By Dr. Nancy Brent

One of the most common problems breastfeeding women experience is nipple pain. This usually occurs in the first few days after birth and is due to the way the baby is latching onto the breast. Although nipple pain is common, it’s not normal.

But it is instead a sign that something needs to be corrected. Breastfeeding is a learned art for both mother and baby. You both need to learn how to latch the baby onto the breast with a wide, open mouth and a deep latch. Once you both have learned this, and any damage previously done to the nipple has healed, breastfeeding should not be painful.

However, some mothers continue to have nipple pain beyond the first week of life despite correction of the latch. There are several different causes for this such as bacterial of fungal infections, flat, inverted or dimpled nipples, a high arched palate or tongue tie in the infant for example.

One less common cause of nipple pain is Raynaud’s Syndrome or vasospasm of the nipple. Raynaud’s Syndrome is a condition in which the small blood vessels in the fingers and toes contract on exposure to cold. This causes a decrease in the blood flow and the tips of the fingers turn white and become painful. Once they start to warm up, the blood flows into them quickly, causing a red or purplish color and a throbbing pain. Finally, the normal flesh color returns and pain resolves. This can occur by itself or can be associated with a group of autoimmune disorders such as rheumatoid arthritis, systemic lupus erythematosis, Crohn’s Disease or ulcerative colitis.

This same sequence of events can occur in the nipples of a breastfeeding woman. This may or may not be associated with classic Raynaud’s Syndrome. It can also be triggered by nipple damage, infection or by certain drugs. The pain will typically occur after the feeding and be associated with blanching of the nipple followed by a deep purple color and then a return of normal color.

Although there is a medication for this condition, dry heat placed on the nipples immediately after the baby comes off is usually effective. You can use a rice sock, wool breast pads, a heating pad or hair dryer on low and at least 12 inches from the nipple or heated nipple pads. Usually, if a mother is careful to do this after every feeding, the sequence stops and the pain no longer occurs. Very rarely is medication needed. If you think this applies to your situation, try heat after feedings and call us at the Breastfeeding Center of Pittsburgh 412-246-2647.

Dr. Nancy Brent is the former Medical Director of the Breastfeeding Center of Pittsburgh.