I am speaking from my sample of one mother with arterial spasms of the nipple whom I was able to follow long-term. I was unfamiliar with the fact that more than one prescription might be needed, and perhaps a larger dose. So I contacted her OB's office and he was very cooperative in prescribing the first prescription of - I believe- 60 mg. and he also was willing to renew the prescription once.

All the difference  that I wqs able to observe was that the mother had very rosy cheeks for several hours after each dose. The posts from March/April 2012 are in the archives. I believe I learned lot from this one case that I will have ready if another crosses my path.

The upshot of it was the best suggestion was to avoid even the chill of the air that results from evaporation 
 of the baby's saliva when the baby comes off the breast. Have the mother immediately cover the nipple and surrounding breast, and on the outside of the clothing apply a source of heat on the outside. Either a heating pad at a safe comfortable temperature, or perhaps a hot water bottle at an appropriate temperature.

Had I known this before I recognized the Raynaud's phenomenon happening, I believe it would have made a huge difference, and I would use it again rather than bother with a systemic medicine that effects so many other parts of the circulatory system.

K. Jean Cotterman RNC-E, IBCLC
WIC Volunteer LC       Dayton OH

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