Breast Pathology That Contributes to Dysfunction of Human Lactation: a Spotlight on Nipple Blebs

Mitchell, Katrina B.; Johnson, Helen M.

doi:10.1007/s10911-020-09450-7

Cited by 12 publications

(18 citation statements)

References 14 publications

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“…A superficial, inflammatory fibrinous lesion, appearing as a white spot on the nipple tip which may block a nipple opening, causing mild to severe nipple pain (fig 2) (This can lead to a blocked duct8)…”

Section: How Do You Diagnose the Cause Of Breast Or Nipple Pain?mentioning

confidence: 99%

Identifying the cause of breast and nipple pain during lactation

Amir

Baeza²,

Jones³

2021

BMJ

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Section: How Do You Diagnose the Cause Of Breast Or Nipple Pain?mentioning

confidence: 99%

Identifying the cause of breast and nipple pain during lactation

Amir

Baeza²,

Jones³

2021

BMJ

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“…Mitchell et al hypothesize that white spots result from subacute mastitis and mammary dysbiosis, in which ductal biofilm formation extends to the nipple epithelium ( Box 6 ). 79 , 80 Their hypothesis builds on the 2017 Rodriguez and Fernandez hypothesis that breast inflammation results from biofilm blockages within lactiferous ducts. 81 …”

Section: Classification: Signs and Symptoms Of Excessively High Stret...mentioning

confidence: 99%

Re-thinking lactation-related nipple pain and damage

Douglas

2022

Womens Health (Lond Engl)

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Nipple pain is a common reason for premature cessation of breastfeeding. Despite the benefits of breastfeeding for both infant and mother, clinical support for problems such as maternal nipple pain remains a research frontier. Maternal pharmaceutical treatments, and infant surgery and bodywork interventions are commonly recommended for lactation-related nipple pain without evidence of benefit. The pain is frequently attributed to mammary dysbiosis, candidiasis, or infant anatomic anomaly (including to diagnoses of posterior or upper lip-tie, high palate, retrognathia, or subtle cranial nerve abnormalities). Although clinical protocols universally state that improved fit and hold is the mainstay of treatment of nipple pain and wounds, the biomechanical parameters of pain-free fit and hold remain an omitted variable bias in almost all clinical breastfeeding research. This article reviews the research literature concerning aetiology, classification, prevention, and management of lactation-related nipple–areolar complex (NAC) pain and damage. Evolutionary and complex systems perspectives are applied to develop a narrative synthesis of the heterogeneous and interdisciplinary evidence elucidating nipple pain in breastfeeding women. Lactation-related nipple pain is most commonly a symptom of inflammation due to repetitive application of excessive mechanical stretching and deformational forces to nipple epidermis, dermis and stroma during milk removal. Keratinocytes lock together when mechanical forces exceed desmosome yield points, but if mechanical loads continue to increase, desmosomes may rupture, resulting in inflammation and epithelial fracture. Mechanical stretching and deformation forces may cause stromal micro-haemorrhage and inflammation. Although the environment of the skin of the nipple–areolar complex is uniquely conducive to wound healing, it is also uniquely exposed to environmental risks. The two key factors that both prevent and treat nipple pain and inflammation are, first, elimination of conflicting vectors of force during suckling or mechanical milk removal, and second, elimination of overhydration of the epithelium which risks moisture-associated skin damage. There is urgent need for evaluation of evidence-based interventions for the elimination of conflicting intra-oral vectors of force during suckling.

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“…Disruption of the blebs, whether intentional or unintentional, may result in a scabbed or scarred appearance. 52 Treatment of nipple blebs includes appropriate breastfeeding techniques, particularly to address hyperlactation, if present. Use of sunflower lecithin may be recommended for individuals with concurrent plugged ducts.…”

Section: Nipple Blebsmentioning

confidence: 99%

“…Blebs may arise related to plugged ducts or hyperlactation and, because of their obstructive nature, predispose to milk stasis and mastitis. Disruption of the blebs, whether intentional or unintentional, may result in a scabbed or scarred appearance 52…”

Section: Lactational Dermatosesmentioning

confidence: 99%

Common Complications of Breastfeeding and Lactation: An Overview for Clinicians

Radke¹

2022

Clinical Obstetrics &Amp; Gynecology

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Lactation and breastfeeding are core components of reproductive health care and obstetrical providers should be familiar with common complications that may arise in lactating individuals. While many breastfeeding challenges are best addressed by a lactation consultant, there are conditions that fall out of their scope and require care from a clinician. The objective of this chapter is to review common complications of breastfeeding and lactation including inflammatory conditions, disorders of lactogenesis, dermatologic conditions, and persistent pain with lactation.

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Breast Pathology That Contributes to Dysfunction of Human Lactation: a Spotlight on Nipple Blebs

Cited by 12 publications

References 14 publications

Identifying the cause of breast and nipple pain during lactation

Identifying the cause of breast and nipple pain during lactation

Re-thinking lactation-related nipple pain and damage

Common Complications of Breastfeeding and Lactation: An Overview for Clinicians

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