Breastfeeding, Nipple Blanching, and Vasospasms

 

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What kind of nipple pain is normal when I begin to breastfeed?

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Nipple blanching (turning white) after a feeding occurs when the blood flow to the nipple is limited or cut off. Blanching is most often related to latch problems. Nipple blanching is often, but not always, associated with pain. Because women may describe shooting, burning breast/nipple pain, this can be mistakenly diagnosed as thrush.

Nipple blanching is a term used to describe painful, white nipples. Blanching can be the result of a vasospasm, when the blood vessels constrict and spasm, 1  or from any other situation that temporarily stops the blood from flowing to the nipples. When this happens, the nipples turn pale or white, and there may be a painful, burning sensation.

You might be experiencing nipple blanching or 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?

Vasospasm is a constriction of the blood vessels in the nipple that causes the nipple to blanch, or turn white. Compression of the nipple is a common cause, either due to shallow breastfeeding or the baby compressing the nipple to slow fast milk flow. Nipple Vasospasm and Breastfeeding If the blood flow to the nipple is limited, the nipple will turn white.

This is called blanching of the nipple. Blanching usually occurs when there are. What are Vasospasm and Nipple Blanching?

Nipple blanching and vasospasm are restricted blood flow in the nipple that can lead to intense breastfeeding pain. Nipple blanching typically happens during a feed due to compression from a bad latch, and nursing mom might feel sharp pain and notice her nipple has turned white after feeding. The name may sound rather unappealing but nipple blanching is actually quite common in breastfeeding mothers. Nipple blanching occurs when there is a temporary lack of blood flow to that area of the breast and as a result they appear white in colour.

Much like when the blood drains from your face if you are in shock!Nipple blanching If your nipple turns white after feeding, it suggests that the blood flow is being reduced or cut off to your nipple. If despite this blanching, your nipple then returns reasonably quickly back to its normal color after feeding, and you don’t experience any pain.

Symptoms of vasospasm in breastfeeding: Burning, stabbing, throbbing, and/or “pins and needles” pain in the nipple and/or in the breast once the baby is off the breast. Pain may also occur when stepping out of a warm shower or when going outside on a cold day. There may or may not be pain during breastfeeding. Vasospasm happens when blood vessels tighten and go into spasm, so that blood does not flow normally.

Mothers with vasospasm of the nipple feel sharp pain, burning or stinging in the nipple. It is usually accompanied by sudden whitening of the nipple, followed by a colour change from red to blue.There are two main causes of nipple vasospasm.It can be a response of the nipple.

List of related literature:

The following nondrug therapies may make deliberate weaning easier and at the same time avert plugged ducts or mastitis: ■ Shower and allow the warm water to run over the breasts or soak the breasts by lying down in the tub.

“Breastfeeding and Human Lactation” by Karen Wambach, Becky Spencer
from Breastfeeding and Human Lactation
by Karen Wambach, Becky Spencer
Jones & Bartlett Learning, 2019

Mastitis may be associated with lactation (puerperal or lactational mastitis), particularly during the first 2 to 3 weeks postpartum in a small percentage of nursing mothers.

“Women's Health Care in Advanced Practice Nursing” by Catherine Ingram Fogel, PhD, RNC, FAAN, Nancy Fugate Woods, PhD, RN, FAAN
from Women’s Health Care in Advanced Practice Nursing
by Catherine Ingram Fogel, PhD, RNC, FAAN, Nancy Fugate Woods, PhD, RN, FAAN
Springer Publishing Company, 2008

Rinsing the affected nipple and areola with the mother’s own expressed milk or with water, then patting the area dry, is also helpful (Barankin & Gross, 2004).

“Breastfeeding and Human Lactation” by Karen Wambach, Jan Riordan
from Breastfeeding and Human Lactation
by Karen Wambach, Jan Riordan
Jones & Bartlett Learning, 2016

For the breast-feeding mother * Instruct the mother to wash her areolae and nipples with water, without soap or a washcloth, to avoid washing away the natural oils and keratin.

“Lippincott's Nursing Procedures” by Lippincott Williams & Wilkins
from Lippincott’s Nursing Procedures
by Lippincott Williams & Wilkins
Lippincott Williams & Wilkins, 2009

West and Hirsch (2008) noted that postsurgical mothers often experience nipple blanching or vasospasm of the nipple.Blanching may be due to a blood supply interruption or nerve trauma to the nipple–areola during the surgery, although the true cause is unknown.

“Breastfeeding Management for the Clinician: Using the Evidence” by Marsha Walker
from Breastfeeding Management for the Clinician: Using the Evidence
by Marsha Walker
Jones & Bartlett Learning, 2010

LBW infants receiving skinto-skin contact with breastfeeding mothers maintained higher oxygen saturation and were less likely to have desaturations below 90%, and their mothers were more likely to continue breastfeeding both in the hospital and for 1 month after discharge.

