Extremely Sore Nipples? Nipples Changing Colour After Breastfeeding? Could it Be Vasospasm?

Vasospasm is not exceedingly common but this definitely happens to a few women. In this blog, we will discuss nipple blanching and vasospasm as they are separate issues, which can often be mistaken for the same thing.

What is Nipple Blanching?

Nipple Blanching happens when the nipple comes out from your baby’s mouth whitened and misshapen. The most frequent reason for this is due to your baby compressing your nipple during a breastfeed.

When you notice your nipple is white after breastfeeding, you may see that the end of the nipple is also flattened, creased or pointed; imagine the shape of a new lipstick – that’s a misshapen nipple!

Your nipple should always come out of baby’s mouth the same shape it went in, but, maybe a little elongated.

You may find that pain in your nipple increases several seconds to a few minutes after the feed.

Nipple blanching can be due to:

• Incorrect attachment at your breast
• Your baby clamping down on your nipple in order to slow down your fast flow of milk
• Your baby may have a tongue-tie (your lactation consultant will be able to assess for this)
• There may be certain oral palate variations (your lactation consultant will be able to assess for this)

It is really important to seek help with breastfeeding from a lactation consultant or your maternal child health nurse to enable you and bub to find a way to solve this for you. This way you will be able to go on enjoying your feeding time together.

What is Vasospasm?

A condition known as Raynaud’s phenomenon, where your fingers turn white when they are cold can also affect the nipples.

Pain can occur during, immediately after, or even between breastfeeds. You may notice that your nipple turns white. Then, you will often see the nipple change colour again; from white to blue to red as the blood flow returns to the nipple.

Vasospasm due to Raynaud’s is more likely to occur on both nipples.

Vasospasm tends to last for longer periods of time than nipple blanching and does not go away even with good attachment at the breast during feeds.

Cold is usually the trigger for vasospasm. This happens when your baby stops breastfeeding and pulls off the breast exposing your nipple to the cooler air.

The pain from vasospasm can be mild or severe, and may be in the form of sharp or burning pains and throbbing.

Vasospasm is often mistaken for thrush of the nipple because of the similarities in how women describe the pain. But the colour change in the nipple tends to make it clearer when it is vasospasm rather than thrush.

What Can You Do if You Think You May Be Suffering from Vasospasm?

First, seek help from a lactation consultant to check your breastfeeding attachment and suggest nipple vasospasm treatment. Your lactation consultant can also check for any nipple damage, infections or thrush of the nipple.

Try and keep your nipples warm. Here are a few options that may help:

• Using a warm heat pack on your nipples straight after feeding
• Placing a pair of clean warm socks in your bra
• Purchasing some Breast Warmers which reflect your own body heat through the reflective material in the Breast Warmers
• Wearing an extra layer of clothes
• Avoiding exposing your nipples to “air” them

Massaging your nipple with olive oil when you are feeling pain is helpful for some women.

Avoid caffeine, nicotine, diet pills and cold medications containing pseudoephedrine or phenylephrine, beta blockers, and other vasoconstrictive drugs. These can all make your symptoms worse.

Oral contraceptives containing estrogen have also been associated with vasospasm, so, it is important to discuss this further with your GP or Gynaecologist.

There are some supplements which have been shown to help vasospasm and may be appropriate to look further into if the above recommendations are not working:

• Magnesium tablets help to relax the blood vessels. It is advisable to speak to a naturopath to discuss the best dose. This can be done in the health store.
• Fish oil capsules or evening primrose oil may also improve blood vessel relaxation.
• Dietary supplementation with a vitamin B complex that includes B6 and niacin may help.
• Ibuprofen for may be helpful for pain management.

Some women may need to discuss this further with their GP or lactation consultant. If none of the above is helping they may need to take a prescription medicine of low dose oral nifedipine to relieve the vasospasm.

The good news is that vasospasm can be treated and you will be able to go on breastfeeding, pain free.

Please reach out to health professionals qualified in breastfeeding support to gain the best information and support for vasospasm and nipple blanching.

If you have suffered with vasospasm or nipple blanching share your thoughts and comments with us on our Medela Australia Facebook page.