When Nipple ‘Changes Color’ During Breastfeeding: How to Treat Vasospasm​

Despite a mom's best intentions, breastfeeding has its fair share of uncomfortable related ailments. Some nursing moms report nipple color changes that can be linked to pain during, immediately after, and between feedings. Women may also feel like their nipple "falls asleep" every time they feed.

This uncomfortable scenario is linked to the constriction and spasm of the blood vessels, referred to as vasospasm, or from any other issue that temporarily disrupts blood flow to the nipples. "First, the nipple goes to white, then it turns to blue just like your lips when they're cold, and then, when the blood flow returns you see bright red or pink, like when kids come back from playing in from the snow," explains registered nurse and International Board Certified Lactation Consultant Paula Fitt, RNC-EFM, BSN, IBCLC. If this is happening, Fitt encourages women to identify the root cause.

Color changes may be due to:

  • A baby's compression of the nipple. This is usually the root cause, explains Fitt, and is where she recommends women begin their investigation of the culprit behind vasospasm, which may be due specifically to shallow latch, improper sucking, the baby clamping down to slow a too-fast let-down, tongue-tie, the baby clamping due to allergies, clampdown bite reflex, or palate variations.
  • Medications or substances like caffeine or antihistimines that constrict blood vessels, or trauma to the nipple, like thrush.
  • Raynaud's phenomenon, a medical condition sometimes associated with autoimmune diseases like systemic lupus erythematosis (SLE) and rheumatoid arthritis. Because the breast pain associated with Raynaud’s phenomenon is so severe and throbbing, it is often mistaken for thrush at first.

That said, the exact trigger for color changes and vasospasm must be diagnosed by a health care provider. In the meantime, how to get relief:

Avoiding cold and applying heat: Because cold temperatures can exacerbate vasospasm, experts recommend women staying as warm as possible and even applying dry heat after breastfeeding. You can use a sock filled with uncooked rice, microwave for 45 seconds, then hold the sock against the nipple to encourage blood flow. A warm cloth or compress will work just as well. Apply as often as feels comfortable.

Massage with olive oil: Massaging warm olive oil into the nipples has been said to be soothing and can address any burning sensation, offering instant relief. Experts recommend massaging the oil into the nipples after breastfeeding, which will also prevent the nipple from air-drying and cooling too quickly, which can promote vasospasm.

Continuing to breastfeed: Fitt notes that many moms will want to continue breastfeeding while trying to treat the root cause of vasospasm. However, pumping — which doesn't stretch the nipple as much as breastfeeding, reduces latching pain, and doesn't come with any sharp change in temperature after feeding — may help reduce pain or give you a break as you try to get the root cause under control.

Asking your doctor about medications and supplements: The prescription drug nifedipine, used for hypertension, could blunt the pain of vasospasm by reducing smooth muscle tone in arteries. High-dose vitamin B-6, fish oil, evening primrose oil, and magnesium (which may improve blood flow) have all been recommended due to anecdotal evidence, but lactation consultants encourage women to check with their health care provider about trying any of these therapies.

The bottom-line: While these measures should all help a nursing mom manage pain, Fitt emphasizes the importance of investigating and treating the specific culprit behind any nipple color changes and vasospasm so both mom and baby can resume a happy and comfortable breastfeeding routine.

Have you ever had nipple color changes due to vasospasm? How did you address it?

Image via Corbis