Nipple Vasospasm...any experiences or advice please

So for a quick background.....I am currently breastfeeding DD who was born premature in June at 25 wks. We've been home about 10 days and are combining breastfeeds with bottle top ups of EBM. Her corrected age is about 4 weeks old. I've been expressing while she's been in hospital to maintain my supply.

At the moment we are successfully breastfeeding with the help of nipple shields. Without them the pain is excruciating as attachment is quite challenging. Small baby, small mouth, big boobs etc. So the shields are working, its not 100% pain-free but still its tolerable.

Next issue is the vasospasm. I know I have it and several LCs that I've spoken to have identified the trademark symptoms. I get a lot of pain during and after feeds, expressing is also painful and my nipples turn a rainbow of colours too. Generally, my nipples are tender & sore between feeds and expressing. I just kind of accepted that it was how it was going to be.

I know it will be making feeding more painful when it really shouldn't be, and probably contributes to the nipple trauma I experience. We had very bad attachment issues when DS was a newborn which left us abandoning breastfeeding because my nipples were so badly damaged.

It appears that treatment using Nifedipine is quite effective so I have an appt with my GP on Thursday to have a chat about it, and I'm really hoping it will make a difference. Can anyone share any experiences or advice? I know about feeding in a warm environment and warming breasts up before & after feeds etc. I'd love to hear from anyone who has had success with Nifedipine too.

At the moment I'm just taking things day by day. Some days DD will attach really well (like yesterday) but then today she'll have a day where it leaves a little to be desired (like today) and I have to wonder whether my poor old boobs just aren't tough enough LOL! I'm not really interested in persisting through a lot of pain after the past few months that we've had, but I'm hopefuly with some more time and growth things will get a lot easier.

No advice here hun sorry but I hope you can get some relief and continue to feed Miss Heidi
:hug:

hey hun, sorry to hear ur having issue BFing after everything youve been through!
I'm pretty sure Mayaness had vasospasms with her DD, maybe send her a PM incase she doesnt see this.
Good luck babe
xxxx

:hug: It sounds like you are doing a great job with some difficult factors in there.

Although full term, my DD was on the small side initially and I have big boobs, so I know where you're coming from with that one. Luckily, this is something that aleviates itself over time.

Vasospasm is also a problem that I'm familiar with. DD's paed offered me a prescription, but warned me that a very common side effect is headaches, so I opted to try other methods first. I ended up taking a combination of fish oil and evening primrose oil as well as observing all the other 'rules' like warming before feeding etc etc and I manage to keep it under control *most* of the time. I bought some great breastwarmers from a pharmacy although aparently the ABA sell them too, so it may be worth investigating them too.

I think the trauma of cracked nipples etc in the first few weeks can make the vasospasm worse too. I was unable to stand in front of an open fridge door when my vasospasm was at it's worst, but As long as I take my oils I tend to be ok now, and I'm still feeding DD 13 months in.

Good luck, I hope you find a solution which works for you.



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Hollybolly is another who's experienced this, so you might want to PM her too.

I hope you get some good advice soon. What did the LCs suggest to help this issue? Can you go back to see them in the hospital now you're bfing so much more often than you were?

And can I just say, you are an absolute star to have come so far with your bfing journey and all of your challenges with little DD. I am in awe! :cheer:

No advice but just wanted to say well done on getting this far! You've been doing a fantastic job with everything you've had to go through already :hug:

I had severe vasospasm, it's awful isn't it!!! I was put on Nifedipine and felt a big difference within 24 hours and was pain free within 5 days!! I stayed on it for about 4 months and slowly weaned off it and never had a problem after that. DD was about 6.5 months when I weaned and I BF her until she weaned herself 2 weeks before her first birthday.

I got hot flushes in my face straight after taking the tablets but that's a normal reaction and it didn't last long.

FWIW, none of the other solutions worked for me - feeding in a warm environment, heat packs, etc. I was in agonly 75% of the day. The pain would disappear about an hour before DD was due for her next feed. It was hell! Even a cool breeze hitting my face (outside, the aircon or the cool from the fridge!) would set my nipples off despite my 'girls' being rugged up in several layers! I was so grateful for Nifedipine and highly recommend it.

