NIPPLE VASOSPASM - A MANIFESTATION OF RAYNAUD'S PHENOMENON AND A PREVENTABLE CAUSE OF BREASTFEEDING FAILURE
Nipple pain is the most common complaint amongst breastfeeding women and is the second most common reason given for abandoning breastfeeding exceeded only by perceived low milk supply (29) . Painful nipple vasospasm in the breastfeeding woman therefore poses the dual problems of distressing symptomatology combined with the increased risk that breastfeeding will be abandoned early. The most common cause of nipple pain is poor positioning of the baby at the breast or poor attachment of the baby to the breast. Poor positioning and attachment may also be associated with blanching of the nipple secondary to mechanical compression. Poor positioning and attachment must therefore be excluded as a cause prior to considering a diagnosis of vasospasm. Precipitation of symptoms by cold stimulus and triphasic colour change (white, blue, red) are features supporting a diagnosis of nipple vasospasm. There are a range of management strategies which are safe for both the breastfeeding woman and her infant. Fish-oil and evening primrose oil have both been shown to be useful in the management of Raynaud's phenomenon. However large doses and a minimum of 6 weeks' treatment are required to achieve a significant reduction in symptomatology. Nifedipine has proven efficacy in the treatment of Raynaud's phenomenon and appears to be safe for both the breastfeeding woman and her infant. Full article at http://www.gp.org.au/cls/raynaud.html Sally Westbury Homebirth Midwife "You are a midwife, assisting at someone else's birth. Do good without show or fuss. Facilitate what is happening rather than what you think ought to be happening. If you must take the lead, lead so that the mother is helped, yet still free and in charge. When the baby is born, the mother will rightly say: "We did it ourselves!" from The Tao Te Ching -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
