Raynaud's phenomenon is due to spasm that decreases blood flow in a particular area of the body. It is very common in the extremities, but it also occurs in the woman's nipple, a very painful condition when breastfeeding, as it may be accompanied by cracks or blisters.
Although there is still much research on this syndrome, and its exact causes are unknown, there are several risk factors such as smoking, alcohol consumption or cold, among others. In the case of the nipple, it could be triggered when the baby separates from the nipple, due to the change in temperature. In a short time the nipple changes color.
The most prestigious breastfeeding texts (Lawrence, Carlos González and LEP Committee of the AEP ...) talk about the phenomenon Raynaud (FR) is an ischemic phenomenon (cellular suffering caused by the transient or permanent decrease in blood supply), which It is triggered by the cold and can occur in up to 20% of women of childbearing age.
The FR of the nipple hurts both during the shots and between shots, it is characterized by changes in nipple color and can be accompanied by blisters, cracks or ulcers, so it is very painful.
It is often confused with a Candida albicans infection. As for treatment, it is usually recommended to avoid tobacco, cold and vasoactive drugs, and nifedipine (a drug to treat hypertension) is usually effective and is compatible with breastfeeding.
Before a sore nipple, specialists have to ensure that there is a correct breastfeeding technique and investigate the role of cold and the existence of changes in nipple coloration, since it can cause breastfeeding abandonment and treatment with nifedipine can Relieve the problem.
Mothers describe Raynaud's phenomenon or syndrome as a burning in the nipple, when it turns white. After having changed color (you can acquire various shades for minutes and even hours), it returns to its natural color (since blood flows back into the nipple), and the mother will notice as a heartbeat.
Experts in LM have described in the recent Spanish Breastfeeding Congress their experience with 6 mothers suffering from Raynaud's nipple syndrome.
Most visits were in cold months, and the 6 babies were between 15 days and one month old. No mother reported a history of rheumatic pathology, smokers were not confessed during pregnancy or breastfeeding, nor did we have a history of breast surgery.
Only in two cases there was a history of bad position when breastfeeding: a mother presented cracks during the first days, solved before being visited in our consultations; and the other reported symptoms compatible with a syndrome of poor breastfeeding. Another mother had received fluconazole on suspicion of candidiasis of the nipple.
The pain was more frequent after taking, after a few minutes. They explained that the nipple bleached when they noticed the pain. Upon regaining color, the nipple became bluish to very intense red. The shot was rated as correct in 5 of 6.
Although the intensity and frequency of the symptoms varied, they were prescribed to all nifedipine mothers, since the symptoms were progressive (more intense and frequent the more time passed). The 5 mothers who continued with the treatment improved (less frequency and intensity of the crises), but in one case the dose had to be increased to notice beneficial effects.
The conclusions of the specialists are the following:
The nipple FR is rare, early onset (in the first month), is not related to smoking or poor breastfeeding syndrome, appears in the cold months, is progressive and usually improves with nifedipine. As its diagnosis is clinical, we believe it is very important that the mother spontaneously refers to changes in nipple color. In our experience, the nipple FR did not interfere with breastfeeding, but these were mothers very interested in continuing to breastfeed their babies who also responded to nifedipine treatment.
That is, in principle Raynaud's nipple syndrome does not have to be an impediment to breastfeeding the baby in these first days of life and later if it is diagnosed and treated properly.
