How to Treat Milk Blebs on Your Nipple When Breastfeeding

Breastfeeding or chestfeeding parents who've dealt with milk blebs know how uncomfortable they can be. In fact, milk blebs are an often unrecognized source of significant nipple pain. Ouch!

If you are dealing with a milk bleb, you're probably wondering, what's causing this painful bump on my nipple? But most of all, you likely want some relief. You want to know how to get rid of your milk bleb, and how to make sure you don't continue getting them.

We connected with a breastfeeding medicine specialist and a lactation consultant to answer common questions about milk blebs, and to help parents get some much-needed relief.

What Is a Milk Bleb?

A milk bleb is also known as a nipple bleb, and sometimes referred to as a nipple blister. Milk blebs are white or yellow bumps that appear on the nipple themselves, and they present either singularly or several at once. Though small, they can cause pretty intense pain, especially when your baby latches. That said, some parents don't notice much pain or discomfort from them. Milk blebs tend to cover a milk duct, which can mean that milk may have trouble flowing from that spot.

Identifying a Milk Bleb on Your Nipple

Usually parents notice a milk bleb because of a white or yellow bump, but other times, they notice the physical sensations caused by the milk bleb first. "You may first notice new nipple pain and then notice the bump, but sometimes you may randomly find the bump if it's not painful," says Cindy Rubin, M.D., I.B.C.L.C., pediatrician and breastfeeding medicine specialist at Touch Pediatrics and Lactation.

You can often tell that you have a milk bleb because you can see an area on your nipple that appears "blocked," adds Kelly Kendall, R.N., I.B.C.L.C., nurse and lactation consultant at The Balanced Boob. "Some parents will have new onset nipple pain or engorgement in one part of the breast if milk is not able to exit that nipple pore," she explains. "Sometimes a breastfeeding parent will be able to express a hardened piece of milk that was blocking the nipple pore." Other times, the parent's own skin will grow back and block the nipple pore due to inflammation, she adds.

What Causes a Milk Bleb?

It used to be thought that these blisters were caused by milk that gets backed up behind your nipple. And while having an oversupply of milk can be a factor behind milk blebs, new insights from the Academy of Breastfeeding Medicine (ABM) have pointed to inflammation and biofilm formation as the cause of milk blebs.

"Nipple blebs are typically the result of a sticky substance called a 'biofilm' that gets pushed out of the milk ducts and forms a layer of white debris on the nipple," explains Dr. Rubin. "The normal bacteria inside breasts can form biofilm naturally, but sometimes they can go into hyperdrive and the biofilm becomes thicker and causes more problems." Biofilm formation is more likely to happen when a body-feeding parent has an overproduction of milk, is an exclusive pumper, or is dealing with plugged ducts or mastitis, adds Dr. Rubin.

Inflammation is also a common factor of milk blebs, says Kendall. "This inflammation narrows the nipple pore opening which can cause a backup of milk and a disruption of the microbiome (or bacterial balance) in the duct/nipple," she describes. "Blebs are basically a surface presentation of what happens deeper in the breast when a parent develops a breast clog."

How Do You Get Rid of Milk Blebs?

If you're lucky and don't have any pain or discomfort associated with the milk bleb, you can just let it be, says Dr. Rubin. According to ABM, milk blebs often resolve on their own in due time.

However, if you're dealing with discomfort or pain, you can take some measures to relieve your symptoms. First, some topical treatments can help, particularly a steroid cream. "A steroid ointment can help reduce local inflammation and can help a bleb go away more quickly, but this is something that a physician would need to prescribe, and you would want the help of a medical practitioner trained in breastfeeding to help you if this is needed," says Dr. Rubin.

Using a saline soak can work wonders as well, says Kendall. "I recommend doing a saline soak of 1/4 tsp salt with 1 cup of water to soften the blocked nipple pore," she says. Another at-home treatment involves applying a cotton ball with coconut oil or olive oil to your nipple to soften the area where the bleb is, suggests Kendall. Talk to your health care provider about doing these treatments safely when breastfeeding.

It's also important to treat the underlying condition that's causing the milk bleb, says Dr. Rubin. This may include regulating your milk production and bringing it down if you are overproducing milk. You may also consider pumping less and transitioning to more direct nursing, if possible, she says. If you need help with either of these situations, consider contacting a breastfeeding counselor or lactation consultant, along with a health care provider.

Can I Pop a Milk Bleb?

Milk blebs often have a blister-like appearance and many parents feel tempted to pop them. In the past, this was often something that was suggested. But that's not the case anymore. It's no longer recommended by the ABM, nor is it advised by most lactation professionals.

"Though it might be tempting, you should not try to pop a nipple bleb yourself," says Dr. Rubin. "It might cause temporary relief if you have a blockage behind it, but popping it typically does not solve the underlying problem, and has the potential to make things worse by causing infection, more inflammation, or even scarring of the nipple and ducts."

When to See a Health Care Provider

You shouldn't hesitate to reach out to a lactation consultant, breastfeeding medicine specialist, or health care professional if you need assistance with a milk bleb. This is particularly true if your bleb isn't going away with at-home treatments, or if your bleb keeps coming back after resolving, says Kendall.

An OB-GYN, midwife, or health care provider can also recommend prescription-strength steroid ointment that can help you tackle the problem (plus give tips on safely nursing when using the cream). Additionally, a lactation specialist can help you manage breast milk oversupply, or any other feeding issue that might be contributing to your milk bleb.