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Subject:
From:
Judy Le Van Fram <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 25 Nov 2003 15:52:28 EST
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Terri wrote:

<< 2) Ask mom if she has cold hands and feet.  Nipple vasospasm mimics
 yeast symptoms, and can be treated with 30 mg Nifedipine daily until
 symptomology is gone, or for the duration of breastfeeding, if need be
 per Ruth Lawrence. >>


Also Raynaud's of the nipple doesn't have just pain, but triphasic color 
changes of the nipple as well, with blanching/turning white, blue/cyanosis, and 
thne red. If the mom has seen this, then it may be Raynaud's. The last time an 
MD suspected Raynaud's,  I saw the baby and chalked it up to chomping by the 
babe with a shallow latch ( shallow latch protecting against huge flood of 
milk). After working on positioning, managing flow, baby getting comfortable with a 
deeper latch, the latch-on pain went away, but it took another 2 weeks or so, 
and some APNO perhaps, for mom to get completely comfortable. After 6 weeks 
of chomping and bruising, it made sense to me that there would be a lag between 
better latch and pain-free feedings. Mom and MD concurred, and things are 
going well now. 
Here's a bit from a website:
"Classically there is a triphasic colour change associated with Raynaud"s 
phenomenon. Firstly there is pallor induced by vasopasm and then cyanosis caused 
by deoxygenation of pooled venous blood. Finally there is rubor associated 
with reflex vasodilatation (4) The triphasic colour change occurs in two thirds 
of patients with Raynaud’s phenomenon (13) . 


The signs of vasospasm may be accompanied by symptoms of numbness, burning, 
tingling (14) and of course pain. It is pain that causes distress to the 
breastfeeding woman and will precipitate her presentation for help. 

Attacks of vasospasm may be induced by cold exposure or by emotional 
stress (15). "   ........  http://www.gp.org.au/cls/raynaud.html
Judy LeVan Fram, PT, IBCLC, Brooklyn, USA

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