As well as Calcium and Magnesium, I have heard of nifedipine, a calcium channel
blocker, as a treatment for vasospasm. The dose was 5-10mg three times a day.
Nifedipine is used for high blood pressure and cardiovascular insufficiency, and
one of its side effects is flushing and vasodilation, so I suppose this is how it works.
I know Tom Hale posted on nifedipine recently, and said that only 5% of maternal
dose got into breastmilk, and that they were relatively safe to use. It might be
helpful as a last resort for mothers with bad vasospasm. Might be safer than using
nitroglycerine topically, as this might well cause problems for baby. (Has anyone
actually tried this?). The nifedipine suggestion I picked up from a conference in
Melboourne Australia this year. Another Doc who is an LC.
As I don't have contact with many LCs (apart from Joy Anderson on holiday with her
laptop and modem - Hi Joy!!!), Lactnet has become not just a source of information
and ideas, but also somewhere where we can exchange the frustrations and joys of the
job - it's the lunchtime chat that I would have with my colleagues if I had any
close to hand. Keep on going just as you are!!!

Fiona Coombes
Family Physician IBCLC
Perth Western Australia