You’re cuddling with your baby after a nursing session, only to experience severe shooting pains through your nipples moments later. Your nipple may turn pale or white, or look misshapen.
You might be experiencing nipple blanching or a nipple vasospasm, two conditions that can affect nursing moms and may have you wanting to throw the towel in on breastfeeding entirely. The good news: A few fixes can usually ease symptoms so you and baby can return to breastfeeding bliss.
What is nipple blanching?
If you finish nursing and your nipple pops out of your baby’s mouth whitened and in a funny shape — almost like the tip of a brand-new lipstick — you might have nipple blanching. This usually happens because your baby bore down a little too hard on your nipple while he was feeding. As a result, the nipple becomes compressed.
What is a nipple vasospasm?
A nipple vasospasm occurs when the blood vessels around your nipple contract abnormally, resulting in impaired blood flow to the area. Almost a quarter of all new moms experience vasospasms within the first eight weeks of baby's birth, according to one study.
Women who have Raynaud’s phenomenon — a rare disorder that causes blood vessels in the fingers and toes to narrow when you’re cold or stressed — are often more susceptible. While nipple vasospasms usually first crop up when you begin nursing, they can occur occasionally during pregnancy as well.
What are the symptoms of nipple blanching?
With blanching, you might notice the following:
- A white or misshapen nipple as soon as it leaves your baby's mouth
- A white stripe across your nipple
- Some pain a few minutes later as circulation and blood flow returns.
What are the symptoms of nipple vasospasms?
Nipple vasospasm scan feel more intense than nipple blanching. Signs include:
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- Intense nipple pain once your baby is off your breast. The pain may be burning, stabbing or throbbing. Some women also notice it when their babies latch and as milk lets down.
- Worsening nipple pain when you're cold. You also experience it when you step out of a warm shower or venture outdoors on a cold day.
- Color changes. Your nipple may turn white, blue, purple or red before returning to its normal color.
- General nipple pain, which can last for as little as a few seconds to as long as a few hours.
One way to tell nipple vasospasms apart from other types of nipple pain is that they're predictably triggered by cold while other causes of pain are not.
What causes nipple blanching?
The main reason women experience nipple blanching is poor latch. If it’s too shallow, it will compress the nipple as baby nurses.
Other common causes are a too-fast milk flow, which leads to a baby clamping down in an effort to control it. (A tip off that this is the cause could be if your baby often chokes or sputters during feeds.) Your baby may also have tongue-tie or a palate problem that leads to trouble nursing.
What causes nipple vasospasms?
It’s not completely clear why some women get vasospasms and others don’t. Women who get nipple vasospasms are more likely to have a family history of Raynaud’s phenomenon, to complain in general of cold fingers and feet or even to have an underlying autoimmune disorder such as rheumatoid arthritis, hypothyroidism or lupus.
Other factors can then exacerbate the problem — for example, trauma to the nipple due to poor latch, or finding yourself in a very cold environment.
How can you treat nipple blanching and vasospasms?
Blanching itself is usually related to a poor latch, so working with a lactation consultant to fix that often solves the problem.
Treating vasospasms can be more challenging. If you notice that your vasospasms get worse when you’re cold, try breastfeeding in warm environments, wear warm clothing and put a breast warmer or moist warm washcloth on your breasts prior to nursing.
As soon as your baby finishes nursing, cover your nipple right away while you slip your bra on. You may also consider putting wool breast pads in your bra, which tend to keep your nipples warmer than regular cotton pads. Avoid nicotine and caffeine, as they can make vasospasms worse.
If you still experience pain, try massaging your areola (the ring of pigmented skin that surrounds your nipple) with olive oil. You can also massage the chest muscles above your breasts before feedings, or during a vasospasm, for 60 seconds on each side.
Another tactic to try: Stretch the muscles around your breasts several times a day to help blood flow to your nipple area. Lift one arm to shoulder height, and press it back behind you while taking a couple of deep breaths, then repeat on the other side.
If these steps don’t work, you can try an over-the-counter pain reliever such as ibuprofen (Advil, Motrin IB and others) or acetaminophen (Tylenol and others), both of which are safe to use during breastfeeding.
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