There are many causes of nipple vasospasm. Vasospasm may be primary, meaning there is no underlying cause of the vasospasm or it may be secondary or caused or aggravated by something else.
Severe nipple trauma, or soreness can actually cause vasospasms as can infections in the nipples especially yeast. Diflucan, a medication used to treat yeast can aggravate nipple vasospasm. If the baby clamps on the breast that may cause or aggravate nipple vasospasm.
B/c there are so many reasons for vasospasms and things that may need improvement I think it’s really important to see an LC if you think you have vasospasm to rule out or correct latch concerns, infection, or clamping. An experienced LC can determine the cause and therefore tailor fit the treatment to your situation.
A primary cause of nipple vasospasm may be Raynaud’s syndrome, an autoimmune disease in the family of rheumatoid arthritis. Also, women with fibromyalgia may have nipple vasospasms. If you think you may have either of these diseases it’s important for you to be seen by a rheumatologist who can accurately diagnose and treat these diseases.
If the nipple vasospasm is secondary to nipple infection, trauma, poor latch, clamping or another cause the first step to help get rid of the vasospasm is to treat the underlying cause. Once the underlying cause is treated sometimes that is all that is needed to clear up the vasospasms though it can take from a few days up to a week or two. Other times the nipple is so damaged or ’jumpy’ as Dr. Jack Newman describes, that you need to also get some treatment to help relieve the vasospasms. However, if you don’t treat the primary or root cause the treatment for the vasospasms may not be effective.
In "Breastfeeding and Human Lactation" by Riordan and Auerbach, they recommend warm compresses as being the first line of treatment for nipple vasospasm. It might help to keep a heating pad handy by your favorite nursing chair to apply to the nipples asap after a feeding. Another handy way to apply heat is with prepackaged heat packs that are used by nurses. You can get them in drug stores or surgical supply stores. I would not put them directly on your skin but maybe on top of a cloth breast pad, held in place by your bra. Obviously remove it if it is too hot or add padding. Remove any source of heat slowly as the sudden change to cold may aggravate another vasospasm.
Also, ibuprophen can alleviate the pain. You would need to take any pain medication in anticipation of when the pain usually occurs. Some medications can make the vasospasms worse such as, fluconozole ( Diflucan a yeast treatment), and oral contraceptives.
Dr. Newman has used is Nifedipine 30mg of the slow releasing type one time per day. Nifedipine is approved by the American Academy of Pediatrics for use in breastfeeding mothers, and there are other peripheral vasodialators that your doctor may recommend if needed. Most mothers stay on this dose for 2 weeks and are fine. Occasionally he has needed to keep a mom on for 4 weeks and once a mom was on for 6 weeks before she had relief.
Riordan and Auerbach also recommend supplements of calcium, 2,000mg/day and magnesium 1,000mg/day, when vasospasms occur.
Dr. Newman has also used vitamin B6 100 to 200 mg for four days then 25 mg per day after that.
I hope you are successful in finding solutions to relieve your pain. Don’t forget to keep your doctor and an LC involved in the plan.
I know this is something you mentioned in 2003 but you may wish to reconsider even discussing the use of Nitro Paste on nipples for vasospasm.
Here are my thoughts on this: One it is an off label use. Two it isn't a matter of GI absorption in an infant but is a matter of sublingual absorption. While the doctor reccommends this after a feeding, I would not be confident if an infant wanted to comfort nurse a short time thereafter that there would not be a remaining amount on the mother's nipples to cause a concern. Three, I would imagine that nitro paste is contraindicated in infants. And four, this is a very potent medication and would be toxic if put on in a wrong amount or if gotten into the hands of young children!
This is a medication meant for angina, not for nipple vasospasm. To utilize it in a fashion it is unintended and manfactured accordingly for leaves a myriad of adverse consequences possible.
Valerie thanks for pointing that out. I checked on Thomas Hale's site, he's the author of "Medications In Mother's Milk" and he feels that the practice of using nitroglycerin on the nipple is dangerous and recommends against it.
Here's what Hale has to say:
I would under NO circumstances use glyceryl trinitrate directly on the nipple. Nitrates are potentially toxic to infants. Methemoglobinemia, thrombocytopenia, bradycardia, light-headedness, reflux esophagitis, and contact dermatitis could potentially occur.
They even make adults sick if used in higher quantities. An infant could ingest significant quantities from the nipple....so I would strongly advise you to not use this product directly on a breastfeeding mothers' nipple.
Tom Hale, Ph.D.
Apparently there is disagreement between Hale's information and Jack Newman's, which is where the suggestion of nitro paste originated. I'll take care of having that information removed.
am 46yr old am having a pain in my rigth nipple is like sharp pain i took some pain medication and that pain still there ,am scared,i need answers please?
