What do you do when breastfeeding hurts, even with a good latch? Learn if you have nipple vasospasm and how to overcome this breastfeeding challenge.
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A Bit of My Story: Why Breastfeeding Still Hurt, Even With A Good Latch!
I knew I had a good latch! I’d followed all the instructions, asked for help and watched videos on how to get a good latch, see my other post. Even my midwife, nurses and the hospital lactation consultant confirmed my baby’s latch was perfect. So I was confused why breastfeeding hurt soooooo badly!
The answer I kept getting was that your latch looks good, it will be fine. “Maybe your nipples are just needing a bit of ‘toughening up’ before nursing is pain free?” “Maybe your nipples are a bit inverted and you can first encourage them yourself to stick out, then it should be fine?” “Keep practicing a good deep latch, it is normal feel some pain at the beginning.” Sound familiar?
Contrary, the breastfeeding pain continued to worsen and fast. I dreaded every single feeding clenching my teeth while stifling a scream and instead stomping my foot in pain. If it wasn’t for my supportive husband and the knowledge I had learned about how good breastfeeding is for your newborn running though my head, I would have given up by day two!
When Breastfeeding Hurts, Even with a Good Latch
I was about ready to quite breastfeeding for sure. What stopped me? My intuitive midwife’s home visit and observations.
My midwife confirmed my latch was good. Double checked for a tong tie, but found nothing. She recommended putting cabbage leaves on my breasts to help with the continued engorgement, along with hand expressing in a warm shower.
Showering?! What new mama has time for that? And it hurt! I’d feel nipple pain again right after getting out of the shower!
I explained this along with the fact that Dr. Jack Newman’s All Purpose Nipple Ointment she’d prescribed me would sting for a few minutes after applying. Come to think of it, my nipples would burn and sting even before putting the cream on right after a feed!
As my midwife reflected on this, she noticed something at the end of my feed. Ahah! She pulled up the below list of questions and started asking me if I also had any of these symptoms.
Do I Have Nipple Vasospasm? Symptoms of vasospasm:
- Breastfeeding hurts, possibly during a feeding.
- Burning, stabbing, throbbing, and/or “pins and needles” pain in the nipple and/or in the breast after the baby comes off the breast.
- Similar kind of pain occurring when stepping out of a warm shower or when going outside on a cold day.
- Nipples change colour (red, white, or purple) and go back and forth between colours (e.g. white to pink, back to white) for several minutes or even an hour or two after a feeding.
- Cold fingers or toes, particularly when exposed to colder temperatures.
- Color changes in the skin (hands, feet) in response to cold or stress.
- Numb fingers or toes, prickly feeling or stinging pain upon warming or stress relief.
Yup, pick me! Now we knew why breastfeeding hurt, even with a good latch. I had nipple vasospasm!
Although annoying, I never thought much about some of the non-nipple symptoms I’d had most of my life. It was just me, the person who was always cold! However, the nipple/breast pain was a whole new level and not something I could just tolerate with a nursing baby.
My midwife gave me a list of things I could do to bring pain relief and promote healing. I want to share her 13 tips to treat nipple vasospasm with you.
Wait, What is Nipple Vasospasm?
Nipple vasospasm means that there is a constriction of blood flow to the extremities, in this case the nipples.
If the latch isn’t good, the pinching of the nipples can trigger the blood vessels constriction and thus the pain. However, even if the latch is deep and good, the change in temperature from the warm baby’s mouth to the cooler outside air (or from the warm shower to cooler air) causes the constriction of blood vessels around the nipples. These reasons is why the blanching (changing colour) can be seen. It’s also why, in my case I experienced stinging after applying the cooler-then-baby’s-mouth nipple cream.
Additionally, blood flow constriction to the nipples means it will take longer for the nipples to heal once damaged. This was definitely an issue for me with my cracked, bleeding nipples.
13 Tips To Treat Nipple Vasospasm Naturally
- Improve baby’s latch, to avoid pinching, watch these two videos AND rule out any tongue tie.
- Think: I must keep my nipples warm at all times and improve blood flow!
- Apply dry heat to covered breasts/nipples using a water bottle or electric heating pad shortly before and after breastfeeding.
- Immediately cover nipples either with hand or breast pad soon as baby comes off the breast.
- Keep nipples and breasts warm by wearing cloth breast pads. (Wool is best, but I found the thick cotton or bamboo night pads did the trick too and cost less.)
- Warm up nipple cream or olive oil between fingers before applying to nipples. You can even reach inside your bra to do this to keep those girls as warm as possible.
- While taking a shower cover breasts/nipples with a facecloth, when finished immediately cover with a towel.
- Massage pectoral muscles, 60 sec each side. Vigorously and firmly rub the chest muscles below the collarbone and above the breasts after the feedings or whenever you feel nipple or breast pain. Additional gentle massage under or between the breasts or in her armpits.