I had an awful time with vasospasm too, as well as a few other issues like tongue tie. For me, keeping warm was a big thing, and I was recommended to take magnesium (I had blackmores) which seemed to help a lot.

I really didn't think we'd get past the first few weeks, and it took a while but feeding was eventually pain free, I hope that's the same for you too. Good luck!

i had this with my Ds3 and Dd.. i am pming you with a link

Hi Infinity,

I really empathise as I am in a similar boat. My bub is now 2 months old and I have been putting up with this awful pain since she was about 3weeks. My nipples are also cracked and scabby now because she has a high arched palate as well (also feeding always hurts regardless of how well she latches on so I never know when she is really on properly. I was diagnosed with thrush initially and treated for that for about 3 weeks before the local LC realised it must be something else. She then referred me to another LC who finally diagnosed nipple vasospasm.

I have been on nifedipine (30mg slow release) since Friday (day 5 today) and am yet to see an improvement. Sometimes I think things are getting a bit better but then I have another really bad night of being awake half the night with pain and realise it is not better. Also I am getting slight headaches and lightheadedness from the medication.

I was really pleased to see this thread as I am also looking for some alternative treatment (will start taking evening primrose oil today).

You are doing really well to keep bfing I know how hard it is!!

Out of interest where are you in SA? I am in Streaky Bay.

Thank you all so much. Sorry to hear that so many others have had it too though :(

Aussienic thanks for the PM, I will def look into the link.

Swoop, I'm so glad you were able to see improvement with taking the oils. I am aware of the side effects of the Nifedipine but need to talk to my GP more thoroughly on Thursday. I know its a drug to lower blood pressure & I already have a very low blood pressure normally so it might not be ok for me.

Taurean, I'm please the Nifedipine worked for you so quickly. I have hopes that it might be the 'fix' I've been waiting for but I'm preparing myself for otherwise.

Jen, the Neonatal Outreach team from hossy are seeing us regularly at home and they're onto it with me as well so I've got lots of support. They're lovely. I am considering getting a private LC to come and see me at home too though - we are still having a lot of attachment issues. Feeding is still painful and its because she's struggling to get on right with such a little mouth. We're doing our best but almost all feeds are still painful.

Chuckie - I'm in Adelaide. I'm sorry you're having such a tough time too. I hope things improve for you.

I'll keep you posted ladies. Thanks again for your help.

Yep, I had it with DS, actually, when he had the Tongue Tie, and for some time after it was snipped. It was the most hideous thing! I was never prescribed anything for it. I managed it with wheat bags - I'd heat one before a feed and stick it down my top immediately afterwards.
It's a response to the fear of further damage, in very simple terms, so you need to talk to a IBCLC LC who can help you with the BFing more than a hospy one who thinks she's a LC - IBCLC is the highest and only qualification a proper LC has. Once you get more comfy with the BFing, you'll see the vasospasm settle down and disappear. It's something that is controlled and eliminated psychologically once you've sorted out the attachment issues.
The fear response triggers the blood vessels to the nipples to close up, leaving them feeling cold and losing colour. It becomes like the chicken and the egg - damage causes fear causes vasospasm, fear of damage causes vasospasm, then just fear of breastfeeding causes vasospasm with or without damage, if the BFing issues aren't dealt with.
Give 1800mum2mum a call - a breastfeeding counsellor can help you in the middle of the night or day :) But definitely it's worth paying a proper LC to sort it out, medicine-free. :hug:

If feeling cold seems to be an issue you can get a product called breast warmers which you pop into your bra and they keep them warm so it is less painful. I doubt they are a miracle cure but perhaps a bit easier to use all day than wheat bags.

Chuckie, with the oil, you need to take a decent dose to make it work - I'm taking 4 epo and 4 fo a day, not sure of the dose per cap (am sitting car on phone while sleepless in Seattle is snoozing) but I'll check when I can.

Hope it goes well for you on Thursday infinity


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I should add that I had DS in the middle of June, so the cold weather didn't help. The wheat bag was used not because I feel it was the best thing to use, but because I couldn't get hold of the warmers the ABA sells!

Swoop - thanks I am on 3X 1000mg caps of both EPO and FO each day (the recommended dose on the bottle) maybe I will up it.

