Nipple vasospasm

Vasospasm occurs when blood vessels constrict (or tighten). It can be very painful and is usually worse when you are cold. 

Vasospasm may occur in any blood vessels in the body such as in the heart, brain or eyes. Fingers are most commonly affected, a condition known as Raynaud’s phenomenon where your fingers turn white when they are cold.  Less commonly, the blood vessels in the nipples are affected, causing pain during, immediately after, or between breastfeeds.

Who does it affect?

This condition is more common among women:

• with a family history of Raynaud's phenomenon
• who tend to have cold fingers or feet or have ‘poor circulation’
• with a low body mass index (i.e. thin people).

Describing nipple vasospasm

• You may feel intense nipple pain, which is worse when you are cold. Some women describe the pain as a burning and throbbing.
• You may notice the nipple or the tip of the nipple blanches or turns white.
• You may notice other colour changes of the nipple. The nipples may turn blue or purple or red before returning to their normal colour.

How long does an attack last?

You may notice the signs and symptoms for a few seconds, minutes or even longer.

How severe is nipple vasospasm?

Nipple vasospasm pain ranges from minor discomfort to severe pain. Some women may feel that the pain is so severe that they are unable to continue breastfeeding.

How to manage nipple vasospasm

Avoid or to reduce exposure to known triggers. These include:

• poor attachment (seek advice from your lactation consultant)
• nipple damage (e.g. cracked nipple) or an infection (e.g. nipple thrush)
• exposing your nipples to cold air
• some medications or chemicals may worsen nipple spasm, e.g. nicotine (smoking cigarettes).

Things to try:

• Keep your nipples warm. Applying a warm pack may relieve pain immediately.
• Wear an extra layer of clothing.
• Use ‘breast warmers’, e.g. Flectalon (available from the Australian Breastfeeding Association).
• Avoid cold exposure (or sudden temperature changes).
• Do not ‘air’ your nipples.
• Warm your bathroom before undressing for showers.

If the pain continues, you may consider taking supplements or medication.

Supplements include:

• Fish oil capsules (containing essential fatty acids) or evening primrose oil (gamma linoleic) may improve blood vessel relaxation.
• Magnesium tablets help to relax the blood vessels. You may take one to two Blackmore's Biomagnesium tablets daily (each tablet is equivalent to 300mg magnesium).
• Prescription medication may be appropriate. Contact a lactation consultant or medical professional for more advice.

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