nipple vasospasm/Raynauds

[redtabby]

I am six weeks in to breastfeeding and have developed this very painful problem in the last week. I already knew I had Raynauds in my hands and feet (have to wear heat pads in shoes and gloves in cold weather), and during pregnancy I developed serious pain in my nipples whenever I was exposed to the slightest cold.

Now I am getting total blanching of the nipples and a lot of pain if I let my nipples get even slightly cool, and they are hurting when he feeds, especailly the few minutes after latching on. I am absolutely determined to continue breast feeding, has anyone else got any good advice apart from heat pads. (And any tips about which pads you use? Just putting on a reusable warmed pad that lasts a while, an hour or two, is no good at all, the problem will just return the minute the pad cools down a bit. I am using those self heating pads you use for your toes when skiing at the moment, any other tips?).

I would just love to hear from others who have had this problem. I have spent a lifetime getting white fingers when I pass by the chilled cabinet in the supermarket, one can live with that, but this effect on the breastfeeding is very disappointing!

I had this pre and post birth (winter baby) and really sympathise!

A few tips would include using the slightly thicker breast pads to keep your nipples insulated and limit feeding outside for obvious reasons! Also my little one always had a very strong suck and I've had a strong let down - neither of which helped. I did find that if I was very 'full' then getting her latched on and then moving around gently to a lying down position helped the pain.

It does get better as supply sorts itself out so keep going! The self-heating pads are probably your best option as well as overdressing your breasts....

Of course for after you do stop you could consider going to your GP to discuss treatment - your Raynauds does sound significant.

I had the blanched nipple problem with DS and it was soooo painful, you have my every sympathy. Mine was caused by poor latch due to tongue-tie.

I used a wheat bag to keep my boob warm and I also used to have a lot of warm baths and showers. I recognise that you can't do that after every feed tho!

I did find that it improved as DS got bigger and he wasn't squashing my nip so much and also went longer between feeds.

I don't think it can be down to a bad latch as it happens when I express. In fact it's much worse when I express and I get lipstick nipple when ds sucks away!

I try and grab a shower as soon as he's finished if he's been on for a long time.

ThinksThereNeedsToBeMoreResearchIntoThisTiggaxx

Mine is not related to the latch but to a hereditary vascular problem, I am now wearing the ski toe warmers inside my bra (outside a nipple pad or too hot!) constantly day and night and holding a hot water bottle to my bresats before and after he feeds, and it seems to be helping. One nipple still hellishly sore at the beginning of a feed but I think it is a little better than it was. Warmth seems to be the answer! (for me at any rate)

Redtabby - I have been there and it is awful isn't it! I used to have to go outside with hand warming pads tucked in my bra or within five minutes I would be almost in tears and frantically rubbing my boobs trying to get the circulation going - a good look I might add

I don't know if this is something you want to do but I ended up getting medication for it - I saw a wonderful bfing counsellor at the hospital (after 20 weeks of being told I had thrush by my hv and various gps - grr) an she gave me the information to take to my gp. I got lucky there as the gp I saw had seen the very same bfing counsellor with her son and knew she really knew her stuff so had no problems prescribing to me.

I had a two week course of Adalat (nifedipine) which I believe is a drug usually given to people with high blood pressure - basically it opens up all your blood vessels - it gives you really strong hot flushes which is a bit bizarre if you are always used to being cold like me.

After the two weeks you stop taking it and basically see if it comes back, you can then get another course if needed, mine did slowly come back last autumn but nowhere near as bad and now that I am down to just one feed a day it very rarely happens - I can actually walk down the freezer aisle again!

If you can get your hands on a book called Medication and Mothers Milk or find out if they hold a copy at your gp surgery - this medication is in there and it is ok to take while you are bfing.

Apart from that the bfing counsellor told me that wool breast pads are better at keeping the nipples warm and I can only recommend what you probably already know - keep warm! I had a lot of hot showers - some nights I would have to get up in the middle of the night and either run a sink full of hot water to dip my boobs in or get in the shower as I was in agony.

If you want to send me an e-mail it is completely absolutely @ live . co . uk (without the spaces!) I can maybe give you more info about the medication and give you the e-mail address of the bfing counsellor I saw - I'm sure she won't mind and might be able to help you out if you are having problems getting a prescription from your gp.

Oh and in the meantime I got a huge stack of heat pads from the pound shop - they did small 8 hour ones which heated up enough to go next to the skin, not sure what they were called but I'm fairly sure you got four to a box and they were in a black and orange box - the much bigger ones get too hot and only last for an hour or so.

They are disposable ones which is a bit rubbish but they were the best ones I found and frankly I was in so much pain I didn't care.

Completely, thanks so much for taking the time to share all that , it is really good to know I am not alone in this and other people have also walked around with warmers in their bra (creates a funny shape doesn't it!).

I have been thinking about the nifedipine option (am a doctor myself so had looked in the medical options but decided to go the warming route first if poss) and am glad to hear it really did help in your case. Did you get a headache or any other side effects apart from the hot flushes? I may well go with that option soon. It is nice to know that the effects last longer than just the course of medication, apart from the breastfeeding problem it would be great to be able to walk past the cold cabinet in the supermarket without having pain!

Meanwhile, I got a big box of toe warmers from (of all things) a pet website (the cheapest place to buy the good quality longlasting ones I found! I suppose people put them in their kitten's beds or something?)

I can so much relate to the getting up to put your breasts into a basin of hot water, I was doing this during my pregnancy as well! And my DH and stepchildren got completely used to me spending every evening last winter with my breasts pressed against the radiator in the lounge or running upstairs to blow dry my breasts with the hair dryer!

I will probably try the Nifedipine out next week. I'll let you know how it goes!

