Common Concerns While Breastfeeding: Why are my nipples white?

Are you feeling a burning sensation in your nipples that creeps up into your breasts?  Does this happen most often IN BETWEEN feedings, rather than during your breastfeeding session?  Have you noticed that your nipples turn white as soon as your baby pulls off?

What you might be dealing with are vasospasms!

Raynaud’s syndrome, or a vasospasm, is a common phenomenon that affects up to 20% of women of childbearing age.  It was originally described as affecting the body’s extremities (hands and feet), but now has been described as affecting many other vessels, including the nipples.  The symptoms are often confused with thrush, as both cause a burning sensation in the nipples, yet they are completely different from one another. 

Thrush is a yeast infection that can be treated with antifungal treatments (see your article Common Concerns While Breastfeeding: Yikes!  Why are my nipples burning?).  Vasospasms are constrictions of the blood vessels that usually occur as a result of exposure to cold and are not an indication of an infection.  Vasospasms will not be resolved with antifungal treatments.

What are vasospasms?

Imagine sitting cross-legged and your foot ‘falls asleep.’  Your foot becomes numb as the blood leaves the area.  As soon as you start banging your foot on the floor and ‘waking it up,’ the blood flows back into your foot, causing a sensation of pins and needles.  This is the same philosophy with nipple vasospasms.  Essentially, as soon as your baby’s warm mouth leaves your nipple, the cold air triggers a vasospasm, causing the blood in your nipple to escape and leave the area.  This causes blanching, or whiteness of the nipple, since the blood is constricted.  Then, as the blood comes back and starts to flow better, the nipple is ‘woken up,’ causing a burning sensation.  This can be extremely painful and frustrating, as the throbbing can be felt throughout the entire day and night.

Symptoms for vasospasms:

• Nipples turn white as baby pulls off from feeding (due to the restricted blood flow to the nipples)
• As blood flows back into the nipples, they turn from white to blue, purple, or red, accompanied by throbbing, burning pain.
• Nipples throb in between feedings, especially when mom feels cold or if she feels a let-down, rather than during a feeding.

It is important to rule out the following, as they can also cause vasospasm-like symptoms:

• Poor latch that compresses and/or pinches the nipple
• Tongue-tie
• Sensitivity to nipple creams
• Thrush/breast infections
• Pregnancy

*** None of these can be treated with vasospasm remedies

Once you have ruled out other causes of vasospasms, you can begin to treat them.

How to treat vasospasms:

• Avoid vaso-constricting substances, such as nicotine, caffeine, and alcohol
• Try to keep your nipples and breasts warm in between feedings.  Wool breast pads, such as the ones made by LanaCare, can be fantastic
• Try herbal and vitamin supplements to help increase blood flow and reduce symptoms.  My favorite daily regiment is 5000IUs of vitamin D3, 200mg of vitamin B6, the minimum dosage of Natural Calm Magnesium, and Nordic Naturals Omega 3 vitamins.
• Acupuncture – since vasospasms are caused by lack of blood flow to the nipples, acupuncture can help move your blood and keep it from being stagnant in your body
• If none of these measures help with the pain, speak with your doctor about nifedipine, a calcium channel blocker that has vasodilatory effects.  Nifedipine, as any medication, has risks of side-effects.  These side effects include dizziness, headache, and tachycardia, so please consult your primary healthcare provider.

As always, it can be very helpful to meet with an IBCLC to determine whether your nipple pain is due to vasospasms or to another breastfeeding issue.  You can find an IBCLC in your area on the International Lactation Consultant Association website.

Did you experience vasospasms while breastfeeding your child? 

What were your symptoms and how did you resolve them?

Help a Mama Out: Getting the Most Milk Out While Pumping

‘Help a Mama Out’ Topic of the Week: Tips for getting the most milk out while pumping

PJ's Bliss pump 

Alison: Massaging the breasts!  That’s the biggest helper for me.  Also, leaning over a bit, as gravity can sometimes help.

Nova: Crank it up if you can tolerate it.  If your pump has those little white membranes, change them once a month or so.

Sondra: Relax!

Melissa: Whenever I pump at work, I put a little coconut oil on the inside of the pump flanges.  This way the inside is lubricated and my areola doesn’t chafe alongside of the plastic flanges.

Laura: If I need to increase volume, I get into a pumping boot camp and spend an hour pumping with 10 minute intervals and 10 minute breaks.  Whenever I have a supply dip, this would bring it back within a day or so.  Also, I’ve had great output when I watch a comedy where I am laughing out loud.  And it never hurts to have my hubby give me a back massage just before pumping or during a break.  Also, my supply is related to my water intake, so I make sure to drink a minimum of 100oz per day.

Jen: Pump the full 20 minutes.  I always get a late let down of another ounce or so if I wait it out.  Also, a hands-free bra is a lifesaver!

Pump Ease hands-free bra 

Jennifer: A picture of my baby always helped when I was away from him.  Focus on him and how much you love him.

Ann: Relax for sure!  Lots of deep breathing and looking at photos of my sweet girl’s chubby cheeks.