- Stretch muscles around the breast throughout the day to improve blood flow. Lift arm to shoulder height or a bit lower and press it behind you on a wall. Hold through a few deep breaths. Do 2x for each arm, once with palm facing back and once forward.
- One breast per feeding, if you don’t have mastitis symptoms and your midwife or doctor confirms that baby is gaining weight well.
- Avoid caffeine as it can also be vasoconstricting as you don’t want to ingest any substances that could be constricting your blood vessels more.
- Wear nipple shields that fit well for a short time to give the nipples a chance to start healing. Be careful as there can be disadvantages to nipple shield use, especially long term. Read this article to find out more about nipple shields. For us it was worth it and no problems.
- Surround yourself with support. Find an IBCLC or LC to monitor and support feedings until nipples are healed and breastfeeding is pain free.
Next Steps: Does Breastfeeding Still Hurt Even After These Treatments?
- Twice a day take 250 – 300 mg of magnesium bisglycinate or magnesium citrate. (Magnesium citrate also helps with constipation.) It helps relax muscles and blood vessels, really helpful if vasospasm pain is in your breasts. If you see no improvement by 3 – 4 weeks, stop. If the magnesium lessons the pain, keep taking it until your pain has been stable or you’ve been pain free for 2 weeks, and then stop.
- Take a B complex that includes B6 and niacin (B3). Make sure to get 100 mg of B6 twice a day. If you see no improvement by 1 week, stop. If the B complex lessons the pain, keep taking it until your pain has been stable or you’ve been pain free for 2 weeks, and then stop.
What If Still Nothing Is Reliving Vasospasm Pain From Breastfeeding?
- If there is still no improvement after doing all this talk to your midwife/doctor/IBCLC about prescribing Nifedipine (or other medication that relaxes blood vessels).
Dr. Jack Newman gives some advice you can discuss with your health care professional: "Nifedipine is a prescription drug used for high blood pressure. One 30 mg tablet of the slow release formulation once a day often takes away the pain. After two weeks, stop the medication. If pain returns (about 10% of the time), start it again. After two more weeks, stop the medication. If pain returns (which is uncommon), start it again. No more than three, two-week courses should be needed although some have needed it for a longer period of time. Side effects are uncommon, but headache is not rare. The dose can be increased if 1 tablet is insufficient (contact [Dr. Newman] for more information). Nifedipine may be used in conjunction with all of the other treatments listed above."
Other Reasons for Experiencing Breastfeeding Pain
Nipple vasospasm could be the reason breastfeeding hurts, even with a good latch. However, there are other reasons that can more commonly cause breastfeeding pain when the latch is good. Nipple vasospasm is often misdiagnosed as thrush as symptoms are similar. Other reasons can be damaged nipples, chafing from clothing on sore nipples while they heal, pumping can help give your nipples a break while they heal as well. Check out my post on what to do when breastfeeding hurts where I share 14 tips that truly work.
Don’t Lose Hope!
You can work through the challenges of breastfeeding hurting. Because I can tell you, after breastfeeding my first for almost two years, it is so worth the struggle! Breastfeeding is natural, it can be pain free and beautiful. Hang in there mama, you got this!
Have you experienced nipple vasospasm pain when breastfeeding?
Did breastfeeding hurt for you, even with a good latch and was it caused by nipple vasospasm? What things worked for you? Have you found something else that was helpful in being able to breastfeed pain free? I’d love to hear about it in the comments below.
Check Out More of My Posts On How to Breastfeed Successfully
What To Do When Breastfeeding Hurts
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In the USA:
- nipple cream
- warm breast pads
- hot water bottle
- electric heating pad
- nipple shields (choose one that fits a bit bigger)
- loose fitting bra
- Haakaa Manual Breast Pump (for engorgement)
In Canada:
- nipple cream
- warm nursing pads
- hot water bottle
- electric heating pad
- nipple shields (choose one that fits a bit bigger)
- loose fitting bra
- Haakaa Manual Breast Pump (for engorgement)
Juliea Huffaker
So much important information here for nursing mothers! I had a white blister once and it really messed up my flow! When you have nipple problem is slows production a d is so frustrating! But this will help so many mothers get back on track! So thank you! ❤️
Dusty
Such a great & informative post for breastfeeding mamas!
Alissa
I started experiencing vasospasm at about 12weeks pregnant and it got worse as time went on! Keeping the nipples warm is key – I used single-use hand warmers from the dollar store in my bra. Breastfeeding is HARD and this condition makes it almost unbearable some days but I know it’s so good for my baby physically and important for our bonding. Wishing all the mama’s struggling with vasospasm strength and perseverance!
Xoxo
simplylivingthislife
Oh I’m so sorry to hear this Alissa! It’s such a sacrifice for you but also so worth it in the long run. I love the hand warmers idea, that’s great! Hugs, healing & strength to you! Hopefully my story brings some encouragement to you.