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Posted by on Dec. 12, 2012 at 8:05 PM
  • 5 Replies
Did you deal with cracked nipples & soreness?

My baby is 5weeks old and my nipples are still cracked, sored, pink & hurt beggining&end of each feeding. They also hurt on temperature changes.
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by on Dec. 12, 2012 at 8:05 PM
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by mel on Dec. 12, 2012 at 8:16 PM
When baby had a bad latch for months. When I had no latch issues no cracks.
Are you sure baby has a good latch?
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by on Dec. 12, 2012 at 8:27 PM
Not 100% sure. How can you tell?

Quoting melindabelcher:

When baby had a bad latch for months. When I had no latch issues no cracks.

Are you sure baby has a good latch?
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by Gina on Dec. 12, 2012 at 9:07 PM

Latching and Positioning Resources


No matter what latch and positioning look like, the true measure is in the answers to these two questions:

  1. Is it effective?
  2. Is it comfortable?

Even if latch and positioning look perfect (and, yes, even if a lactation consultant told you they were fine), pain and/or ineffective milk transfer indicate that there is a problem somewhere, and the first suspect is ineffective latch/positioning.

If baby is transferring milk and gaining weight well, and mom is not hurting, then latch and positioning are – by definition – good, even if it’s nothing like the “textbook” latch and positioning that you’ve seen in books.

“Rules and regulations have no place in the mother-baby relationship. Each mother and baby dyad is different and what works well for one mother and baby may not work well for another mother and baby. The important thing to do is to look at the mother and baby as individuals.”– Andrea Eastman, MA, CCE, IBCLC in The Mother-Baby Dance

Following are some of my favorite resources on latch and positioning:

Biological Nurturing: Laid-Back Breastfeeding from Dr. Suzanne Colson. Breastfeeding in a semi-reclined position can be very helpful for both mom and baby.

Newborn Hands: Why are they always in the way while breastfeeding? from the San Diego Breastfeeding Center

Latching handouts by Diane Wiessinger, MS, IBCLC

Breastfeeding: Off to the best start from the UK Department of Health
(Lovely latching pictures here, with simple directions.)

Deep Latch Technique from The Pump Station.
(Good latching pictures and directions.)

When Latching by Anne J. Barnes, has instructions with drawings
(The drawings and tips here are helpful.)

Latching videos by Dr. Jack Newman

Animation illustrating assymetrical latch technique by Victoria Nesterova
(Nice animation — text is in Russian.)

The Mother-Baby Dance: Positioning and Latch-On by Andrea Eastman, MA, CCE, IBCLC
(This is a longish article written for breastfeeding counselors that has some nice descriptions of latching and positioning, along with info on why some things tend to work better than others.)

Is baby latching on and sucking efficiently? How to tell from
(A useful list.)

L-A-T-C-H-E-S * Breastfeeding Assessment Tool (for the first 4 weeks) and Scoring Key by Marie Davis, RN, IBCLC
(A tool for professionals that could also be useful for moms who are wondering if breastfeeding is going fine and whether additional help is needed.)

Help for various nursing positions

Lactation yoga, or side-lying nursing without getting up to switch sides by Eva Lyford, @ 

Nursing Laying Down (step-by-step description with photos) from

Some tips on the football & cross cradle nursing positions by Kathy Kuhn, IBCLC

Some tips on nursing while lying down by Kathy Kuhn, IBCLC

More useful information

Latching: Thoughts on pushing baby’s chin down when latching @ 

Taking baby off the breast by Marie Davis, IBCLC

PDF Baby-led Latching: An “Intuitive” Approach to Learning How to Breastfeed by Mari Douma, DO, from the Michigan Breastfeeding Network Newsletter, December 2003, Volume 1, Issue 3.

