Why Has My Nipple Gone White?

When I was first breastfeeding William I had a lot of breast and nipple pain after feeding.  One lactation consultant thought thrush, another thought vasospasm.  After meeting a lot of women in similar situations and reading on the subject it seems that vasospasm is often diagnosed as thrush.  Thrush has become more popular over the last few years and I meet a lot of women who have been diagnosed but haven't received any relief from the typical treatments.  I guess it's a case of looking for zebra's when you should be looking for horses.  There are two main reasons for nipple blanching or vasospasm, and I imagine that the first reason (compression) could be a cause of discomfort in quite a number of cases.

Nipple blanching due to compression will happen when the nipple becomes squished during nursing stopping the blood from circulating and leaving the nipple white.  As the blood rushes back in you can feel pain similar to pins and needles which usually starts after the feed and can last quite a long time between feeds.  The pain can be tingly, shooting.  I felt like I wanted to hold my breast and couldn't easily ignore the pain.  There are a number of causes of nipple blanching due to compression -

• A poor or shallow latch when the nipple doesn't reach the soft palate during feeds.
• Baby clamping down on the nipple/breast due to a fast flow or fast let-down to slow the flow.
• A high or bubble palate which can cause the nipple to not reach the soft palate during feeds.
• A tongue-tie which prevents the tongue from having a typical range of motion.

Improvement of the latch through working with a breastfeeding specialist or a referral to a tongue-tie specialist can reduce and indeed remove all symptoms.

Nipple blanching due to Raynaud's phenomenon can occur with anyone that suffers from this condition which causes sudden vasospasm in the extremities (hands, feet, nipples).  The nipple turns white and then often blue and red before returning to its normal colour as the blood rushes back in.  Coldness can often set off the symptoms, so women often report feeling pain when they step out of the shower or when they walk down the freezer aisle at the supermarket.

There are a number of ways to reduce or treat symptoms -

• Keeping the breast/nipples warm and avoiding cold (Breast Aid Breast Warming Pads are perfect as they cover the nipple and use body heat to keep the area warm)
• Avoiding caffeine and nicotine (vasosconstrictors)
• Nifedipine has been found to help in some cases at low dosage.

I think it is important to look at the entire picture when working through breastfeeding problems.  Quite often thrush or mastitis are the only conditions associated with breast/nipple pain and I think that treatements are often issued without looking for a cause.  Treatment that doesn't work can lead to an early end to breastfeeding.  I'm not diagnosing anyone, just giving you a little bit of information so that you can go away and really think about your symptoms and what they really mean.  Sadly, Doctors who write prescriptions don't usually work with mothers on position and latch which in many cases I'm sure could be the solution.