Nipple blanching

If your nipple turns white after feeding, it suggests that the blood flow is being reduced or cut off to your nipple.

If despite this blanching, your nipple then returns reasonably quickly back to its normal color after feeding, and you don’t experience any pain, then this isn’t a problem.

However, if you’re looking at this information, you may be experiencing pain because of this blanching, and it’s important, for your comfort, to identify the cause.

There are four possible causes for this blanching. The first one can be the way your baby latches at the breast.

If the latch isn’t a deep one, your nipple is likely getting compressed. So look at the information relating to good positioning at the breast

Sometimes, only one nipple is getting blanched, and the other one is fine. Usually, this is because your baby is latched well on one side and not on the other.

If the nipple blanching is a result of positioning, then you may find that after feeding, your nipple looks a different shape from the shape it was before the latch.

Some women may describe the nipple ‘like a new lipstick,’ wedge-shaped, or notice that it has a stripe across it. In this situation, blood supply gets temporarily cut off to the nipple.

A few seconds after the feed, sometimes even a few minutes, as the blood flow starts to come back, the pain begins.

Woman covering her breast with hand

It may be that you feel that your positioning is fine, and your nipples are not coming out looking misshapen. 

Another cause can be a fast flow of milk.

If you’re experiencing this, your baby may also be struggling to control the fast flow and trying to clamp down to control it, compressing the nipple in the process to avoid choking and spluttering.

Look at the information relating to fast flow, and how you can make that more manageable for your baby.

A third reason why you may be experiencing blanched nipples is if your baby has a potential tongue tie, which may be impacting on the latch itself and causing a compression of the nipple.

The blood supply will be temporarily cut off.

A fourth possibility for the nipple blanching could be something called vasospasm, which is a sudden narrowing of a blood vessel within the nipple itself, which can cause quite severe pain.

Many women suffer from vasospasm. What you tend to see is a white circle appearing on the end of the nipple just after the feed.

This vasospasm may occur because you’ve already got sore, damaged nipples, or even a thrush infection. Once you resolve these things, the vasospasm resolves too.

It’s sometimes possible that cold can cause vasospasm, for instance a breastfeeding woman who has gone to a supermarket, and entered the freezer section of the shop, can suffer vasospasm because of the sudden change of temperature..

The good news is that once you have worked out the cause for the nipple trauma and strategies used to address the cause, the vasospasm will also disappear too.

Please bear in mind that it may take a little while for the vasospasm to disappear because sometimes damaged nipples can take time to heal – they may still be a little bit sensitive until they fully heal.

Another type of vasospasm can occur as a result of a medical condition called Reynaud’s phenomenon.

If you have this condition, your hands and feet become extremely cold or turn white when there is a change of temperature.

This type of vasospasm can also affect the nipples. Breastfeeding will exacerbate this condition.

Some women have been on the brink of giving up breastfeeding because of the intense pain relating to this.

If you are experiencing vasospasms due to this phenomenon, then your nipples may turn from white to blue to red, sometimes white, to purple to red.

Sometimes there is only a two-color change, but it’s a very indicative sign of this condition.

One thing worth noting is that if the vasospasm that you have is related to a Raynaud type phenomenon, then you’re likely to be experiencing this on both breasts as opposed to the other types of vasospasm, which are generally isolated to one breast.

It’s possible that the pain will be more severe and lasts longer, more than just a few seconds or a few minutes after the feeding.

Woman covering her sore breast with hand

You may even experience pain when your baby hasn’t fed at the breast!

One of the real difficulties that many women experience is that the symptoms that are experienced with this type of vasospasm can be very like the symptoms that women experience when they have thrush inside the breast – shooting pains that happen after feeding and which can last for up to an hour.

So many women receive treatment for thrush, sometimes more than once, in the hope that thrush was the cause, when in fact it was a circulation issue.

So what measures can you use to treat this type of vasospasm? There are, in fact, a few.

First of all, it’s imperative that you keep your breasts as warm as possible, and even your whole body. It’s also essential to avoid the cold if you can and avoid very sudden changes in temperature.

Apply dry heat to the nipple and areola area at the end of every feed – an excellent treatment to enable the blood flow to come back as fast as possible.

The blood coming back to the nipples causes this intense pain – so if you can get the blood flow coming back quicker, all the better. 

Many women use microwavable wheat bags to place on the breast after feeding.

Some also use hand warmers inside the bra, which is another novel idea. Whatever you find, as long as it can help to bring the heat back to the nipple and areola area swiftly, will be useful.

Avoiding caffeine and drugs like beta-blockers or any other medicines which can constrict blood vessels can be useful.

It’s also important to know that contraceptives containing estrogen are associated with vasospasm. Supplements like vitamin B complex and even fish oil supplements can be useful.

If, after trying all of these strategies, you find that you are still experiencing the pain of vasospasm, it may be necessary to consider medication – Nifedipine 60 mg dose daily is an effective treatment.

Look at the information to help you identify the potential causes of nipple blanching, and seek out skilled help while you go through this process too – and know that there are lots of ways to go forward.

Review dates, references & further resources

Review Dates

Version 1.1 published in March 2019. Next review date: Jan 2022


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