PDF When the Back of the Baby’s Head is Held to Attach the Baby to the Breast by Robyn Noble DMLT, BAppSc(MedSc), IBCLC and Anne Bovey, BspThy

Breast Compression by Jack Newman, MD. The purpose of breast compression is to continue the flow of milk to the baby once the baby no longer drinks on his own, and thus keep him drinking milk. Breast compression simulates a letdown reflex and often stimulates a natural let-down reflex to occur. The technique may be useful for poor weight gain in the baby, colic in the breastfed baby, frequent feedings and/or long feedings, sore nipples in the mother, recurrent blocked ducts and/or mastitis, encouraging the baby who falls asleep quickly to continue drinking.

by Gina on Dec. 12, 2012 at 9:08 PM

You can tell you have a bad latch when you have the symptoms you report.

by Kate on Dec. 12, 2012 at 9:11 PM

Adding to what G posted:

Nipple blanching and vasospasm

JULY 27, 2011. Posted in: BF CONCERNS: MOTHER

By Kelly Bonyata, BS, IBCLC

Nipple blanching (turning white) after a feeding occurs when the blood flow to the nipple is limited or cut off. Blanching is most often related to latch problems. Nipple blanching is often, but not always, associated with pain. Because women may describe shooting, burning breast/nipple pain, this can be mistakenly diagnosed as thrush. If the normal color returns after your baby has finished a feeding and there is no pain, then the blanching is not a problem.

Compression blanching | Vasospasm | Treatment options | Resources

Blanching due to compression

The most common reason for nipple blanching is that that baby is compressing the nipple while nursing. This can be due to:

When blanching is due to baby’s compression of the nipple, the nipple is white and often misformed (flattened, creased, pointed, etc.) immediately upon coming out of baby’s mouth. There may be a white stripe across the nipple directly after nursing. Pain may not start until a few seconds to a few minutes after nursing, as the circulation returns to the nipple. If you are experiencing pain with the blanching, then finding and remedying the underlying cause will also eliminate the blanching.

Blanching due to vasospasm

Vasospasm, which is more severe, is a sudden constriction/narrowing of a blood vessel (in the nipple, in this case) that is extremely painful. It might occur a short time after nursing or in between nursings. Vasospasm can have various causes:

Vasospasm can be a secondary response to pain or nipple trauma (damaged nipples orthrush). In this case, the nipple(s) turns white shortly after nursing (rather than coming out of baby’s mouth white and misformed). Mom might notice a white circle on the face of the nipple a few seconds to a few minutes after breastfeeding. Cold often triggers the vasospasm and/or makes it worse. Unlike blanching due to compression, latch and positioning may be fine if the source of any nipple damage has already been fixed. Healing the nipple trauma or other source of pain should eliminate the vasospasms, although they may persist for a short time after the nipple has healed (previously damaged tissue can remain sensitive for a time).

Raynaud’s of the nipple

Vasospasm can also be caused by Raynaud’s Phenomenon (more info here), which causes sudden vasospasms in the extremities. When nipple vasospasm is caused by Raynaud’s Phenomenon (Raynaud’s of the nipple), the nipple turns white, then there is usually a noticeable triphasic color change – from white to blue to red – as blood flow returns. The color change may also be biphasic – from white to blue.

Vasospasm due to Raynaud’s is more likely to occur on both sides (rather than just one nipple), lasts for relatively long periods of time (rather than for a few seconds or a few minutes), and can occur during pregnancy and/or at times unrelated to feeding. Vasospasms may also occur in fingers or toes. Cold typically triggers the vasospasm and/or makes it worse. Nipple trauma (and other causes of compression blanching or vasospasm) can exacerbate the problem. Raynaud’s phenomenon may recur with subsequent pregnancies/breastfeeding, so be prepared to seek treatment quickly if you have experienced this in the past.

Per Anderson et al, “Because the breast pain associated with Raynaud’s phenomenon is so severe and throbbing, it is often mistaken for Candida albicans [yeast] infection. It is not unusual for mothers who have Raynaud’s phenomenon of the nipple to be treated inappropriately and often repeatedly for C albicans infections with topical or systemic antifungal agents.”

Keep in mind that Raynaud’s is not caused by breastfeeding (anyone might have it) — it simply has the potential to affect breastfeeding. For example, any person might have inverted nipples, which might or might not affect a mother’s breastfeeding relationship (as this can make latching or sore nipples more of a challenge in the beginning). Raynaud’s works the same way – anyonemight have it coming into breastfeeding, and it might (or might not) affect the breastfeeding relationship if the vasospasms are triggered by bad latch, a sudden temperature change as baby unlatches, etc.

