What are Vasospasms and How to Recognize Them

Pain with breastfeeding is not uncommon, although it’s not necessarily normal and can be helped. There are a lot of very common reasons for nipple pain with breastfeeding, and some that are not so common. Vasospasm is an uncommon breastfeeding issue that can be hard to diagnose -unless you know what to look for. Many people suffer with unexplained breastfeeding pain. You might try fixing the latch, positioning, and still experience no improvement. Be sure to see a lactation consultant if breastfeeding is painful for more than about 30 seconds after you start feeding your baby. It can be normal to have some discomfort at first, but it should go away quickly.

What Does Vasospasm Look Like?

A lot of times, it can be complicated to figure out what might be causing nipple pain. Sometimes it’s that the baby has a bad latch. That might not be so easy to figure out, because there are a lot of reasons that a baby might have a bad latch. There may be an issue with flat nipples, a small mouth or high palate. A baby might have an oral restriction. It might be the way you’re holding the baby, or that there is some nipple damage that hasn’t healed yet. But if you’re having vasospasms, it might be very obvious. 

Nipple vasospasm is caused by a reduced flow of blood through the capillaries. Here’s what to look for: 

• Your nipple, or even just the tip of your nipple, will probably look “blanched” after your baby detaches from your nipple. If you’re a lighter-skinned person, this might mean that your nipple turns white. If you have darker skin, look for a lightening of the color, an ashen hue, or yellow-white skin. 
• Then as the blood flow returns, the nipple may start to regain some color and may look ashen, darker or red. 
• There will likely be some pretty intense sharp, burning, and shooting pain that goes along with the color changes. This is usually right after your baby unlatches from the breast. 
• Sometimes pain can occur during a feed, but usually after. 
• The pain might last for a few seconds or even a few minutes. 
• Cold might make this worse, or you might notice some nipple pain when you are cold even if you’re not breastfeeding. 

 

Causes of Vasospasm

If you do a web search, you might see a lot of information about Reynaud’s Syndrome or “Reynaud’s Phenomenon” being the cause of vasospasm. That sounds scary, but it’s not all that uncommon, affecting 1 in 20 or more, and doesn’t necessarily mean anything else is wrong. It may mean that a person gets more cold in their extremities and it’s harder to get warm because of less blood flow to the area. That can include nipples. 

When a person is breastfeeding, vasospasm might be triggered by special situations. 

• A baby has a shallow latch, causing a lot of nipple compression. 
• The baby isn’t sucking correctly. 
• A baby is clamping down on the nipple because of a very powerful milk ejection or other issues. 
• A baby has oral restrictions or anatomy that makes getting a great latch more difficult. 
• Cold

 

Treatments for Vasospasm 

There are many things to try that could make a big difference in your discomfort levels. For some people, prescription medication like Nifedipine might be the key, but for most people, some simple modifications are all you need. 

 

• • Improve latch. If your baby is latching well, you’ll likely experience less pain. 
  • Keep warm. Try putting a warm compress on your breasts before and after breastfeeding. For a lot of people, the nipple gets cold right after the baby unlatches because it’s damp and exposed. Having something warm nearby can help. 
  • Avoid Nicotine. This can make it worse because nicotine can cause a contraction of blood vessels. 
  • Decrease caffeine intake. Caffeine can also cause blood vessels to narrow and tighten. 
  • Supplementing with Omega fatty acids, calcium, magnesium, and vitamin B6 might help. Talk to your health care provider before adding these into your routine. 

 

It really is best to be seen by a lactation consultant (IBCLC) if you are experiencing nipple pain of any kind. Remember that nipple pain is a sign that something is wrong and should be treated. Too many people accept nipple pain because they believe it’s normal when breastfeeding. Some initial level of discomfort is to be expected, but not prolonged or chronic pain. 

References

Nipple Pain in Breastfeeding Mothers: Incidence, Causes and Treatments – PMC

Nipple Pain, Damage, and Vasospasm in the First 8 Weeks Postpartum – PMC

Raynaud’s Phenomenon Symptoms, Types, & Risk Factors | NIAMS

Raynaud’s phenomenon – PMC

Nipple Blanching and Vasospasm

Persistent Pain When Breastfeeding – La Leche League International