Sarah: Staying hydrated (lots of water and coconut water) and pumping at the same times each day.

Stacy: Hands-on pumping (massage and compression), staying hydrated, and changing the cycle speed and angle of the flanges.

Veronica: Watching videos of my little one always made a big impact.

Lydia: Warm compresses, relaxed and comfortable, use the correct flange size and check the suction.

Pumpin' PalsAngelica: Pumpin Pals!  Made pumping so much more comfortable!

Ria: Massaging my breasts while pumping almost doubled the amount I could get!

Carmen: Hands on pumping!  See the Stanford pumping video about maximizing pumping.

Don't miss our Boob Group podcast episode about Maximizing Your Pumping Sessions! 

What tips do YOU have for getting the most milk out while pumping?

iMothering Talks Giveaway

Have you heard about the iMothering Talks?  They are like an online parenting workshop with all of your favorite gentle parenting experts!  And it's super affordable!!!

A few weeks ago we had the pleasure of interviewing Iona Macnab, one of the founders of the iMothering talks, on The Boob Group podcast.  We gabbed for about 45 minutes about how mothers can connect with lactation consultants over Skype, which was a whole new concept for those of us in the room.  To thank us for our participation in the iMothering Talks, they are running a Giveaway for a free registration for the Talks.

Want to know more????

iMothering TALKS 2013 is a new event, bringing some of the key voices of gentle parenting to your screen to inspire you on your mothering journey. Topics range from breastfeeding, bonding, crying and sleep, to raising girls, how to talks so kids will listen, home cooking and creating resilient families.

Started by two lactation consultants and LLL Leaders (Iona and Sarah) in the Asia Pacific region, iMothering is the sister site to iLactation, which was built for the health professionals and counselors who work with breastfeeding mothers. iMothering has been developed mainly with mothers in mind, but much of the information is also relevant for fathers too!

You’ll hear from experts such as Professor Helen Ball speaking on infant sleep, Dr Jenny Thomas (aka DrJen4Kids) who speaks on meeting your breastfeeding goals, Pinky McKat talks about calming crying babies and Robin Kaplan of The Boob Group will host a session about finding breastfeeding help long distance.  You’re sure to learn a lot and walk away with amazing information and inspiration.

iMothering starts online on Mothers Day May 12th, and continues until Fathers’ Day, June 16th. You can register now for three FREE TALKS or use the coupon code BOOBGROUP to pay only $28 for the whole series. TALKS can be listened to anywhere you have an internet connection - on your smartphone, tablet or at your computer.

Here is the Rafflecopter for the Giveaway... a free registration for the iMothering Talks!  The Rafflecopter only goes for 1 more day, so enter now!  We hope you enjoy this fantastic resource for parents!

a Rafflecopter giveaway

Managing Speed-bumps Along Your Breastfeeding Path

This past Saturday, I had the honor of hosting the Breastfeeding Lounge and speaking at the Your Natural Baby Fair about my favorite topic... breastfeeding, of course!  The topic for this presentation was a little different than those discussed at the prenatal classes I teach each month.  Instead, I was finally able to address all of the questions I am asked at my weekly support group.  You know... those questions about hiccups that happen AFTER the initial latch/positioning/initiating milk supply issues.  The questions that pop up AFTER the first few months of breastfeeding, right when you think you have it ALL figured out!  Now those are truly my favorite!

My presentation was titled: Managing Speed-bumps Along Your Breastfeeding Path.  During this talk I focused on:

• Appropriate feeding amounts for babies (for up to a year)
• Appropriate weight gain for babies (for up to 1 year)
• Lactogenic foods that support your milk supply 
• How to maintain your supply during baby's distractable times, returning to work, and when offering solids
• Benefits (both nutritional and emotional) for breastfeeding beyond 1 year

Since this talk could only accommodate 60 people (who happened to be in San Diego at the fair), Sunny, from New Mommy Media and the Preggie Pals podcast, interviewed me to discuss the topics in my presentation.  

So, here it is... Managing Speed-bumps Along Your Breastfeeding Path!

Video streaming by Ustream

How did you maintain your milk supply after introducing solids?

What are your favorite reasons for breastfeeding beyond a year?

Our Interview with Abby (THE Badass Breastfeeder!)

A few weeks ago, I serendipitously stumbled upon the e-mail course called "Becoming a Badass Public Breastfeeder in 7 Days."  For those of you who have been following our blog since January 2013, you are already well aware that I am in the process of creating a San Diego Nursing in Public Task Force to assist mothers who have dealt with nursing in public harassment.  In this process, I have been combing the Internet to find websites to include in our resource list.  Well, as always, Abby (The Badass Breastfeeder) has outdone herself by creating something that is fresh, pertinent, and totally relatable for breastfeeding mothers.  I was dying to 'meet' her, as well as ask her a few questions about her email course, and she enthusiastically agreed to an interview.  So, here's Abby telling a little about herself and sharing her fantastic resource, Becoming a Badass Public Breastfeeder in 7 Days! 

