Avoiding and managing plugged nipple pores

What to Know

  • The causes of plugged nipple pores
  • Your options for treatment
  • How to manage discomfort associated with plugged nipple pores

Plugged nipple pores, milk blisters and blebs are closely related issues with the same manifestation – a painful white (or clear or yellow) bump on the nipple that looks a lot like a pimple. Timely treatment will allow you to resolve the plug and minimize the duration of your discomfort. You can (and should!) continue to breastfeed with a plugged nipple pore.

Mom breastfeeding baby

Causes of plugged nipple pores

An obstruction within the milk duct close to the surface of the nipple (which can cause milk stasis, literally, milk standing still), or an obstruction on the surface of the nipple can cause blisters and plugged pores. Often a bit of skin grows over the pore, further preventing milk flow. Contributing factors include:

  • Inadequate removal of milk – A sub-optimal latch, weak suck, or tongue tie can affect your baby’s ability to remove milk from your breast efficiently. Infrequent feeding, a poor latch (which can create friction), long separations (without pumping) or abrupt weaning can also cause a back-up.
  • Pressure on the breast – External pressure, from a tight bra, diaper bag strap or seat belt, for example, can restrict milk flow. Lying on your stomach for extended periods may also cause unwanted pressure.
  • Oversupply – Producing more milk than baby needs can create an imbalance in milk removal from each breast.
  • Thrush – The tell-tale white rash associated with thrush can block your nipple pores, causing plugs.

Managing nipple pores

You can usually treat a plugged nipple pore at home while continuing with your usual feeding or pumping routine.

Applying moist heat to the affected area, soaking the breast in warm water with Epsom salts or gently rubbing the blister with a warm washcloth to remove any skin obstructing the milk duct may provide some relief.

If this doesn’t work, speak with your health care provider. Some plugged pores have to be opened with sterile needles, much like other blisters. Your health care provider may do this in a doctor’s office or they may provide you with instructions to do the deed yourself.

Rest and proper nutrition are also important to keep your milk flowing. Easier said than done right now, we know. But maternal stress and fatigue are risk factors for developing a clogged duct while good nutrition can support your immune system which will help you heal and ward off progression to mastitis (an infection of the breast). A Happy Family Coach can assess your diet and make suggestions for quick and easy meals and snacks – one less thing for you to worry about!

What to Do

Avoid situations that can cause blisters and milk stasis

Emptying your breasts frequently and thoroughly is the best way to prevent and treat blocks and plugs. Feed your baby regularly and make plans to pump or hand express if you know you will miss a feeding. Take care to correct any feeding issues promptly by speaking with a lactation consultant. Avoid underwire bras while you are lactating, and be mindful of any clothing, straps or activities that may be putting pressure on your breast repeatedly or for prolonged periods of time (like sleeping on your stomach).

Contact your healthcare provider if you notice any signs or symptoms of thrush infection: a white rash on your nipple or in baby’s mouth; itchy or burning nipples; or shooting or deep breast pain during or after feeding.

Contact a lactation consultant

Lactation consultants (available at Happy Family) can help you correct any issues with positioning or latch that may be causing friction, or affecting your baby’s ability to empty your breast efficiently. They can also make suggestions to manage oversupply. If you already have a clogged pore, they can provide support so that a pesky blister does not have to mean the end of your breastfeeding relationship.

Many of our Happy Family Coaches are breastfeeding specialists, lactation counselors, or lactation consultants. They can help with many of these issues and help you find local lactation support if you need in-person assessment.

Treat a plug promptly

Before the next feeding, use moist heat to soften the skin on your nipple (try soaking the breast in warm water with Epsom salt). Then apply a very hot compress to the affected area (but not so hot that you burn yourself). Next, gently rub the blister with a clean, moist washcloth, which should remove any skin obstructing the milk duct.

Try hand expressing a bit – you may notice some stringy or pasty milk come out. That’s good news, as it was likely the offending blockage. Now, feed that baby or pump away (with a hospital grade pump if you can get one)!

Don’t be shy about contacting your lactation consultant or healthcare provider for additional support. Even if you successfully open the blister, you may want to ask about appropriate antibacterial creams to apply to the broken skin, like lanolin.

Relieve pain and discomfort between feedings

Try cold compresses between feedings to minimize discomfort. Wearing breastshells can protect sensitive nipples from clothing and taking acetaminophen or ibuprofen may also help.

Prevent plugged nipple pores from recurring

If you’re recovering from a milk blister, a daily soak in normal saline (half a teaspoon salt in 1 cup of water, just for a minute or so) followed by a quick rub with a washcloth for a few weeks may help keep further plugs at bay. Plus, the saline soak can aid in healing broken skin.

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