What causes white spots on nipples and are they linked to breastfeeding?

Breastfeeding can be a tricky skill to master as a new parent.

While so much emphasis is put on preparing for labour and birth, learning how to feed your baby is often something that is left as an afterthought.

How should you hold your baby? What does a good latch and attachment feel like? How often should your baby be feeding? In a sea of new experiences, understanding how to breastfeed (if you decide that's right for you) can be a steep learning curve.

Just when you've found your groove, you might notice a white spot on your nipple. It might come with nipple pain, soreness and discomfort around this nipple blister.

If you're wondering what this white spot could be, how it's caused, and how to treat it, you've come to the right place.

What causes a white spot to form on the nipples?

Let's start with the basics. Some breastfeeding women notice a white spot appearing on their nipples, usually on the nipple tip.

This spot on the nipple is typically about the size of a pinhead and may be surrounded by red or inflamed skin.

Unlike the name suggests, a white spot on the nipple doesn't actually have to be white in colour. Often these spots appear more of a light pink or a shade of cream or yellow [1].

You'll probably notice these spots quite quickly as they can lead to nipple pain, particularly when you breastfeed.

So, what causes a milk bleb to appear? Typically there are two main causes of milk blisters:

• A tiny amount of skin grows over the opening of your nipple and causes a blocked nipple pore or duct.
• A string of hardened milk or thickened milk causes the milk duct to block.

According to the Australian Breastfeeding Association, the blocked nipple pore that you experience with a white spot is similar to the experience of mastitis.

What is a white spot on nipple called?

While the most common name for this condition is a white spot, there are plenty of other names you might hear thrown around.

Some lactation consultants and your healthcare provider might call these bumps a white bleb, a blocked nipple pore or even a milk blister.

No matter what name you or your care team use, the experience of this condition is the same: blocked nipple pores cause your affected nipple to become tender, sore and painful (particularly during breastfeeding).

Are they a cause for concern?

In short, no. Developing a milk blister is very common and is usually not a cause for concern.

In some cases, a milk blister can resolve itself and may burst during feeding (allowing any thickened milk or blocked milk ducts to clear).

In other cases, you make need to soak your nipple in warm water and ensure your nipple is gently rubbed with a wet face washer.

Olive oil is sometimes recommended as a way to massage and gently pull on the nipple to relieve the blocked milk duct.

Unfortunately, some women experience milk blisters on a regular basis and find these white spots continue to appear on a recurring basis.

In these cases, you might need to look beyond solutions that provide instant relief and look for prevention strategies (such as washing your nipples gently with a face washer each day).

What causes the white spots to appear and how to treat them?

As we've mentioned, a milk blister is caused by some kind of blockage in your milk ducts.

Whether it's been caused by skin covering your duct or hardened milk becoming trapped in your duct, there is a range of practical steps you can take to clear your milk duct and get your breast milk flowing.

A blocked pore or duct

By now, you know that the most common culprit for white spots and milk blebs is blocked milk ducts [2].

To understand how this happens, let's run you through how breast milk travels through your breast tissue and into your baby's mouth.

Deep inside your breasts is a series of ducts that help to carry milk to your nipple openings.

However, if one of these ducts becomes blocked by thickened milk or skin, milk can build up behind your nipple.

This can cause a range of issues, from lumps to milk blisters to engorgement. In some cases, you might feel one specific area of your breast is engorged or you may start to see redness or swelling appearing.

In more severe cases, you might begin to experience flu-like symptoms and may be experiencing mastitis (an infection that requires support from your GP as soon as symptoms start to appear) [3].

So, what can you do to clear and relieve blocked ducts?

Before feeding

• Take a hot shower and gently massage your breast under the water to break up the blockage
• Use a warm compress or cloth to wrap your breast and soften the lump

During feeding

• Feed frequently to relieve and drain the affected breast
• Check your baby is latched correctly to ensure your milk is flowing downwards from the blockage to your nipple
• Try hand expressing if you still feel a blockage after feeding

After feeding

• Place a cool ice pack or chilled cabbage leaf on your breast to reduce pain and inflammation after feeding

If your blocked duct doesn't resolve on its own, you may need to visit your doctor to have this duct drained using a sterile needle.

At Kin, we know 92% of mums experience some kind of breastfeeding issue, whether it's engorgement, mastitis or blocked ducts [4].

That's why we created our Nipple Balm, a natural and nourishing blend of avocado oil, lanolin and shea butter to build up skin elasticity, prevent chafing and repair nipple cracking. It also helps to combat dryness and is safe to leave on for feeds, so you don't need to wipe it off.

Milk drainage

Another common cause of a blocked duct is poor milk draining. Usually, this is caused by the way your baby is attached to your breast tissue.

If they don't have a deep latch and good attachment, your breast milk might not be draining correctly and causing blockages in your ducts [5].

Breastfeeding positions can take a bit of practice to get right. In broad terms, some of the signs of a good latch include:

• You're not experiencing pain or pinching during feeds
• You can't see any of your areola (the dark skin around your nipple)
• Your baby's mouth is filled with your breast
• You can see and hear your baby swallowing
• Your baby's chin touches your breast

If you're struggling to properly drain milk from your breasts, make sure to chat with a lactation consultant.

They'll be able to assess your positioning and your baby's attachment, offer suggestions and help you feel comfortable and confident as your baby feeds.

Pregnancy and hormone changes

In some cases, women can notice raised white bumps on their breasts (known as Montgomery tubercles) [6].

This can be a sign of early pregnancy, with studies showing anywhere from 30-50% of pregnant women experience these bumps.

These white bumps can also be caused by hormonal changes (such as your menstrual cycle, if you try a new form of hormonal contraception or if you're navigating a hormonal imbalance due to stress).

These bumps aren't usually harmful, but they can easily be treated by avoiding any harsh cleansers on your nipples and ditching any non-breathable bras that can cause friction on your nipples.

Pressure on the breast

Another common cause of white spots can be wearing clothes that place unnecessary pressure on your breasts.

Not only does this cause rubbing and friction, but it can lead to milk blockages and even white spots appearing on your nipples.

Your best bet is to switch to a bra that is made of a soft breathable material, ditch your underwire bras and avoid tight tops.

Thrush

This fungal infection can happen on your nipples, especially if you recently had a course of antibiotics or have had vaginal thrush.

Not only will you see white spots, but you might also notice your nipples are red and painful.

Thrush is very contagious and is easily passed onto your baby so make sure to visit your doctor for an antibiotic ointment or anti-fungal cream that can be used to treat you and your baby.

As you can tell breastfeeding isn't always a breeze. If you're navigating sore nipples, engorgement or white spots, grab Kin's nourishing Nipple Balm to relieve pain, prevent chafing and soothe your sore nipples.

And remember, if you need help, don't hesitate to reach out. Breastfeeding can be a difficult experience and there's no shame in asking for assistance.