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Thread: Vasospasm from nipple trauma

  1. #1

    Default Vasospasm from nipple trauma

    I've been having vasospasms and nipple blanching for the last two months. I think the cause may be nipple trauma from a combination of pumping and bad latch. When I pump the areola gets sucked into the flange, so when I take the pump off, there's a hard, ring around the base of the nipple on the right areola. My left side doesn't seem to have the same issue. I never realized this could be the problem until 7 months into breastfeeding, because I thought my pain was from thrush or Raynaud's. It dawned on me that I started work two months ago and started pumping regularly. I use a Medela In Style and have switched to the smallest flange (21mm) and put it on the lowest setting to get milk from both sides, but the areola still seems to get sucked in quite a bit. Does anyone have this problem and/or any suggestions on how to fix this? After two months of desperately trying to find out what's causing my pain, I'm starting to think it's hopeless. Thanks!

  2. #2
    Join Date
    Mar 2006
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    10,440

    Default Re: Vasospasm from nipple trauma

    I personally found a larger horn helped with the pain of pumping. My entire areola is sucked in, but it doesn't hurt me like the one I "should" be using.

    You could try the PumpinPals. I hated them, but some moms love them.

    You could try the Medela Soft Cup horns. I didn't like them either, but it might be more comfortable for you.

    Lube your horns a bit with olive oil or lanolin.

    You probably need two different sizes. That is pretty common, as we discussed in our pumping chit chat thread in the pumping forum. Some moms even noticed they need a different size halfway through a pumping session.

    All of this said, I personally found EPing very painful for about 11 months, until I stopped using anything but a hospital grade pump. It took a few weeks for the soreness to go away after that because of the trauma from the other pumps; I had high quality professional grade pumps, but they aren't as smooth as a hospital grade, and apparently, it makes me really sore. You could try renting one and see how it feels.
    Susan
    Mama to my all-natural boys: Ian, 9-4-04, 11.5 lbs; Colton, 11-7-06, 9 lbs, in the water; Logan, 12-8-08, 9 lbs; Gavin, 1-18-11, 9 lbs; and an angel 1-15-06
    18+ months and for Gavin, born with an incomplete cleft lip and incomplete posterior cleft palate
    Sealed for time and eternity, 7-7-93
    Always babywearing, cosleeping and cloth diapering. Living with oppositional defiant disorder and ADHD. Ask me about cloth diapering and sewing your own diapers!

  3. #3
    Join Date
    May 2008
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    SW Ohio
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    1,624

    Default Re: Vasospasm from nipple trauma

    with Susan's suggestions.

    I too found that I had better luck with larger flanges. Two different sizes may do the trick also.

    I have Raynaud's and it was horrible with my first. For my second I had to EP and the vasospasms were not so bad and lasted a MUCH shorter period of time. I credit this to 1) experience and already knowing what size flange to use and 2) pumping with a Symphony, which has a smoother suction. It was worth it to use that pump.
    JoEllen married to Jason 10-29-2005.

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  4. #4

    Default Re: Vasospasm from nipple trauma

    I tried the next size up (27mm), and the hard ring was bigger, and the pain was worse.

    I know it sounds kinda funny, but I was thinking of trying to use the nipple shield inside the horn. Has anyone ever tried that? Does it not work?

  5. #5
    Join Date
    Sep 2011
    Posts
    65

    Default Re: Vasospasm from nipple trauma

    I liked the Pumpin' Pals flanges. I think I know what you are describing. I was using the Medela standard flanges and the angle of the flange definitely makes a ring or lump there on the areola. Give the Pumpin' Pals a try. They do suck in the areola but not at such a sharp angle.

  6. #6
    Join Date
    Mar 2006
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    10,440

    Default Re: Vasospasm from nipple trauma

    How much suction are you using?

    You could also try going down a size.

    I have never heard of anyone using a nipple shield inside a pump.

    I would again suggest renting a pump or trying one. You might just be too sensitive to the more jarring action of the a PISA. That one made me super sore.
    Susan
    Mama to my all-natural boys: Ian, 9-4-04, 11.5 lbs; Colton, 11-7-06, 9 lbs, in the water; Logan, 12-8-08, 9 lbs; Gavin, 1-18-11, 9 lbs; and an angel 1-15-06
    18+ months and for Gavin, born with an incomplete cleft lip and incomplete posterior cleft palate
    Sealed for time and eternity, 7-7-93
    Always babywearing, cosleeping and cloth diapering. Living with oppositional defiant disorder and ADHD. Ask me about cloth diapering and sewing your own diapers!

