Blebs, breastfeeding and mastitis

Blebs, breastfeeding and mastitis

Are you pregnant and wanting to breastfeed? Maybe you’re breastfeeding right now? Perhaps you tried breastfeeding and it wasn’t successful, maybe you got mastitis and you didn’t want to continue anymore, but you’re open to trying again if you have another child.

Do you know what a nipple bleb is? Have you even heard of that term before? How does a nipple bleb cause blocked milk ducts? How does it contribute to mastitis?

Interview series

In this interview, I ask my friend Kyra about her experiences breastfeeding her 2 children. Both experiences were very different for her.

I have known Kyra for at least 5 years. She was first a patient of mine, but we’ve grown to become good friends. She is one of the friendliest people I know. She is good for a laugh and a talk, and I asked her some questions, to which she very generously answered. Her journey was really awesome, she taught me a lot about nipple blebs and I hope her information might help somebody out there too!

Hi Kyra,

Thank you so much for agreeing to do this interview. I had heard about nipple blebs many years ago, yet I hadn’t known anyone who had them, until you started talking about them. I want to share your breastfeeding experiences in the hopes that your journey may help others out there. Imagine all the women out there who may be experiencing mastitis due to blebs and not know!

Firstly, tell us a little about yourself.

I’m a mum to two beautiful girls (Mia, aged 4 and Jasmine, 18 months) and wife to Michael, a very supportive husband. We also have a handsome rescue furbaby, our dog, Cody. I’m a primary school teacher – I have always loved working with children and love learning from the students I teach. In my spare time I enjoy crafting, particularly sewing.

Did you have any strong feelings about breastfeeding before having kids and did that change once you were pregnant?

I was certainly keen to breastfeed and definitely assumed that I would; I was eager to follow in my mother’s footsteps as I know she successfully breastfed my younger sister and I for at least twelve months each.

Did you breastfeed both of your children? How long did you breastfeed each child for?

I did breastfeed both of my children. Unfortunately, the journey came to an end quite quickly with Mia – at six weeks of age. However, I have only just finished feeding Jasmine at just over 17 months – to say I am ecstatic is an understatement. 

What breastfeeding education did you receive when you were pregnant with your first child, Mia, to prepare for breastfeeding? Did you do any further education in hospital after you had Mia? Did you find the hospital staff helpful?

When I was pregnant with my first child, I became a member of the Australian Breastfeeding Association and attended an afternoon session with my husband to become more informed about breastfeeding. I had my daughter at a private hospital and was therefore able to seek advice from the midwives/nurses there. I found that each of the nurses had their own little tweaks to breastfeeding and quickly worked out whose advice I felt worked for myself and my baby. 

Some advice was unhelpful, for example, one of the first nurses I met during my first feed let me know that I was ”not following the position featured on the poster” in the nursing room.

 It’s all a rather overwhelming time when you’ve just had your first baby and it’s all new and you’re trying to get the hang of how to actually feed successfully. Overall, yes, I did find the hospital staff helpful.

You breastfed Mia only for a short time. How would you describe that experience? Did you get any further help once you were at home? 

I was following the advice of the hospital and thought I was feeding Mia correctly but she was losing weight as I actually wasn’t draining each breast properly per feed. The home nurse rectified this for me and I was given a few days for Mia to put on weight – my new method of feeding worked and she put on weight quickly after this time. 

I thought I was feeding quite well until we hit the six-week mark. During that week, I didn’t pay attention to latching off correctly and Mia bit my nipple/areola. It was rather painful to continue feeding her from this breast so my husband purchased an electric breast pump so I could pump from that side to give myself a break. Little did I know that within a day or two of this happening, I had mastitis. This was diagnosed two days after getting advice from the nurses in the hospital and from the ABA. The advice they gave to help drain my breasts meant I was making more and more milk because I wasn’t experiencing any relief at all (due to undiagnosed mastitis).

I was in a lot of pain over this weekend and so we started our daughter on formula. By the time I could see my GP first thing in the morning on Monday, I was a complete mess and utterly exhausted. I had tried calling the lactation consultant several times over the weekend that Jacinda had recommended but I just couldn’t get through and felt like I was at a loss. It was on that Monday that I decided I didn’t want to keep breastfeeding. I was extremely upset to stop breastfeeding with my baby being only six weeks old. I also felt guilty that I wasn’t doing what my body was supposed to… what I thought it was meant to do ‘pretty easily’. However, my own health had to be put first at this stage so that I could look after my baby and that was what cemented my decision to cease feeding at that stage.

Hiring a lactation consultant can be beneficial

When you found out you were pregnant for the second time, did you consider breastfeeding again? Did you do anything different to prepare?

We were so excited to be having another little baby join our family and I was very determined to breastfeed successfully (and for much longer!) this time. I am very thankful to have had Jacinda be part of both my pregnancy journeys, looking after my wellbeing and making sure that I was looking after my body the best that I could. This time, I made sure I sought advice from a lactation consultant, independent of the hospital I gave birth at for additional support and strategies for when our second child was born. The advice we received from (midiwfe and lactation consultant) Jane Palmer was absolutely invaluable. For example, she taught me about a technique called “reverse pressure softening”. This was a life saver at the beginning to help with latching, when I had an abundance of milk and my breasts were always full.

