>Help! I have a client, baby is 10 weeks old, was pre-term and sent home
>from NICU using nipple shields. Recently baby refused shields and went
>to breast. Since then mom has had very painful nipples (24 hours/day)
>with bleeding noted from the ducts. No external damage seen. Nipples
>are white after feedings and take time to resume normal color. Baby
>appears to be latched on properly. Also same mom has been supplementing
>for "not enough milk". I do seem to inherit the oddest cases. What can
>I do for this one? Karen (help me)Lemieux

Blanching after feeds could be due to compression of the nipple, or
generally nipple trauma.However I have recently become the queen of nipple
Raynauds phenomenon, as I now have my second case in just 6 weeks. But
these women will definitely tell you that the blanching will occur BETWEEN
feeds ALSO. Raynauds is a vasospasm of the tissue classically seen in
fingers/toes in women more that men, some are not due to any particular
disease (idiopathic) and others are secondary or due to a connective tissue
illness such as rheumatoid arthritis or lupus. Also the color changes may
include not just blanching, but blanch, blueness then redness. Anne Eglash
MD