Types, Causes, and Safety of Blisters on the Breasts and Nipples

Woman holding newborn child
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Blisters are tender, raised, red or white areas on the skin with a collection of fluid underneath. The fluid in a blister may be clear and watery or made up of blood or pus. Blisters can develop on your skin from an allergic reaction, a virus, or irritation. If a blister forms on your skin, it can be painful and interfere with breastfeeding. Depending on the type of blister, you may even have to stop breastfeeding for a while.

Here are the types of blisters that can develop on the skin around the breasts.

Friction Blisters

A friction blister forms when there is constant rubbing or pressure put on the same spot on the skin. When you're breastfeeding, friction blisters can develop on your breasts, nipples, or areola. The causes of friction blisters include:

  • A Poor Latch: When your baby is not latched on to your breast correctly, it can cause damage to your breast tissue, areola, and nipple. A poor latch can also cause friction blisters to appear on your baby's lips.

  • Breast Pumps: The improper use of a breast pump can cause irritation and damage to your breasts. When the pump flanges (shields) do not fit you well, or the suction of the pump is set too high, blisters can form.

  • Nipple Shields and Breast Shells: You can get blisters if you wear breast shells or use nipple shields that constantly rub against your nipple, areola, or the skin on your breast.

  • A Nursing Bra That Doesn't Fit: If your bra is too big it could rub against your skin. If it's too tight, it could put excessive pressure on your breast tissue. Both of these situations can lead to blisters.

If you have a friction blister on your breast, you can continue to breastfeed. It may be painful for you, but a friction blister will not cause harm to your baby.

However, if the blister breaks open and the fluid leaks out while you're nursing, it could change the flavor of your breast milk. Your baby may stop breastfeeding if he doesn't like the taste.   

Other Types of Blisters

Milk Blister: A milk blister or nipple bleb is a small white or yellow spot on the nipple that blocks the end of the milk duct. It looks like a whitehead pimple. Some women are not bothered by the small blister, but for others, it can be very painful. Milk blisters often go away on their own. If you have a milk blister, you can continue to breastfeed and pump very frequently to keep the milk flowing and help to remove the bleb.     

Poison Ivy, Oak, Sumac: Poison Ivy, poison oak, and poison sumac are plants that can cause an allergic reaction on your skin if you come into contact with them. You can develop an itchy, red rash with raised fluid-filled blisters. If you get this type of blistery rash on your breasts, you should not breastfeed. You can give your baby pumped breast milk while you have the rash, and begin breastfeeding again once the blisters have healed.

Herpes Simplex Virus: Active herpes lesions on your breasts can look like small red bumps, fluid-filled blisters, or open sores.

They may be itchy or painful. The herpes virus can pass to your child through contact with the blisters or sores. Since herpes is dangerous, and even deadly, to infants, you should not breastfeed with active herpes lesions on your breasts. You should see your doctor and receive treatment. In the meantime, you can pump and dump your breast milk to keep up your milk supply. Then, once the lesions dry up and heal, you may be able to resume breastfeeding.

Chickenpox: Chickenpox (Varicella) is a very contagious illness that can be spread through the air or by contact. Due to vaccinations and previous childhood immunity, adults in the United States do not often suffer from chickenpox infections.

If, however, you do come down with chickenpox while you're breastfeeding, you can usually continue to nurse your child. By the time you notice the blistery rash, your child would have already been exposed to the virus. If your health care team determines that you need to stay away from your child while you're contagious, you should still be able to pump your breast milk for your baby.

Sources:

Berens P, Eglash A, Malloy M, Steube AM, Academy of Breastfeeding Medicine. ABM Clinical Protocol# 26: Persistent pain with breastfeeding. Breastfeeding Medicine. 2016 Mar 1;11(2):46-53.

Heller MM, Fullerton‐Stone H, Murase JE. Caring for new mothers: diagnosis, management and treatment of nipple dermatitis in breastfeeding mothers. International journal of dermatology. 2012 Oct 1;51(10):1149-61.

Lawrence, Ruth A., MD, Lawrence, Robert M., MD.  Breastfeeding A Guide For The Medical Profession Eighth Edition. Elsevier Health Sciences. 2015.

Riordan, J., and Wambach, K. Breastfeeding and Human Lactation Fourth Edition. Jones and Bartlett Learning. 2014.