Breastfeeding pain - vasospasm in nipple

[rachel200811]

Hi, I've been trying to BF my son for 5 weeks (he's 5 weeks old) and have come up against a few challenges. He has onw formula bottle at night but other than that is breastfed. He's had his tongue tie cut, I have a rather fast flow and he has issues opening wide enough to latch... he even has a terrible habit of sucking the nipple in like a strand of spaghetti! It's been this way since before the bedtime bottle was introduced so I'm confident it's not nipple confusion. As a result I've had bleeding and white/pink blanching on the ends of my nipples and shooting pains in the breast and nipples between and during and after feeds. I've tried every BF position possible I think and an using hydrogel pads, compresses, nipple cream and jelonet to heal the nips. I've seen midwives, BF groups, a private lactation consultant and am taking him to a cranial osteopath (potential forceps delivery trauma as suggested my LC). He thrashes around on the breast at the start of a feed and pops off loads and gets very stressed too. I've also tried expressing before a feed to slow the flow, plus doing laid back BF to slow it too. Now that's the history, but my main question is how do you manage the pains from vasospasm of the nipple as that's what the issue is apparently. Its caused by mammory constriction and nipple trauma and raynauds has been ruled out. Any advice other than resting them every now and then and expressing? I'm hoping for a magical fix that I don't think exists! But the burning, stabbing pain means me dreading the next feed and crying during latch sometimes.. but it comes and goes. Help please!

I had exactly this, tongue tie snipped very strong suck/fast feeder, bleeding/blisters, what I thought was vasospasm, turned out to be Reynaud's of the nipple! I had pink, white blanching and also purple nipples. Only meds they can give aren't suitable for breastfeeding. It is agony. The best thing I found was a covered hot water bottle in my top, do not let your boobs get cold at all. Keep extra hydrated, warm drinks, use lots of lansinoh, extra layer of clothing. Mine subsided after a few weeks. I also had a mild infection from the blisters which was being disguised by the Reynaud's so worth checking that and getting antibiotics if necessary.

Oh nipple shields also gave some relief when the cuts were bad

My nipples bled for about 12 weeks. Eventually I gave up on one side completely and just used the good side for a year.

Also, my midwife told me to buy 2 plastic tea strainers, hacksaw off the handles and wear them inside my bra during the day. Being surrounded by air helped the cuts heal but it was a bit mad when I hugged people.

If you can afford them then I recommend the silverette nipple cups. They help a lot with healing. Just express a bit of bm into them and pop them on between feeds. The silver of the cups and breast milk both have healing properties. I was in tears with pain last weekend but now am basically pain free (lo is 2 weeks tomorrow). Hang in there. I hope it gets better for you.

Thanks all. I'll try the silver cups! My main issue is the vasospasm/raynaulds. Does the blanching and pain associated stop or did you have it for the duration of you breastfeeding?? Also having issues with him popping off latch then trying to relatch furiously and this repeats over and over and he gets frustrated and cries! It makes me sore and us both stressed. Occasionally it seems to be wind but not always. He is very gassy both ends. Any experience of this?

Sorry I've just seen you said it went after a few weeks. I'll hold tight for another few then. 🤕

Sorry to hear you're having such a hard time op. You're doing amazingly to still be feeding. It sounds like he's got a shallow latch and that will be the main factor causing pain (it exacerbates pain of vasospasm as well as causing trauma to nipples) so I would suggest still working on the positioning. Ask as many people as possible for help, go back to the drop in if you can and there should also be an infant feeding team who you can be referred to. It may also be worth seeing your gp to rule out thrush as that can have similar symptoms. The early weeks are so tough and I know it can feel like things will never improve but they definitely do!

Yes I do get a squashed nipple after feeds sometimes so his latch needs work for sure! I've visited groups, midwives, paid for 1 on 1 advice with a consultant, tried the rugby ball/laid down/laid back/cradle/koala positions and the ones that feel right are laid back and koala. The lactation consultant said I'm doing all I can by sandwiching the nipple or using the 'flipple' approach to get the wide latch and I'm taking him to a cranial osteopath once a week for a month to see if that helps. Sometimes he latches beautifully and stays on but other times it's like feeding an angry snapping turtle. 🙄 Any new advice I might be able to try? He is feeding on the boob about 6 times a day (every 2-4 hours) for 15-30 mins at a time and he has one bottle around midnight where he takes 5 ounces and he might go abit longer with that.

The amount he is feeding is totally normal for his age. Usually vasospasm is made worse when there's nipple trauma so I would expect that it will get easier now that your getting more comfortable with the latch. Once your nipples have healed it should be much better. Cold can also make the vasospasm worse (not great at this time of year!) So make sure you are wrapped with up warm and cover your breast as soon as possible after he's finished feeding. It could also be worth seeing your gp about any medication that can help the vasospasm as well as anything that might be making it worse. The koala feeding position is really good for being able to lean back and manage milk flow so I'd carry on with that one if you still have a fast flow, that often makes babies pull back or clamp down. But your milk supply should regulate around this time so that should naturally improve too.

Hey, I know this is old but I wondered if this got any better? I have the exact same thing down to the tongue tie and getting a private consultant. I’m trying to at least get to six months but I am really struggling with the pain.

Hi just wondering if this got better as a m having the same problem an am in foods of tears

Hi Pattyann, coming in on this thread to say that I suffered from Raynaud's Phenomenon causing nipple vasospasms, starting around 4 weeks after my baby was born. It was absolute agony and so hard to cope with physically and psychologically. I probably would have had to give up feeding had I not got really quick help from the local BF team (all remote--baby born right around first lockdown) and medication prescribed right away by GP. The medication is called nifedipine and I really recommend pushing to be put on it if you are suffering vasospasm. I took it consistently until just recently (now almost a year into breastfeeding) when I decided to try going off it. I haven't had the problem return.

If you look it up on the NHS you'll find that they say "Small amounts of nifedipine may get into breast milk, but it's generally considered safe for breastfeeding mothers and babies."

So so glad that I got prescribed it right away because it worked really effectively really quickly. I had an increase in dosage after a few weeks when I was still having a bit of pain, and then no pain at all, having a wonderful BF experience since.