After reading Rhoda's excellent post on blanching, I realized how inadequate mine had been. I agree entirely with Rhoda that this is a type of vasospasm. ( If any of you have Raynaud's phenomenon, you will notice that your finger(s) or toe(s) turn dead white then when the blood flow resumes, they get very pink and warm. When I talked about positioning and latch I should have been more specific . These babies really do seem to clench their jaws and clamp down hard on the nipple. It also seems to be a conditioned response. By that I mean that it begins after a period of several weeks of nursing, and even when the clamping has ceased. it may take several week for the mother to stop experiencing this vasospasm. The medical director where I work has on two occasions prescribed nitroglycerin paste for the mother to rub into her nipples when she has the problem, however he prefers not to do this and to use other means such as warmth and analgesics if needed. ( The idea for the nitro paste came from Dr. White at an LLLI Physician's Seminar many years ago.) Nitro paste can cause severe headaches if the mother uses more than the tiniest amount. One other solution which I have tried and has occasionally worked, is to use a primed SNS with a small amount of EBM or ABM , just enough to keep the baby from clamping until the MER occurs. However, while it may improve immediately, it doesn't seem to go away immediately, but recedes over a period of several weeks, IF the mother can persist that long, And yes Rhoda, I too have seen some mothers who just cannot continue. I would like to know what caused it in the first place, since I have only seen one of these mothers early on--- the rest arrived somewhere after two weeks post partum. Eileen Shea, BSc, IBCLC