Breastfeeding: Nipple blanching
I have a problem with my breasts and I am very concerned how it will affect breastfeeding. The doctors seem to think I have an "abnormal surge of oxytocin unders different stressors." My nipples turn white and then purple. I get painful attacks that last for twenty minutes. It is some type of vasoconstriction, which is vascular. No one can give me any answers about how this will affect breastfeeding. Can you help me?
Question:Debbi Donovan
Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more
Some mothers do experience vasoconstriction, commonly known as nipple blanching, while breastfeeding. Usually it is in conjunction with a baby who "chomps" or clamps down on the breast while nursing. It is not well-studied. Some medications, such as theophylline and terbutaline have been associated with this condition, as have nicotine and caffeine. There may also be an allergy component to vasospasm.
In the Breastfeeding Review, May 1996, it is suggested that smoking as little as two cigarettes a day and ingesting caffeine (nicotine and caffeine are both vasoconstricters) can exacerbate this problem. Moderate aerobic exercise is suggested for the mother, along with 12 capsules of evening primrose oil or fish oil per day. (This can take up to six weeks to work.)
Nifedipine (5 mg. three times a day, gradually increasing dosage to needed level) has also been used. It is a calcium channel blocker, available by prescription. According to Thomas Hale, R.Ph., Ph.D., Medications and Mothers' Milk, 1996, it does transfer to breastmilk, but in low levels. The American Academy of Pediatrics considers this drug to be compatible with breastfeeding.
There are comfort measures to use while nursing your baby. Be especially careful when supporting your breasts and your baby as you begin to breastfeed. Look at your nipples as your baby comes off your breast. They should be round and pink, with no crunching or creases. Avoid becoming chilled, since this can worsen the condition. Warm compresses applied to the nipple and areola area prior to nursing may help to prevent the intense reaction and the subsequent pain. Anecdotally (no research to back this) I have heard Niacin recommended to mothers experiencing nipple vasospasm. Recommended dosage is 125 to 250 mg. each day. Calcium/magnesium supplements have provided relief for some moms. Ibuprofen can be taken for pain relief. Best of luck with your baby-to-be!
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