Nipple Whitening - Vasospasm

If the blood flow to the nipple is restricted, it begins to turn white. The condition is also referred to as vasospasm. It may be accompanied by pain, but it may be absent. Most often the problem is associated with improper breastfeeding by the baby or due to Raynaud's phenomenon.

Symptoms that occur with this condition include:

• sore nipples - the pain is often described as a stabbing or burning sensation and may be felt soon after breastfeeding or between meals. It usually worsens at low temperatures;
• graying of the nipples - the nipple may appear white after breastfeeding, and later acquire other colors - blue, red (changes in color are associated with the Raynaud's phenomenon);
• severe chest pain;

Grain whitening due to compression

The most common reason for this change in nipple color is the squeezing of the nipple by the baby while breastfeeding. This may be due to:

• improper breastfeeding;
• inefficient sucking;
• short bridle;
• bite restriction;
• changes in the palate;

When whitening is due to compression caused by the baby, the nipple is white and often deformed (it is flattened, wrinkled, pointed) immediately after feeding. The pain may begin just minutes after breastfeeding, when blood flow begins to return.

For breastfeeding mothers, the main cause of vasospasm is probably improper breastfeeding. In addition, a number of risk factors are indicated:

• low temperatures;
• periods of severe emotional stress;
• smoking;
• migraine;
• diseases such as fibromyalgia, systemic lupus erythematosus, rheumatoid arthritis, hypothyroidism or carcinoid or previous breast surgery;
• medications - fluconazole, oral contraceptives containing estrogen.

Vasospasm caused by Raynaud's phenomenon

In this case, the vasospasm is more severe. It is extremely painful. It can occur after breastfeeding or between breastfeeding. The nipple turns white shortly after breastfeeding, and does not come out white from the baby's mouth immediately after feeding. The color of the nipple changes from white to blue to red - when the blood returns.

Vasospasm due to the Raynaud's phenomenon is more likely to occur on both grains (rather than just one grain), lasts for a longer period of time (rather than a few seconds or a few minutes), and may occur in pregnancy and non-breastfeeding periods. Vasospasms can affect, in addition to the nipples of the chest, fingers and toes. Raynaud's phenomenon can recur with subsequent pregnancy or breastfeeding, so be prepared to seek quick treatment for the problem. Low nipple temperatures and injuries usually provoke vasospasm and / or worsen it.

Because women often describe burning, stinging, and pain sensations, this can be misdiagnosed as a bacterial (staphylococcal) or fungal infection (thrush). Improper diagnosis will lead to unnecessary treatment, which can worsen the symptoms of vasospasm.

Keep in mind that Raynaud's phenomenon is not caused by breastfeeding (anyone can be affected by the disease) - it simply has the potential to affect breastfeeding itself (especially if you have flat or sunken nipples; problems with positioning and breastfeeding by the baby ).

How to avoid the symptoms of vasospasm?

Try to avoid risk factors. This will greatly help prevent the symptoms. Try to avoid smoking and cigarette smoke, caffeine, stress or any vasoconstriction medication (eg some decongestants).

For guidance on the correct positioning of the baby, it is necessary to meet with a breastfeeding consultant. Improper breastfeeding and ineffective breastfeeding can cause the nipple to turn white.

More information can be found in the topic "Preparation and postures for breastfeeding".

See your doctor to rule out other possible causes of burning, stinging and painful sensations in the nipples.

Low temperatures can worsen the symptoms of vasospasm. In such cases, you can apply warm compresses on the nipples. Breastfeed in a well-heated room and cover the nipple as soon as you have finished breastfeeding.

It is good to massage the nipples with warm oil after breastfeeding to stop vasospasm.

If the cup of your bra is smaller than necessary, it can put pressure on the nipple, which in turn can lead to circulatory disorders.

Breastfeeding tips for Raynaud's syndrome

The association to help and support pregnant and lactating mothers gives specific advice for people suffering from Raynaud's syndrome:

• Never place the baby on the breast while the nipple is vasospasm. Try to warm the breast and squeeze the nipple several times to help restore blood circulation before you start breastfeeding.
• In some mothers, expressing breast milk may be less painful than direct breastfeeding. If you have severe pain, try this.
• Warm the nipples and do not let them dry after breastfeeding.

Treatment options for vasospasm

Apply warm compresses to the breast when needed (this relaxes the blood vessels) or put on warm clothes.

After you have finished breastfeeding and apply a warm compress, cover your breasts as soon as possible. You can make one yourself by filling a sock with rice. Place it in the microwave for 45 seconds (or until the desired heat is reached) and hold it in the nipple area (above the garment or using a towel on the breast) until blood circulation is restored.

Caffeine, nicotine, diet pills, drugs containing pseudoephedrine or phenylephrine, beta-blockers and other vasoconstrictors, as they may aggravate symptoms. Estrogen-containing oral contraceptives have also been associated with vasospasm.

• ibuprofen or acetaminophen - can relieve vasospasm pain. The drugs are safe to take during breastfeeding. They are usually prescribed for a period of 2 weeks and this may be enough to relieve the pain. Some mothers may need a longer intake;
• food supplement with calcium and magnesium;
• dietary supplement with vitamin B complex, which includes B6 and niacin;
• food supplement with supplements with omega fatty acids, fish oil, evening primrose oil;
• low-dose nifedipine (usually used for high blood pressure, but can also help with nipple vasospasm and is safe for breastfeeding mothers and babies). As nifedipine lowers blood pressure, it is imperative that you consult a doctor to monitor your condition. If you experience any side effects such as dizziness, weakness, headache, palpitations, redness or swelling of the legs, you should stop treatment and contact your doctor as soon as possible.