If you’re experiencing burning nipple pain or sore nipples after pumping, nipple vasospasms may be the culprit. Here is everything you need to know about nipple vasospasms when exclusively pumping, including symptoms, how to treat them, and prevention.
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What are nipple vasospasms?
Nipple vasospasms (also called mammary constriction syndrome) are a sudden narrowing of the blood vessels in the nipple. This narrowing can prevent blood from getting to certain areas of the nipple, and it often happens in response to cold.
Nipple vasospasms are associated with Raynaud’s Phenomenon, and can be quite painful.
What are the symptoms?
Below are six common vasospasm symptoms:
- A burning, stabbing, itching pain in the nipples in between feedings
- Misshapen nipples
- Shooting pain deep within the breast
- Nipples changing color to white, blue, or dark red (see photo here)
- General nipple soreness
- Sensitivity to cold temperatures (to the degree that the cold causes pain)
In exclusive pumping mothers, vasospasms frequently occur after pumping sessions, when the air hits the nipple after the flanges are removed. It’s common to feel a burning pain, followed by a color change in the nipple.
How do I know my nipple pain is caused by vasospasms?
The two symptoms that are most likely to indicate vasospasms (as opposed to other issues like thrush) are the nipple color change and extreme sensitivity to cold.
If you have either of these, vasospasms are likely an issue for you.
What should I do if I think this is what is causing my nipple pain?
You need to do two things – resolve the underlying issue, and manage the pain you may be experiencing.
Treat the underlying issue
The first thing that you need to do is treat the issue that is causing the vasospams, which is usually one of two things:
1. Damaged nipples
This could be caused by a bad latch from nursing (if you sometimes nurse or have recently switched to exclusive pumping), or breast shields that don’t fit well or haven’t been positioned correctly.
Make sure that your flanges are the right size, and each time you pump, double-check to make sure that your nipple is centered.
2. Thrush
If you think you may have thrush, you should see a doctor for a diagnosis and a prescription to treat it.
OTC APNO may also be helpful. More info on thrush here.
Note that if there’s no pain associated with your vasospasms – only color changes (known as nipple blanching) – then there is no need to treat it, though it’s worth confirming that you do not have thrush and your breast shields fit correctly.
Treating pain related to nipple vasospasms
Then, you’ll need to treat the pain associated with it while your nipples heal. Some options include:
- Try to keep your nipples as warm as possible, while avoiding cold. Use warm dry compresses like a heating pad or Booby Tubes – these can both stop the vasospasm and treat the pain
- Massage olive oil very gently into your nipples
- Avoid caffeine, nicotine, and oral contraceptives that contain estrogen (you should avoid the latter anyway when breastfeeding, as this medication can affect supply)
- Take Motrin for the pain and inflammation – Motrin is compatible with breastfeeding
- Massage vigorously for about 60 seconds above your breasts and below your collarbone immediately after you unhook yourself from the pump, or when you begin to feel nipple pain
- Take a Vitamin B6 Multi-Complex – per Dr.Jack Newman, the dose of B6 should be about 100mg twice per day, and it should be taken as part of a B complex of vitamins
If none of these work, you can see your doctor. She may prescribe nifedipine for about two weeks, which can help with the pain.
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How can I prevent nipple vasospasms?
The most important thing that you can do to prevent vasospasms if you’re exclusively pumping is have the right size breast shields, and make sure that you position them correctly.
If you are nursing, you will want to make sure that your baby is latching well.
You’ll also want to do what you can to prevent thrush. Some ways to do this are to add a probotic (such as yogurt) to your diet, change your breast pads and nursing bras frequently, and wash your hands regularly.
Have you dealt with nipple vasospasms while exclusively pumping? Tell us your story in the comments!
