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Lactation Information and Discussion <[log in to unmask]>
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Mon, 2 Feb 2004 07:01:54 -0600
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I saw three ladies with vasospasm on Saturday.

I think it is a very common component of chronic nipple pain. (ie
lasting longer than the first few days)  It seems to usually be
associated with damage to the tissues, usually compression, sometimes
+/- yeast overgrowth.  Sometimes the mom has noticed color changes, but
usually not.  It pays to look at the nipple for a minute or so after the
baby comes off...it often turns white in a circle on the face of the
nipple, or sometimes purple more around the edges, but NOT in a
compression-line.
Sometimes mom has a history of raynauds of the fingers...but usually
not.  They often describe the pain as burning, sometimes stinging,
sometimes aching.  Heat helps, as does covering the exposed nipple as
soon as possible after the baby comes off.  Vit B6 has been very
helpful,,,Dr Newman has a protocol of 150 mg QD X 5 days, then 25
mg/day.  I have many women whose symptoms recur when they decrease the
dose, so I tell them to titrate it to the lowest effective dose. (Since
it is a water-soluble vitamin, I don't see why decreasing should be
necessary.)  I explain to them it is important to find the cause of the
original damage and take care of it (usually "chomping" or pinching),
but that the spasm can perpetuate damage by causing intermittent tissue
hypoxia, and needs to be addressed.

Hope this is helpful-
Kathy Leeper, MD, IBCLC

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