  7. #7

    Default Re: Vasospasm from nipple trauma

    Thank you for your suggestions and support.

    I've been using the 21mm flanges lubing them with coconut oil and pumping only 10 minutes at a time, and it seems to be getting slightly better. I had minimal pain for a couple of weeks, but sadly, the vasospasms came back at full force this past weekend. They're also now on the left side as well. I'm ready to give up and just formula feed. I really don't want to, but it's been such a struggle the past 3 months trying to figure out what's going on.

    I've spent so much time, energy, and money, and now, I feel so stressed out and hopeless. I went through phases where I thought it was thrush and tried to fix it with home remedies and Nystatin. Didn't really help. I was told it was Raynaud's, but applying heat and wearing a bunch of layers hasn't worked. Airing out the girls actually helps, but I can't really have them hanging out all the time especially at work. I've been taking vitamin B and calcium supplements, but I'm not sure how affective that is. I've been trying to change positions to try to get a better latch, but baby doesn't seem to be enjoying any of them and refuses to nurse.

    Sorry to vent, but I'm just a mess. Thank you all for being so kind on this forum. It's nice to know that there are so many mommies out there that care and are willing help.

  8. #8
    Join Date
    Jan 2012
    Posts
    18

    Default Re: Vasospasm from nipple trauma

    I just read your post and I really can comiserate! I have been EBF'ing my 5 month old son since birth, and have had a lot of the same issues/pain that you are having. I was treated for thrush 5 times, with no relief, and was also told I had Raynaud's. I have seen just about every LC in the area, multiple doctors, and no one has been able to "fix" my issue. Although I never really considered giving up, I do know the frustration of pain and feeling frustrated that no one knows how to make the pain go away! "Breastfeeding should not hurt" became irritating to hear. I was stressed out and hopeless.
    However, once we got to about the 4 month mark, things have been SO much better. I cannot say that I am pain free, but nursing is enjoyable and not miserable. I do not dread feedings like I used to and frequently think to myself, "This is so easy! I am glad I stuck with it. Pumping hurts, I do not enjoy it, but it makes me look forward to the next nursing session that much more. I use a Medela Symphony, and I really enjoy the pump, but it is not painless. If you have vasospasms could you try Nifedipine? From what I hear that can help with spasms...
    I encourage you to continue with breastfeeding.

  9. #9
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    May 2006
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    Default Re: Vasospasm from nipple trauma

    If it's Raynaud's, there's a drug called Nifedipine that is used to treat it. Might be worth a shot if you've exhausted all other options...
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  10. #10

    Default Re: Vasospasm from nipple trauma

    Trying different flanges as suggested in pps would be my first suggestion too-but here are a couple of other ideas:

    Is your pump new? Older pumps (and I suppose any pump) can run weird and its not always that they just don't pump well enough; They can run wonky and cause breast injury. Personal use pumps are designed to be used by one mom a few times a day for about one year. Some last way longer than that just fine, of course, but esp. if this is an older pump this may be something to consider.

    Weird story to illustrate this: I helped an eping mom who was using a pump in style which had worked fine for a year with her first child but hurt her when she used it for her second. She got milk fine, but was in pain and having nipple injury from pumping. She figured out it was how the pump was cycling because she went out of town and forgot her cord so had to use batteries, and running on the less effective power source the pump was finally comfortable to use.

    Also the Pump in style was recalled a few years ago so you want to make sure you don't have one of those models.

    Another idea-Have you tried a different pump? Maybe this pump is just to hard on you on that one side, and a different pump (or hand expression) would be better for that one side.

    is there any way this is thrush after all? (or also thrush?) Because if it is, nystatin is probably the least effective prescription treatment, fluconazole is considered much more effective. I am not sure what you mean by home remedies but the OTC treatment that is generally suggested for baby and mom is gentian violet. With thrush, both baby and mom both have to be treated even if baby has no symptoms. Have you seen an IBCLC? And am I understanding right that the pain started two months ago? Was nursing OK until then?

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