I think that there is sufficient understanding of nipple vasospasm now
so there is much less confusion with candidiasis.
The common precipitating factor I see is that the nipple is being
abnormally compressed by the baby during sucking (often the child has a
minor tongue-tie or a short lower jaw). If we can fix the latch and
sucking, often the vasospasm resolves. In cases where the sucking can't
be readily improved, or the mother suffers from Raynaud's syndrome
elsewhere and is particularly susceptible, we try immediately drying the
nipple to prevent chilling, dry heat after feeding, wool nursing pads to
keep the nipple warm and dry, and nifedipine is almost always effective.
Catherine Watson Genna, IBCLC NYC
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