Some maternal medications have been associated with vasospasm, including oral contraceptives. Fibromyalgia, rheumatologic diseases (eg, systemic lupus erythematosus or rheumatoid arthritis), endocrine diseases (eg, hypothyroidism or carcinoid), and prior breast surgery have also been associated with Raynaud’s phenomenon. Some sources indicate that the antifungal medication fluconazole may be associated with vasospasm, although the manufacturer does not report this as a known complication of fluconazole use. Other sources feel that vasospasms experienced by mothers taking fluconazole are a result of nipple pain/trauma due to thrush (and not due to the medication used to treat the thrush).

Treatment options for vasospasm

  • Avoid cold. Apply dry heat to the breast when needed (this relaxes the “cramping” blood vessels). Some mothers benefit from keeping the entire body warm (warm clothing, warm room, wrap up in a blanket, etc.)
  • Cover the nipple as soon as possible after baby comes off the breast. Some moms say that it is helpful use a wool breast pad or a soft cloth diaper.
  • Apply dry heat immediately after breastfeeding. A rice sock can be useful as a source of dry heat: Fill a sock or a cloth bag with uncooked rice and microwave 45 seconds (or until desired warmth is achieved); hold the rice sock against the nipple (over the cloth or mom’s shirt) until blood flow resumes.
  • Avoid caffeine, nicotine and other vasoconstrictive drugs, as they can precipitate symptoms.
  • Ibuprofen.
  • Dietary supplementation with calcium/magnesium.
  • Dietary supplementation with vitamin B6.
  • Low dose oral nifedipine.

See links below for additional details.


Additional information and references

Nipple pain – links 

Nipple compression stripe by Kathy Kuhn, IBCLC

Baby clamps down during breastfeeding by Debbie Donovan, IBCLC

Clampdown Bite Reflex by Mary Jozwiak, from Leaven, Vol. 30 No. 4, July-August 1994, pp. 53-4.

Nipple Vasospasm -A Manifestation Of Raynaud’s Phenomenon and a Preventable Cause of Breastfeeding Failure by Laureen Lawlor-Smith BMBS IBCLC and Carolyn Lawlor-Smith BMBS IBCLC FRACGP

Vasospasm and Raynaud’s Phenomenon by Jack Newman, MD

Nipple blanching: “My nipples turn white” by Debbi Donovan, IBCLC

Nipple vasospasm by Kathy Kuhn, IBCLC

Does nipple vasospasm recur? by Debbie Donovan, IBCLC

Raynaud’s Syndrome and Breastfeeding by Cher Sealy, RN, BSN, IBCLC, LLLL

Seeking Relief by Debbie Granick, from New Beginnings, Vol. 16 No. 3,
July-August 1999, p. 120.


Anderson JE, Held N, Wright K. Raynaud’s Phenomenon of the Nipple: A Treatable Cause of Painful Breastfeeding. Pediatrics. 2004 Apr;113(4):e360-4.

Garrison CP. Nipple vasospasms, Raynaud’s syndrome, and nifedipine (case report). J Hum Lact. 2002 Nov;18(4):382-5.

Riordan J and Auerbach K. Breastfeeding and Human Lactation, 2nd ed. Boston and London: Jones and Bartlett 1999, p. 492-493.

Lawlor-Smith L, Lawlor-Smith C. Raynaud’s phenomenon of the nipple: a preventable cause of breastfeeding failure? Med J Aust. 1997 Apr 21;166(8):448.

Lawlor-Smith L, Lawlor-Smith C. Vasospasm of the nipple – a manifestation of Raynaud’s phenomenon: case reportsBMJ. 1997 Mar 1;314(7081):644-5.

Snyder JB. [letter]. J Hum Lact. 1994 Sept;10(3):153.

Escott R. Vasospasm of the nipple: another case [letter]. J Hum Lact. 1994 Mar;10(1):6.

Coates MM. Nipple pain related to vasospasm in the nipple? J Hum Lact. 1992 Sep;8(3):153.

An Overview of Solutions to Breastfeeding and Sucking Problems by Susan Meintz Maher, IBCLC, La Leche League 1988, p 14.

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