I would definately think vasospasm here.  It's also possible that there 
is both thrush and vasospasm.
Increase asymmetry of latch, check out baby's mouth for thrush, short 
lower jaw, or severe tongue tie (both the latter can cause clamping 
during sucking that cuts off blood flow to the nipple and causes the 
blanching and reflex vasospasm as the nipple reperfuses after release).  
If the jaw is short, a lot of head extension to bring it forward can be 
helpful.  If it's tongue tie, the easiest fix is to encourage mom to get 
it evaluated and treated.  Optimizing the latch can be helpful, but 
won't make it perfect until the baby reaches a certain critical size.
The fact that the first baby could not bf increases the index of 
suspicion that there is a genetic anatomical cause, like tongue tie or 
retrognathia/micrognathia.
Catherine Watson Genna, IBCLC  NYC

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