
• Let your nipples air dry after breastfeeding
• Change nursing pads often to keep them clean and dry
• Use a mix of nursing positions
• Start feeding on least sore side
• Express milk onto your nipples before and after feedings
• Wash your breasts with clear water- soap can dry your nipples
• If engorged, gently apply pressure around the base of your nipple with your fingers.

Now, let’s learn what a bleb is and what to do if you get one.

What Is A Bleb?

If you haven’t heard of a bleb, you may have heard of a milk or nipple blister. They are a tiny, painful sac filled with milk on the tip of the nipple or areola. It will look as if skin has grown over the duct opening and stopped the milk from coming out.

The tiny dot is typically white, clear or yellow in color and pain is located right at the tip or behind the duct. It can be painful to the touch and during feeds. Blebs can last for a few days to weeks.

What Causes A Bleb?

There are a range of reasons why a bleb may appear. Blebs can be caused by injury to the nipple or too much pressure on the breast. Causes range from: clogged milk ducts, clogged nipple pores, oversupply, or even milk that is too fatty or thick. Like with sore nipples, blebs can occur if you have incorrect latch and positioning, or other problems such as a yeast infection.

How do you treat a bleb?

Even though a bleb can be a cause for concern because of the tenderness, there are a few treatment options you can try at home. If you are unable to get the bleb to go away with any of these methods, see your healthcare provider so they can remove the bleb with a sterilized needle.

1. Apply Moist Heat To The Nipple Before You Nurse

Several times a day you should add an epsom salt soak prior to applying the moist heat. This will help keep the area clean while also helping to open up and heal the blockage.

You can easily do this by mixing 2 tablespoons of epsom salt with 1 cup of hot water. Either let the water cool on its own or add a small amount of cold water until it is cool enough to soak in. After you are done with the soak, apply the moist heat compress to the nipple to aid in softening the bleb. You can also use olive oil if you do not want to try moist heat. This should be done before nursing or pumping.

2. Clear The Skin From The Milk Duct

This may not be necessary if the epsom salt soak and moist heat have already opened up the skin or clogged duct.

To clear it you can try gently rubbing your nipple with a warm, moist washcloth. This movement may be enough to pull the skin back that is covering the opening. You may also use your fingernail to scrape back the skin. As I mentioned above, if none of this is working for you, have a healthcare professional use a sterile needle to open up the bleb.

3. Nurse Or Pump With A Hospital-Grade Pump

Directly after you apply the moist heat you should nurse first on the breast with the bleb. It can be helpful to massage the breast and hand express to assist in breaking up any of the thick, fatty milk that may be clogging the duct. This can aid in expressing the milk.

4. Use Ointment To Treat The Bleb After Nursing To Aid Healing

All Purpose Nipple Ointment (APNO) is antibacterial, anti-fungal, and anti-inflammatory. Using an ointment will ease the discomfort in between feedings. It will also help to speed up healing.

APNO should be applied after nursing and it is suggested to use a pea-sized amount. You do not need to wipe it off before nursing again. Your healthcare provider can write you a prescription to be filled at your local pharmacy. Make sure to call your healthcare provider to get relief.

Please be vigilant for signs of infection like fever, redness or inflammation, swelling, oozing or pus from the affected area. If you experience any of these symptoms contact your healthcare provider because you may need to take oral antibiotics if an infection is present.

Have you ever experienced sore nipples or a bleb? Did any of these treatments work for you? Let us know in The Official Milky Mama Lactation Support Group. This is your place to get advice from our team of Milky Mama experts and seasoned breastfeeding moms. If you are needing more one-on-one help book a call with one of our International Board Certified Lactation Consultants here.