References
- Bonyata, Kelly, IBCLC. “Nipple blanching and vasospasm.” https://kellymom.com/bf/concerns/mother/nipple-blanching/
- Newman, Jack, MD. “Vasospasm and Raynaud’s Phenomenon.” https://ibconline.ca/information-sheets/vasospasm/
- Pearson-Glaze, Philippa. “Nipple Vasospasm and Breastfeeding” https://breastfeeding.support/nipple-vasospasm-breastfeeding/
Comments & Chitchat
Nicole says
I don’t get this while pumping, I get the pins and needles pain randomly when I NEED to pump. Not all the time, but it happens. Is this also a vasospasm?
Amanda Glenn, CLC says
Hi Nicole! I don’t think so if it’s just the pins and needles – that just sounds like a letdown.
Sarai says
My Vasospasms are severe. It’s the most excruciating pain I’ve experienced aside of labor. I’ve ended up in the ER with the pain only to be continually refused the Nefedipine. The pain lasts anywhere from 3-4 hours consistently. Sharp needle-like pain from my nipple through my entire breast. Heat doesn’t work, ibuprofen doesn’t work. Ive been measured by a LC so I know I’m in the right size flange. I’m taking all of the vitamins I’m supposed to. I’m trying to dry my milk because of the pain and haven’t been able to because I’m also prone to Mastitis through engorgement & plugged milk ducts. I wish there was a way to have been told about all of this I would’ve never tried to produce milk
Amanda Glenn, CLC says
I’m so sorry you’re going through this Sarai! I hope your LC can help you wean quickly. ❤️
Kathleen says
I’m in this same boat hoping to wean but I clog so easily. How did you do it?
Anna Krauze says
Hi, I’m experiencing the same exact symptoms you are. Were you able to wean effectively?
Brittany says
Is this the same if the nipples go purple and swell no matter the flange size? I’ve been beating my head against a wall and bleeding my wallet dry trying to find flanges and accessories that work for me and so far nothing helps
Amanda Glenn, CLC says
Hi Brittany! Do you think you maybe have elastic tissue? Here is some info:
https://exclusivepumping.com/how-to-make-pumping-with-elastic-nipples-less-painful/
Stephanie says
I was diagnosed with them yesterday! My nipples turn black while pumping. I thought it was normal at first and was grinning and beating it, but I’m almost to the point of quitting. I went to my LC and she watched me pump. My flanges fit, it’s just something that I guess I was unlucky to get. They did tell me to try pumping pals, told me to rub WARM coconut oil onto my nipples, and to keep them in my shirt at all times when not pumping to try and keep them warm. I have a handout on all the vitamins and supplements that they say to try to help stop them, but they didn’t recommend the blood pressure medicine. If you don’t have blood pressure problems, it can drop your blood pressure low, which will give you headaches and the possibility of passing out (which you don’t need when you’re watching your baby).
Cyndi says
I have THE WORST PAIN . It made me stop breastfeeding with my daughter 13 years ago . Just had my son 10 months ago and the pain came back . I’ve stuck it out this time tho . Sometimes pain is soooo u bearable . I apply a hot rice pack and hold my chest tight . It’s the worst pain . Makes me wanna quit so bad . Only 2 more months till he’s one . Pain has been worse the last few months . So sensitive . Even a shirt laying on me hurts . My son can’t even rub against me Whitney cringing .
Rachel says
I have the change in color but no pain, thankfully. I use pumpin’ pals and have found the best sized shield that works for my nipple size so it just is what it is. Thank you for this article though … I was freaking out when it first happened to me about a month ago (or 4mos. pp).
Amanda Glenn says
Thanks Rachel! Glad to hear no pain!
Angel says
Did the color come back that’s what is wrong with me!
Holly says
You read my mind! I was just thinking today how much my nipples hurt when I went out in the cold weather! My symptoms definitely match up with nipple vasospasms. I don’t think it’s due to a wrong flange size, although maybe I don’t position them correctly during my middle of the night pumping sessions (I try not to turn on any lights). I’m also on planning to drop a pumping session, so hopefully that’ll help. Thanks for the info and suggestions!