“Maternal Child Nursing Care” by Shannon E. Perry, Marilyn J. Hockenberry, Deitra Leonard Lowdermilk, David Wilson
from Maternal Child Nursing Care
by Shannon E. Perry, Marilyn J. Hockenberry, et. al.
Elsevier, 2013

The risk involved with continuing to breastfeed if the lesions are on the nipple or areola results from the possibility of secondary infection from infant to mother, which will cause skin breakdown and delayed healing.

“Breastfeeding: A Guide for the Medical Profession” by Ruth A. Lawrence, MD, Robert M. Lawrence, MD
from Breastfeeding: A Guide for the Medical Profession
by Ruth A. Lawrence, MD, Robert M. Lawrence, MD
Elsevier Health Sciences, 2015

Vasospasm, or Raynaud’s phenomenon, of the nipple manifests as a blanching of the nipple tip with pain and discomfort radiating through the breast after and between feeds [192].

“Management of Breast Diseases” by Ismail Jatoi, Manfred Kaufmann
from Management of Breast Diseases
by Ismail Jatoi, Manfred Kaufmann
Springer Berlin Heidelberg, 2010

Nipples that have been traumatized with breaks in skin integrity are easily colonized with bacterial and fungal species, are slow to heal, represent significant pain to the mother, and may lead to partial or total discontinuation of breastfeeding if therapeutic interventions do not provide quick relief.

“Breastfeeding Management for the Clinician” by Marsha Walker
from Breastfeeding Management for the Clinician
by Marsha Walker
Jones & Bartlett Learning, 2016

Localized cellulitis from an infection through a cracked or fissured nipple causes postpartum mastitis.

“Manual of Obstetrics E-book” by Daftary, SUDIP Chakravarti, Muralidhar Pai, Prahalad Kushtagi
from Manual of Obstetrics E-book
by Daftary, SUDIP Chakravarti, et. al.
Elsevier Health Sciences, 2015

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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  • My baby doesn’t open the mouth enough, only if he cries. If he cries and I put my nipple and areola in his mouth, he will slip to the nipple only and clamp even more because he is upset. Is neck is strong so I cant force his head. Don’t know what to do, he is 2 months old already and I fear that when he starts teething I won’t be able to breastfeed him

  • thank you!!! for the first time since his birth, last night I was able to latch my son correctly after reading A REALLY well written article and watching this video twice!

    I know his latch was perfect because my nipples are war torn, scabby and slightly bloody from improper latching, and it STILL didn’t hurt when he latched correctly! I felt just a slight jolt of pain at his first suck that instantly went away. and even with my very short nipples, he was able to grip, eat and get good, deep gulps of milk for more than 10 minutes!

    I can’t say thank you enough for this video… we are still learning but I have such relief in knowing it can be done…we CAN exclusively breastfeed comfortably!

  • I had the best breastfeeding guide written by Susan Urban ‘How to make breastfeeding pleasant and easy’ ( found it here http://www.parental-love.com ) Can recommend it:)

  • Does Clegenatur Methods really help to increase cup size with natural ways? I have read a lot of good stuff about this popular breast enhancement methods.

  • Yeah, Idk I’ve watched and studied this video literally like 20 times and been practicing and re latching but the latch still is horrible dammit. No tongue tie so I am so lost on what to do.

  • This video is great but would be improved by a segment defining anatomical terms pertaining to nipple and breast geography. “Below “ behind “ nipple is difficult to interpret

  • My baby is one month and she can’t latch on properly,she can’t open her mouth wide as yawning she always has a shallow sucking that lasts fir less than 4minutes.I tried alk the tips of the video but couldn’t fix it ☹️

  • The most instructive image in this video is from 0:48 1:05, that is a true asymmetric/deep latch. Notice how the breast pushes the lower jaw to get the mouth open all the way. If you are having trouble latching, watch that over and over and copy it!!

  • We have been trying your latch technique for the last 2 days. My two week old son has very powerful jaw and seems to grow many more arms when trying to latch. How can I make sure he is doing the 1-2 steps of latching if I am trying to tame his many arms that are near his mouth or flailing around?

  • I have large flat nipples, my 3 week old closes her tiny mouth on nipple so quickly that we only get a painful latch, pain goes away after 10 seconds, but when she comes off it’s a lipstick shape and keeps cracking/bleeding/blistering. No matter what holds or positions, we try football, cross, pillows, no pillows, weird sideways, laying down, half reclined, everything! Yes, I do tongue training with finger first, yes I hold chin down when latching, and pull chin down during, pinching nipple as small as possible, yes, I point up and wait for large mouth and tongue down over gums. However, Baby girl is a ninja and clamps/pulls tongue back before I can get nipple past gums. Every so often there is no lipstick but still pinched conpressed line in middle of nipple. Lips are flanged and look great. What else can I do?