All about nipple blebs!

Please describe your experience the second time around breastfeeding Jasmine. Did you have any difficulties this time? I understand this time you discovered what “blebs” are. What did you do differently to succeed for so long the second time? 

I kept telling myself that I’d be happy with breastfeeding my second child for at least six weeks and that anything after that would be a bonus. However, it did not come without its challenges. Amongst plenty of other useful and practical advice, both Jane and Jacinda suggested taking probiotics once the baby was born and I took them until I finished feeding Jasmine. I feel these probiotics assisted in me never having mastitis – not even once this time. 

When Jasmine was just short of a month old, I thought I was having my first bout of mastitis.  Turns out it was a blocked duct and a bleb on my nipple. I didn’t know about blebs with my first child. They are often described as a “milk pimple”. My bleb didn’t seem to be the textbook kind I was reading about… throughout my breastfeeding journey, I had quite a few blocked ducts, with each and every one being accompanied by a bleb. The best way to describe them would be like those annoying blind pimples I’d get from time to time on my face… the best way to see the bleb was to soak the affected breast in a hot water solution with Epsom/ magnesium salt. This would expand and soften the pores so I could attempt to burst it and then release the blocked duct so my baby could suck that milk out and relieve the pain I was experiencing. I’d burst the blebs with a sewing needle. Eventually I moved to acupuncture needles – much finer and easier to get the pesky suckers! In between soaking blebs, it was important to keep the affected nipple soaked in an oil-soaked cotton-wool ball. Sometimes it took a few soaking treatments before I could burst the bleb and it was painful to contort my body and try to see the tiny things when I was tired from looking after my two gorgeous girls. I won’t lie, every time I got a bleb, they truly scared me as the pain of each blocked duct reminded me of the mastitis I experienced with my eldest but somehow I managed to get past each one.

My journey of 17 months of breastfeeding has just come to an end – all on my daughter’s terms. Looking back on it now, it has been a wonderful journey. I was so lucky to have an amazing tribe of people telling me that I could do it and my mindset was open and (mostly!) positive because of their belief in me. As well as my husband and best friend, I had the most supportive acupuncturist, chiropractors, physiotherapist and massage therapist all providing much needed treatment and advice whenever I needed it.

Did you make a conscious decision to wean Jasmine when you did? How did you wean her? And how do you feel now that you’ve stopped breastfeeding?

I thought that I would wean Jasmine at 12 months when it was deemed safe for her to have cow’s milk, just like I did with Mia. I found that with Mia, this transition was rather easy. I cannot be certain, but maybe this has to do with formula (for which I am VERY grateful!) being not as ‘sweet’ as mummy’s milk! Jasmine did not want a bar of cow’s milk. So, I returned to work after 12 months of maternity leave… and just as I did, I got yet another bleb! I kept the morning and night breastfeeds going for my little girl as she seemed to still want mummy’s milk. After 13 months, I did not get anymore blebs. Perhaps because my breasts weren’t making as much milk and they were FINALLY settled? Jasmine would always see Mia drinking cow’s milk and at the 17-month mark, decided she wanted some of that too. Just like that, she started having her morning (cow’s) milk with Mia after breakfast. She wasn’t really interested in mummy’s milk bar anymore.

The next night, we continued our normal night routine; this involves popping her sleep suit on, reading one or two books (usually one before a breastfeed and one after), brushing her teeth and then off to bed. We replaced the breastfeed with cow’s milk and she wholeheartedly accepted. Seemed like she couldn’t get enough! It was definitely a bittersweet ending. I didn’t think that night feed would stop so quickly and I was definitely holding onto it. However, it was so beautiful to see my little girl make the choice… to show me how much she enjoyed breastfeeding and to let me know that she’s now okay. There were happy tears because not only am I proud, but I honestly can’t believe we made it this far. 

Do you have any advice for any other women/mums who would like to try breastfeeding either for the first time, or try again if they didn’t quite succeed at previous attempts?

I have seen both sides – formula and breastfeeding and I definitely agree with the statement that fed is best. Having said that, there definitely is an absolutely indescribable and amazing bond formed when you choose to breastfeed and overcome obstacles you never thought you could.

Firstly, it’s important to believe in yourself. Don’t believe in the first professional you speak to. It’s not just about the baby’s wellbeing – you cannot successfully breastfeed without also looking after yourself. All professionals have different opinions and it’s very important to explore your options so you’ve got the right fit for YOU and have the confidence in the people you trust to support you and your baby. Don’t just believe the advertisements you see on television and assume that they’re the best because that’s what you’ve been exposed to. Take on the advice of people you trust but also do some research for yourself. It takes a village to raise a baby and having support is crucial to staying positive, particularly if you choose to breastfeed because it can do many things to your body. If you WANT to do it, you can!

Thank you so much Kyra for giving of your time so generously to answer these questions!

Kyra utilised the help and support of many different people in order to set herself up for success the second time around. These include myself and:

Jane Palmer, independent midwife and privately practising lactation consultant

Amber Duff, chiropractor from Integrated Chiropractic and Wellness

Trisha Ching, Women’s health physiotherapist, from Sydney Women’s Physiotherapy