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Vasospasm

Vasospasm //


What is it?
Vasospasm is a term which describes the painful constriction and intermittent loss of blood flow in the blood vessels in the body. It may occur in any blood vessel such as in the eyes, brain or heart.
Fingers and toes are often commonly affected by vasospasm, a condition known as Raynaud’s phenomenon. Less commonly, raynauds may affect the nipples as well, causing pain during or immediately after a breastfeed.
Raynauds Phenomenon is known to affect up to 20% of otherwise healthy women of childbearing age and has only recently been recognised by lactation experts as a treatable cause of nipple pain.


What are the symptoms?
Described by many as an intense and often debilitating nipple pain which may be burning or throbbing sensation. Onset is usually following the breastfeed (although can occur during)
Vasospasm is characterized by a triphasic or biphasic colour change in the nipple. When the baby comes off the breast you may notice the tip of the nipple ‘blanches’ as vasospasm occurs and constricts blood flow, followed by a blue discolouration, then a plum red colour returns. This is due to reflex vasodilation in response to constricted blood flow.
Vasospasm can last a few seconds, minutes or in some cases longer.


What causes it?
- Exposure of the nipple to cold environments particularly when susceptible to vascular abnormalities such as Raynaud’s phenomenon
- Poor attachment to breast and subsequent nipple damage
- Studies show it can also be caused by emotional strain, smoking and vasoconstricting drugs


How to manage vasospasm?
- Stay warm and avoid breastfeeding in a cold environment
- Immediately after the breastfeed, dry the nipple and apply a warm dry heat pack to the breast – this often provides immediate relief
- Effectively manage attachment or sucking abnormalities if detected
- Avoid caffeine and smoking
- May require medical consultation for prescription of calcium channel blockers which dilate restricted blood vessels
- Fish oil, calcium and magnesium supplements and B6 supplements


References
Anderson, J., Held, N. and Wright, K., 2004. Raynaud's Phenomenon of the Nipple: A Treatable Cause
of Painful Breastfeeding. PEDIATRICS, 113(4), pp.e360-e364.
Barrett, M., Heller, M., Fullerton Stone, H. and Murase, J., 2021. Raynaud Phenomenon of the Nipple
in Breastfeeding Mothers.
Buck, M., Amir, L., Cullinane, M. and Donath, S., 2014. Nipple Pain, Damage, and Vasospasm in the
First 8 Weeks Postpartum. Breastfeeding Medicine, 9(2), pp.56-62.


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