Breastfeeding: White pimple on nipple
I have a white "pimple" on my nipple. My doctor said I could come in and he would try to drain it with a needle. I also have had discharge from my right breast off and on for many months and think I may have a fever. It is very painful, especially the week before my period. What can I do to help resolve this condition?
Question:Kathy Kuhn
Kathy Kuhn is a registered nurse who has been working with breastfeeding families since 1981. She has been an International Board Certified... Read more
It's difficult to assess exactly what the "pimple" on your breast is without seeing it. I strongly urge you see your physician for an examination. It's possible that you have a plugged duct, milk blister or an abscess along with a case of mastitis. Plugged ducts, milk blisters and abscesses can give a pimple-like appearance.
The most common contributing factor that causes these conditions is a back up of milk in the breast (milk stasis). Milk statis can be caused by poor position and latch, abrupt reduction in the amount of breastfeeding, breastmilk oversupply, irregularities in the breast from previous surgeries or injuries, or constriction of the breast caused by a too tight bra. Plugged ducts and milk blisters are generally painful and when they occur on the tip of the nipple can look like a pimple. Milk blisters can be white or clear and may be caused by a plug of thickened milk or skin over the end of a duct. Plugged ducts are literally a blockage in the milk duct, usually of thickened milk, that prevents or greatly reduces the flow of milk from that duct.
To treat both plugged ducts and milk blisters, apply warm compresses to the affected area just prior to breastfeeding or milk expression. I think the easiest way to do this is to "dangle" the breast in a basin of warm water. While you soak the breast, gently massage any plugs working toward the nipple. Plugged ducts and milk blisters increase your risk for mastitis, a breast infection, that could cause the fever. Mastitis is an infection of the breast that usually has a sudden onset with flu-like symptoms, fever and a very sore breast. Sometimes however, a sub-clinical mastitis can occur that has a slower onset and milder symptoms. Mastitis is usually treated with antibiotics, rest and frequent breastfeeding to promote milk drainage. If you are not able to breastfeed, which is the most effective method to promote drainage of the breast, milk expression with a high quality rental breast pump would be the second choice. Typically with plugged ducts and mastitis the breast feels somewhat more comfortable after a feeding or pumping session.
However, because of the drainage and long term pain, it seems more likely that you have an abscess. An abscess of the breast can occur after an untreated or under treated bout of mastitis. If your breast has been painful for many months it's possible that you had mastitis and didn't realize it or seek treatment. An abscess is a localized collection of pus, thus the pimple-like appearance. Abscesses are usually treated by draining the abscess either with a needle or surgically with a small incision. It is possible and usually preferable to continue to breastfeed even when an abscess has occurred and has been surgically drained.
The reason your breast may be more painful prior to your period is because the swelling that can occur premenstrually may be increasing the pressure in the breast and contributing to milk back up and aggravating your pain.
I would also recommend that you get a referral from your physician for a board certified lactation consultant. The lactation consultant would assist you to maintain breastfeeding through any procedures your physician recommends and the recovery period. A lactation consultant would also be able to assess what may have caused the problem. Finding and correcting the cause of the problem would help to speed your recovery and minimizing your risk for a recurrence or other related breastfeeding concerns.
Again, I want to stress that it is important for you to see your physician since my information is not based on a physical exam of your breast and therefore may or may not be entirely appropriate for you in this situation.
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