Oh god yes the hair dryer I had forgotten about that - and the number of times we were out for lunch and I would disappear to get under the nearest hand dryer!

I did get some headaches with the nifedipine, they were generally very intense but very short , the kind that make you go 'ah that really hurts' and then it's over rather than the kind that send you to bed for the rest of the day - hope that makes sense it's really hard to articulate! I got hot flushes a lot and it gave me a heat rash and really itchy legs for a few days but that's about it really.

It has made a massive difference to me, I was at my wits end and my dp who was so keen for me to bf was starting to suggest that I should stop as I was in so much pain all the time and the first few sucks of a feed would literally have me crying with pain as dd sucked the circulation back.

Good luck with whatever you decide to do, as I say the medication worked really well for me, I could probably have done with another course but it was summer by this point and it didn't seem quite so bad and I didn't bother.

I still get very cold hands and feet but they don't get painful so I think to some extent it has helped with that as well.

Please do let us know how you get on. I have linked a post from Kellymom that helped me keep going when I was utterly depressed with it all.

www.kellymom.com/bf/normal/love-bf-24-7.html

Hi Completely, I think this is what I suffered from with dd 2 years ago, and now suffering again with ds, who is almost 4 weeks old. I thought yesterday that I must have thrush, as sometimes it looks as though I have a rash on my nipples/aereola, but was at bf councellor today, and she thinks that it may not be thrush, but doesn't know anything about reynauds.

Can anyone tell me if this condition causes redness that looks like a rash on the nipples /aereola? went to my doc last time, but he was not aware of this condition so just suffered on, and things got better as dd got older, hoping it improves quickly this time. In a lot of pain at the moment.

Hi, I'm not sure if it can look like a rash but the first colour your nipples will go is very bright red, then purple, then white as it gets more extreme.

Does the pain go away by the end of the feed or is it painful all the time? I found that it was agonising when dd first latched on but about 5 minutes in it wasn't painful any more as the circulation had been sucked back in iyswim.

It could be though that if the pain isn't going away but is getting worse during a feed that maybe you are getting vaso spasm not from a severe reaction to the cold but due to compression of the nipple during feeding - what shape are your nipples after the feed?

I know it can feel itchy at first which is why it is often mis diagnosed as thrush - also it can be caused by some trauma to the nipple so thrush can bring it on and then you ended up being treated longer term for thrush when actually it has gone and you are having the vaso spasm symptoms.

Is there another bfing counsellor that you can see? I think this is actually a fairly common thing so it would seem a bit strange that she doesn't know anything about it but maybe I just got lucky with the bfing counsellor I saw.

This might be helpful to you from Kellymom

www.kellymom.com/bf/concerns/mom/nipple-blanching.html

Not really sure what else to suggest, whereabouts are you? If you want to e-mail me my address is below, I can put you in touch with the bfing counsellor I saw and she may be able to help you, or at least send you some better information. I can't access my personal e-mail from work (am skiving!) so it would be this evening before I can get back to you with that.

In the meantime try and keep warm, if you can get one of those wheat or rice bags you stick in the microwave to put onto your breast after the feed and if you feel it starting try and get warmed up as quickly as possible.

Get your dp/dh to read this stuff as well, my dp suggested we get formula a few times as he needed to do something when he saw me in so much pain but I really didn't need to hear that at the time and just wanted sympathy!

Wow that was long - hth though.

Mine go red then quickly completely white then red again when they warm up (exactly what also happens to my fingers and toes in the cold).

I must say that since I started this thread things have improved for me with some simple management: mainly keeping my breasts warm at all times, including covering up quickly immediately after each feed (sadly no lying around doing skin-to-skin as I cannot afford to let the nipple get even slighty cold), using a hot water bottle immediately if any coolness seems to creep in, and wearing self-heating toe warmers in my bra when feeling cool and at night. I ordered a few different makes of warmers and the ones called "Toastie Toes" are proving the best so far, they have adhesive so stick nicely to the inside of your bra (although you must wear them OUTSIDE a breast pad or you will burn your skin!), and seem to last longer than the others (about 6 hours). Basically it seems to be important not to even let the nipples start THINKING about getting cool...

I have also started taking Vit B6 and high dose calcium as some websites suggest. Breastfeeding now going very much better!

Yes those are the ones! remember

Sorry, meant to say remember to wear them outside a niple pad and not against your skin! Also be very careful not to let baby come in contact with thrm, they will burn him

I saw an improvement within a day after starting to use the warmers whenever I felt the dreaded cold spasm coming on (basically any time it is cool enough to start to get my nipples erect I need to put in a warmer). After a week or so of managing the warmth inside my bra carefully (!) I am doing just fine and bf is a pleasure again nearly all the time.

Another thing I have also got now though, which has reduced the amount of self-heating warmers I have needed to use, is a set of New Zealand lambswool nipple pads, they are like "jerseys" for your boobs! I got them from a website called Babykind, they are very nice and cosy!

From about 2 weeks I suffered with nipple vasospasm. My nipples hurt after feeding and changed colour initially going white then going purple. Between feeds this would occur 4-5 times each times causing intense pain. My GP had never heard of it, referred me to the hospital and I was seen in the breast clinic. The doctor there advised me to give up breast feeding........excellent support! My bf advisor helped loads. I improved my latch and my GP eventually prescribed me Nifedipine. I think that this helped slightly. At 4 weeks I was taking painkillers daily and was miserable because I was in pain and not enjoying my baby. I decided to stop taking painkillers. I bought woollen breastpads, fed under a blanket to keep warm and used breastwarmers. Avoided getting cold and tried to stay as well rested as possible! Now at 6 weeks I till have spasms, but I can tolerate them much better. I don't need painkillers and I am able to relax and enjoy my baby. He is gaining weight and we are generally much happier. So for those out there in the earlier stages it can get better.