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 *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html