The 2nd edition of Riordan and Auerbach's BF and Human Lactation states on
page 492, maternal medications such as fluconazole (Diflucan) and oral
contraceptives, may be associated w/ vasospasm.  The reference is, Escott
R: Vasospasm of the nipple: another case {letter}. JHL 10:6 1994,  I don't
have the Escott letter.  I don't know if it is an opinion or fact.  Just
passing it along.
The reason I had the reference in mind is I'm currently working w/ a mom
with terrible yeast whose nipples seem to vasospasm when she pumps and she
has no history of Raynauds.  At least we think it is a vasopspasm.  Her
nipples turn white where the flange meets the breast and after pumping the
nipple and areola are very dark purple.  If anyone has any insight into
this, we would really appreciate it.  Using a Symphony, have changed
suction and flange size and are now using glass flanges w/ some relief.  No
real change with nifedipine and nitroglycerin ointment gave mom a migraine
(tried it for 2 days).  Maybe it isn't vasospasm, any thoughts?  Mom also
has OALD if that helps.  On the up side the yeast and her baby's suck seem
to be improving and baby has started nursing again.  She does not seem to
get nearly as purple w/ the baby.  Thanks, Mandy Frost, MS,RD,IBCLC

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