Raynaud's of the Nipples
Q: Two weeks ago, I gave birth to my first child and she took to breastfeeding
almost right away. The only problem is that after she's done feeding,
my nipples are practically white in color, plus they hurt so bad it brings tears
to my eyes. It's especially bad on really cold days, and since we live
in Minnesota, there are a lot of those! Is there something wrong with my breasts?
Dr. Donnica: Do you ever have extremely cold fingers as well?
It sounds as though you might have Raynaud's phenomenon or syndrome. This condition
is an intermittent decreased blood flow to certain areas of the body (most commonly
fingers or toes), but it may affect the nipples as well, particularly in nursing
women. Raynaud's is nine times more prevalent in women than men. Estimates
are that up to 20% of healthy women ages 21-50 may be affected. However, most
women--and many physicians--are not aware that Raynaud's may affect the
nipples. The good news is that this is generally treatable. Because the breast
pain associated with Raynaud's phenomenon is so severe and throbbing,
and the awareness of this condition is relatively low, it is often inappropriately
mistaken for a yeast infection of the nipples. Symptoms may also occur during
Treatment options include preventing or minimizing cold exposure, avoiding
substances such as vasoconstrictive drugs or nicotine, and medical therapy.
Nifedipine, a calcium channel blocker (available by prescription only), has
been used to treat Raynaud's phenomenon because of its prompt vasodilatory
effects. Very little of the medication can be demonstrated in breast milk and
thus it is believed to be safe for breastfed babies. Some lactation specialists
recommend Vitamin B6 therapy (150-200 mg/day once a day for four days, followed
by 25 mg/day once a day), which has shown to work in some cases after a few
days, although there is no scientific evidence to support it.
Created: 11/24/2004  - Donnica Moore, M.D.