Update - after getting desperate I phoned the ABA helpline to find out how long the meds should take to work they referred me to a chap at the Monash Uni who answers the pharmacy helpline - he was excellent and told me to double the dose of meds and also advised that I could take panadol with the ibeprofen for pain relief at night. He also said that if I saw no improvement by Monday I have prob been misdiagnosed. I had a better night last night so I hope something is working!

Update - I thought I would let you know what finally helped me get rid of my vasospasm in case anyone is still having problems. Basically I was referred to another private LC who put me on a strict diet. The theory is that my milk was giving Pearl a sore tummy and making her chew on my nipples which was causing the spasm. After about 3 weeks on the diet I was about 95% better and totally drug free. It was such a relief after about 10weeks of pain and no solutions. The LC I spoke with was Robyn Noble she runs Bayside Breastfeeding clinic and I would recommend her for unusual BF problems and unsettled bubs.

hi, i'm also battling vasospasms... just wondering what you could eat on your diet, and if it was specifically tested for your child or a more general 'low reaction' diet? I'm working with a LC but not getting much relief so looking for more potential solutions.. thanks

Just saw this and thought I would comment super quickly as I run out the door. I was using glyceryl trinitrate for a different problem (it dilates your blood vessels, but also does it to the ones in your hear causing me severe headaches), which althought made my vasospasm better, I couldn't handle it.

The 2 other things my LC who is also a dr recommended - HUGE amounts of Blackmores BioMagnesium. She said use this brand as it has a better ratio/concentrate or something (it's been 5+ years so my memory is hazy), and the magnesium helps with cramping which is 1 of the problems that is occurring from the vasospasm.

2) - Swedish breast warming pads - you get them from the ABA, they are foil lined so it reflects the head back onto your breast. - they really do work - you wear them any time you are not breastfeeding.

Other than that try to stay as warm as possible, feed is a heated room, and try to also keep the other side covered. Also, warm showers helped a lot.

Rosemary - the main part of the diet was no dairy (at all) I was allowed rice milk instead, no processed foods at all (basically nothing out of a packet with any preservatives etc), no sugar and plenty of animal fat (meat 3 times a day) there were other things as well such as no concentrated tomato and only white or wholemeal bread (had to be bakery bread as well - no preservatives).

It takes about 3 weeks for all of the diary to get out of your system but it was HEAPS better than being on all the drugs (I also purchased some breast warmers but nothing else really worked for me). I am happy to say that after being on the diet for about 7 months I finally stopped a couple of months ago and have had no return of the vasospasm!! The diet was not specifically tested for my baby but I figured it couldn't be any worse than all the drugs I was on. If you are thinking about going on it I would really recommend speaking to the LC I mentioned as she may suggest something other than the diet and she will post you all the details (she is great at dealing with issues on the phone). Good luck - I really know how horrible it is to be in the doldrums with VS an wish you the best of luck - if it is any inspiration I have been feeding pain free for months now and still happily bfing my 11 month old.

I just noticed this thread and am subscribing. I'm an EEer and the reasons I can't BF are probably multifactored but I think the problem started with severe vasospasm and I fit the criteria for Reynards Syndrome. I have been worried about facing the whole thing again if I have another bub. I did see LCs for 9 weeks but no one mentioned treatment for the vasopasm but were quick to 'diagnose' it, but I guess by then it came down to nipple confusion and reflux symptoms which complicated getting the BF happening so the focus was on nipple confusion and attachment by the LCs.

This thread is so inspirational to me and I will take note of the experience and advice offered here in the event I have another bub so I'm not set up to fail again.

Well done to the ladies who have been able to overcome or manage the symptoms, you are so brave to have your little ones at your nipples when you experience vasospasm. I would hesitate and hold my breath each time before getting my DS to latch, so you are certainly brave.

LisaB - I used the cry and stomp my feet every time DS would feed I was in that much pain, and came so close to giving up. We made it to over a year (had no milk as I was pregnant again), and when I had my DD I never got vasospasm again, which was good. I honestly found the biomagnesium made a huge difference, and apparently it is good for those with Reynards Syndrome as I did a lot of googling about it at the time. I should ask our nanny, she also has Reynards Syndrome, so I will find out what she does