Recurrent milk blisters and blocked ducts - help!

[kitpuss]

My DS is just 8 months old, I exclusively breastfed him until 6 months and now he has solids and is still breastfeeding, not used any formula as yet.
For the last couple of months I have been getting painful blocked milk ducts and milk blisters on my right breast. The blocked ducts generally resolve after a good feed, but the blisters have been more difficult. I have tried hot compresses and even stuck a needle in (yes really, that is the advice from all sorts of places!) but that just really hurt and also bled a little so I didn't do that again! I think that now the blisters have taken permanent residence, possibly with skin grown over because they don't look white anymore. I think they are still there because my nipple is still often painful when I feed, and when I try and express at best I only get one stream of milk spurting out, so that suggests to me that the other holes on my nipple are blocked. (I did a comparison today, I got 5-6 spurting streams of milk from my other breast).

Anyway, the problem is that DS really doesn't like feeding from that breast anymore, screams and wriggles and even if I manage to get him on it he gives up quite quickly (can't say I blame him when he's probably getting barely any milk). He feeds fine from the other breast but I have two main concerns:
1- will he get enough milk from one breast?
2- if I have to give up with this breast I am going to be so lopsided it is untrue, I know it may seem vain but I can only think that my left breast is going to be huge and the right absolutely tiny. You can already see a difference, even when I'm wearing clothes!

I really wanted to breastfeed until he was at least 12 months, so would appreciate any help or advice.

[millimummy]

Sorry in a rush. Others might have more advice.

But you could try this: kellymom.com/bf/concerns/mom/nipplebleb.html

It has some advice re recurring blebs.

Also Jack Newman's hypothesis is that recurrent blisters occur in areas of previous damage where the milk is not flowing well. He does recommend a sterile needle (as you have tried). He also recommends All Purpose Nipple Ointment (Mupirocin 2% ointment - 15 grams); Betamethasone 0.1% ointment - 15 grams; Miconazole powder is then added so the final concentration of micronazole is 2%).

• Clotrimazole can be used instead of Miconazole (if M not available) or Nystatin if neither C nor M available.

However he is Canadian and I do not know if you would have to ask your GP to prescribe this or if the chemist would make up the ointment for you.

I used a solution of Epsom salts (cf Kelly mom).

Not sure why you would want to feed only from one side. Maybe speak to LLL?

www.laleche.org.uk/pages/about/helpline.htm

Hope this helps

[millimummy]

Can you fool him into thinking it is the other side? DD went through a phase of favourite side. I tried positioning her so that she still seemed to be feeding from the side she liked (if that makes sense).

Also could there be any other underlying problems with DS (eg sore throat? oral thrush?). Could it be nipple or duct thrush for you? Any shooting pains?

Just trying to make some quick suggestions. Am guessing you have probably tried quite a lot a things.

[kitpuss]

Thanks millimummy, lots of useful advice. I've looked at the kellymom website, was thinking I might try epsom salts or a saline wash.

I found the cream recipe very interesting, but think it's highly unlikely I could persuade a GP to prescribe it. I work in pharmacies and have never seen anything like that prescribed, it would have to be made up in a lab somewhere and would cost far too much for the NHS to bother with it!!

I've tried trying to fool him about which side it is, but the low milk flow gives it away and he starts crying when he realises.

I don't want to go to feeding only on one side, but to try to get him to feed from that side means crying and screaming every feed, and also pain for me and the blocked milk ducts can be really painful, kept me awake the other night!

Don't think there are any underlying problems for DS or me.

I guess I could try La Leche, I rang the National Breastfeeding network and they weren't that helpful, just told me the needle trick.

[millimummy]

I always found LLL useful. Here is the number: 0845 120 2918.

Also, Jack Newman, "The Ultimate Breastfeeding Book of Answers".

If you are trying to boost supply on one side, a midwife at the Portland recommended squeezing methodically (not explaining v well) in between feeds to get the breast thinking it needs to produce more. I suggest this rather than expressing (unless you can do it by hand; Penelope Leach explains to express by hand well in her book. Please let me know if you need the ref) using a pump.

[millimummy]

Blocked ducts can be an indication of breast thrush.

Lecithin also helps blocked ducts.

Probiotics can help counter thrush. Sorry have to go.

I do understand how painful it can be. I had thrush in the milk ducts and it was terrible. Hot bath. Make up a cup of the epsom salt solution. And hand express into the bath.

Good luck. Please call LLL.

[millimummy]

PS re enough milk from one breast. I am not sure as I do not have direct experience but say you had twins, conceivably you might be using one breast.

Also this:

kellymom.com/bf/concerns/mom/lopsided.html

Oh and LLL is 24 hours so if you are awake in the night and in pain, do call.

(Please just remember that you are calling a mother/breastfeeding counsellor).

[Alieight]

Hi,

My sympathies - I know how painful this can be. I had this problem for a little while and also went through the needle sticking thing. Although DP winced when he saw me sticking a needle into my nipple, I pointed out that it was FAR less painful that the pain of feeding from it!

What I found really helped was pumping right after the clearing the blister, and rather than sticking the needle in, using it to kind of lift the blister away iyswim? I also used to peel the bits of blister away as sson as I could.

I did find that since going back to work at when DS was 6 months, I haven't really had any. The only thing that has really changed is that I suddenly went from pumping every so often when I could be bothered to having to pump 4 or 5 times a day to produce enough milk for him at nursery. So for me, pumping lots seemed to work, especially as like you, my DS really didn't want to feed from that side much.

I don't know about feeding from one side only, although I think that the way milk production works there shouldn't be a problem with supply at this point. DS certainly has a favourite side, and will usually feed for far longer that side, and seems to be content with the amount he's getting.

[kitpuss]

Thanks to you both for your advice.

I finally got through to La Leche, they gave me similar advice to you to be honest, but it was just nice to actually speak to someone!

I have bought some lecithin, and I think I'm going to spend the next week or two doing lots of the above tips and hopefully my supply will increase and he'll be more inclined to feed from that side.

Just for interest, La Leche said I could feed from just one side, but hopefully I can avoid that.

Thanks again