Seeking Relief
Debbie G.
NC USA
From: NEW BEGINNINGS, Vol. 16 No. 4, July-August 1999, p. 120-21
We provide articles
from our publications from previous years for reference for our Leaders and
members. Readers are cautioned to remember that research and medical information
change over time.
All during my pregnancy,
I looked forward to breastfeeding. I envisioned many serene moments
of nursing and relaxation with my baby. I knew about difficulties and
had been cautioned that the first few weeks could be challenging and
even physically uncomfortable sometimes. However, I was not prepared
for the intense pain and discomfort which I experienced for the first
three months of my son's life. After consulting many specialists, I
now know that I was experiencing nipple vasospasms. This is a condition
which is particularly common in women with Raynaud's Phenomenon and
which is often overlooked or misdiagnosed by lactation consultants and
physicians. I hope that this description of my experience may help other
women to identify this problem, should they have it, and find treatment that
will prevent it from prematurely ending their breastfeeding relationship.
Raynaud's affects about 20
percent of women. It is a benign condition often characterized by sensitivity
to cold in the hands and feet. Hands and feet turn white or purple when
exposed to cold and may tingle, hurt, or become numb. These sensations
go away with heat. Although vasospasms are most common in hands and
feet, they can occur in the vascular systems of the breast and nipple.
The resulting pain is intense and could easily cause someone to stop
breastfeeding.
Three weeks after my son's
birth I called a lactation consultant about nipple pain. After concluding
that my son did not have a sucking problem she theorized that my pain
might be due to a yeast infection, even though neither he nor I showed
any other symptoms. I began topical and internal treatment for yeast.
At five weeks the pain was deep in the breast, and my entire chest area,
shoulders, and back were sore. Interestingly it was not as painful during
nursing as it was at other times. I would lie on my back awake after
a night feeding, experiencing throbbing pain. I consulted another lactation
consultant who thought I probably had a yeast infection in the milk
ducts and recommended additional treatments. After three more weeks
of treatment and only slight improvement, I went to see another lactation
consultant when I was visiting my parents out of town. By this time
I was miserable. The pain seemed particularly bad if I was cold (the
frozen food aisle at the grocery store was strictly off limits). My
upper body ached, and I had the desire to wrap my throbbing chest up
in a million blankets and weep.
The woman I saw in St. Louis,
Diana Estep, turned my life around by asking one simple question: “Have
you ever experienced circulatory problems in any part of your body?”
No one else had asked me this. She went on to talk about vasospasms-
the constricting of veins, often due to stress. The stress of nursing
on the breast and nipple can cause these spasms, particularly in those
women with a history of circulatory problems. A few symptoms had led
her to ask about this: 1) The color change in my nipples: between feedings
the nipples turned white and then a purplish color which my husband
described as looking “bruised” 2) My description of the accompanying
pain as a stinging, burning, throbbing sensation throughout the nipple
and breast 3) Sensitivity to cold: the breast hurt worse when exposed
to colder temperatures.
My husband wasted no time
in getting on the Internet and finding an article titled “Nipple
Vasospasm- A Manifestation of Raynaud’s Phenomenon and a Preventable
Cause of Breastfeeding Failure" by Laureen and Carolyn Lawlor-Smith,
two lactation consultants in Australia. Every symptom they described
matched my experience: signs and symptoms between feeds, pain in response
to a cold stimulus, color changes, and burning, tingling pain.
There are several recommended
strategies for managing vasospasm pain. Some worked. Most did not. I
tried always staying warm when I nursed: keeping a heating pad on one
breast while nursing on the other. I tried the homeopathic suggestions,
using calcium and magnesium and herbal supplements. I avoided stress
and caffeine and exercised regularly. What really worked in the end
was the more interventionist strategy, the prescription drug Nifidipine.
This drug is often prescribed for people with angina, but has been studied
and found to control Raynaud's. I tried a very low dose and saw a marked
improvement within three days. Within a week, the pain had lessened
dramatically. After a month I experienced no pain at all. After six
weeks I was able to stop taking the drug and the pain did not return.
I now have no discomfort with nursing, and I can walk down the frozen
food aisle for ice cream with no problem at all!
I now feel the joy of nursing,
of snuggling up together at night in the rocker or taking an afternoon
break to nurse, chat, and relax. I anticipated these moments for months
and now relish each one every day. My son is six months old and thriving
beautifully.
I could never have made it
through such a rocky beginning without the support of many people. I
was blessed with a family and husband who supported me and offered encouragement
even though they saw me in pain. I am particularly grateful for my La
Leche League Leader, Elizabeth, who searched her own resources, referred
me to lactation consultants, and offered ongoing moral and emotional
support. She assured me that the vision I had was indeed possible and
would he worth it in the end. How right she was!
I encourage anyone who thinks
she may be experiencing nipple vasospasms to talk to her physician about
treatment and management of the pain. Most importantly, find support
people and don't stop breastfeeding. The pain does subside. My case
was severe. This condition rarely lasts as long as it did with me. The
moments you will spend joyfully nursing your baby are priceless and
easily erase the difficult times at the beginning.
Last updated Friday, November 3, 2006 by njb.
Page last edited Sun Oct 14 09:30:43 UTC 2007.
