Hey all, Computer been down and family problems up, but I'm finally looking at some of the digests and wanted to add some info on blanching. I've worked with a fair number of these over the past 5 years or so, and have found that most seem to be related to vasospasm. This is the protocol I follow (it was suggested by Mary Ann Neifert years ago): Use alternative feeding methods with expressed breastmilk. Pump for the first 24 hours. Next day begin nursing every third feeing and pump the other feedings. Next day nurse every other feeding The next day return to full breastfeeding This has been very successful for the moms that I have worked with, and lends to the theory that this could be a extreme response to sudden suckling of a newborn. Maybe this could even be the reason, in a lesser way, to the normal discomfort most new moms experience. Along with this, I believe the allergy factor, mentioned in an earlier posting, could only increase the likelihood of this vasospasm response and/or the intensity of the episode. Hope this info helps! Barbara Heiser, RN, BSN, IBCLC