What is nipple vasospasm?

When our blood vessels contract or become smaller in diameter, it is called “vasospasm”. Vasospasm can happen with exposure to cold or emotional stress, but in some people, it can be quite severe and cause pain. During breastfeeding, the blood vessels in the nipple can contract or spasm. This is called “nipple vasospasm”.

How can I tell if I have nipple vasospasm?

Pain in your breasts and nipples

Nipple vasospasm can cause mild to severe nipple or breast pain during or between feeds. The pain could be light itching, a burning sensation, a deep numbness or throbbing pain or a sharp, stabbing pain. The pain can last from a few seconds to hours. Your pain may get worse when your nipples are exposed to cold, when you step out of a hot shower or bath or if you go outside in cold weather, for example.

Your nipples change color

Your nipples can change to white (also known as “blanching”) after a feed. They may also change to blue, purple or dark red. These color changes are a sign of nipple vasospasm and indicate that your blood vessels are contracting.

Compression of the nipple

If your nipple is compressed, it may be a different shape after feeding your baby. Your nipple may look creased, folded or more pointed in general or on one side of the nipple. Blood flowing back to the nipple can cause a burning sensation, throbbing or shooting pain. Nipple compression, caused by a shallow latch or the baby pressing into the nipple to slow a fast milk flow, is a common cause of nipple vasospasm.

What causes nipple vasospasm?
  • Compression of the nipple from shallow latch
  • Poor latch and biting
  • Cracked nipples or other nipple trauma and damage
  • Exposure to cold temperatures
  • Periods of severe emotional stress
  • Cigarette smoking or second-hand smoke
  • Migraines
  • Medical conditions such as Lupus, rheumatoid arthritis, and hypothyroidism
  • Certain medications for treating thrush (yeast), such as Fluconazole or Diflucan or the birth control pill

It is important to note that nipple vasospasm may sometimes feel like a thrush infection of the nipple or breast. If you are prescribed Fluconazole/Diflucan for thrush, but your real problem is nipple vasospasm, this treatment may make your vasospasm worse.

What can I do to avoid and treat nipple vasospasm?
  • Ensure your baby has a good latch and that you have no pain while nursing. Don’t hesitate to ask your physician, midwife or lactation specialist for help getting a comfortable positioning and a good latch. This is fundamentally important for a positive breastfeeding experience for you and your baby.
  • Warmth is very important. Breastfeed in a warm room and make sure you stay warm and protect your nipples from sudden changes in temperature, at all times.
  • For immediate relief from nipple vasospasm, use a warm compress. You can use the palm of your hand to create gentle warmth or choose a natural, dry compress at room temperature.
  • Some aerobic exercise may be helpful as it increases blood flow and circulation. Try to stay as active as possible for your general good health.
  • Avoid cigarette smoking and second-hand smoke.
  • Limit or cut out caffeine.

If your nipple vasospasms continue, despite taking these practical steps, it is important to seek help from your health care professional as soon as possible. This is so that they can investigate and rule out or treat any potential underlying condition, such as Raynaud’s disease or thrush (yeast). If either of these is causing your nipple vasospasm, specialized treatment will be required and your physician will be able to help and advise you accordingly.