I have a mom of a 5-week old infant who is suffering daily with extreme nipple and breast pain. She is one of the nurses on our OB/NICU unit, and her husband is a pediatrician (making it ever more important to make breastfeeding work out for her, in her mind!)  

This mom has always had some degree of nipple pain since her child's birth. She is a redhead, so of course everyone wants to blame that on her problems.  She felt as if the pain was getting better last week, but now it is back with a vengeance, and with more frequency.

Mom has all of the classic signs of vasospasm - nipples blanch white after the nursing is finished, then turn red and then blue before returning to normal color. One interesting phenomena is that mom complains her nipples become erect after the feeding and will not go back down for quite some time. During these episodes, she has begun to feel a burning (not itchy) pain in the nipple and inside the breast. Her pediatrician husband has checked and says baby does not have thrush (I haven't looked, however). Burning goes away when nipple erection finally settles down.  The nipple erection never totally goes away.

Warm compresses have helped her, but she is sick of this and wants to know if she must suffer for her entire breastfeeding experience.  

Does anyone know for sure whether topical nitroglycerine or nifedipine works for vasospasm? If so, how much and for how long? She is seeing her midwife next week, and I need to make a recommendation.   THANKS!

Brenda Phipps, BS, IBCLC

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