Tell us a little about yourself.  When and why did you start The Badass Breastfeeder?

Ok, well, I can be a bit chatty so I might tell you more than you ever really wanted to know about me! I was born in Cincinnati, OH. I have lived in Columbus, OH; Racine, WI; Abcoude and Amsterdam, Holland; Brooklyn and Queens, NY; and Chicago, IL. I am 36 years old. I received my Bachelor’s Degree in Criminology/Psychology from John Jay College of Criminal Justice in NYC in 2001 (yes, I was there during the 9/11 terrorist attacks. That sucked). My now husband and I moved from NYC to Chicago, IL in 2003. I received my Master’s Degree in Social Work from Jane Addams College of Social Work in 2009. I spent 14 years working with adolescents and their families involved in the criminal justice system and the child welfare system.

It all came to a sudden stop when my son, Jack, was born on July 30, 2011. I suddenly knew nothing about children. Everything that I had believed and thought was thrown into question when I met my son. There was not one aspect of parenting that I planned for that fit with how I felt about my new life. I started completely over and basically read so much that I got another Master’s degree, but this time in gentle parenting. I didn’t really get another degree, but I immersed myself in information about breastfeeding, babywearing, cosleeping, etc. I struggled big time with getting started with breastfeeding. I felt totally alone and afraid. I felt like a failure every time it was time to nurse Jack. He seemed to hate it. He cried, struggled and popped on and off. We supplemented with formula and my breastfeeding relationship with my son was close to ending every day. I was devastated. Then we decided to kick the formula. The more I read the more empowered I felt. I fought really hard to get him exclusively breastfeeding. I stayed up all day and all night reading everything under the sun. By 2 month we were exclusively breastfeeding. I felt so powerful! I started to feel like my old self again, but better. I had learned so much about myself and we were now on an exciting journey to gentle parenting and Jack would be in charge of weaning. I was so excited. I had so much to say and share. Then one day I was harassed by some moms in a private Facebook group for posting a photo of me breastfeeding in a park. The next day in March 2012 I started a Facebook page to share these pictures publicly because I wanted moms to have a place to celebrate breastfeeding where they would be free from harassment. I started a blog for my friends where I shared the details of my parenting journey. And then I have no idea what happened! It just got really big really fast. I started channeling my passion for advocacy from my social career into sharing information with other moms and challenging what we were hearing from the mainstream and providing support where it was majorly lacking. It grew and grew and grew! I have tried to let moms guide me and show me what they need.

What inspired you to create the email course: Becoming a Badass Breastfeeder?

It became clear from running the Facebook page that our culture sees breasts as sexual and nothing else. Women are afraid of being harassed when they breastfeed in public. Women are being devalued as mothers and nurturers. Women choose not to breastfeed at all sometimes because of discomfort with their bodies or having never been around it. Women get the message that their bodies are to be hidden away for the sexual use by the partners. We have become so disconnected from our natural purpose and power. Some women become mothers and never see breastfeeding at all until they are breastfeeding their own babies. I got so much feedback from women who said that they were afraid to breastfeed in public. This motivated me to take all of my thoughts about breastfeeding in public, all of the support and advice I had given on the Facebook page and my blog, and put it into one place. In November 2012 I created the e-mail course “Become a Badass Public Breastfeeder in 7 Days.” The e-course is a great method because people can get small bits of information allowing them to think about it and digest it before moving onto another topic. I worked harder on it than I thought I would and through writing it I became even more passionate about the topic. I feel like it solidified for me my niche as The Badass Breastfeeder.

What resources does a mother receive when she signs up for the course and where can she sign up?

In the e-course, a mother will receive tips for exuding confidence while nursing in public, tips for dealing with staring (which is the number 1 fear I heard from women), ideas about clothing and finding comfy spots in public, tutorials on how to breastfeed while babywearing, detailed advice on engaging unsupportive family and friends in a conversation about nursing in public, comebacks for negative comments from the public, and a summary of the laws that protect breastfeeding in public. I focus on empowerment through rethinking about our bodies and providing information. You can sign up at www.badasspublicbreastfeeding.com. I have also created a workbook version that goes into much greater detail and engages the mother in a journey of self-reflection designed to empower her on all levels of motherhood. I created this doe to the demand from many women who wanted to do the course with their friends and for professionals interested in running groups on the topic. More information on this can be found at http://www.gentleparentinfo.com/UltimateNIPGuide.html.

Have you received any feedback about this course?

It has gotten great reviews! I get e-mails from women, on a daily basis, who say that they no longer feel afraid, that they nurse in public regularly and feel empowered as a mother. I am quite happy! It’s more than I ever expected. I feel if breastfeeding in public can be normalized then more babies will be breastfed. And that is the entire point.

What are your top five tips for Becoming a Badass Breastfeeder?

1. Change your thinking about your body. We can become so focused on our insecurities, but when we reframe our thinking it actually changes the way we feel about ourselves and the way we act.

2. Engage fully with your baby. This will help take the focus off of others so you won’t be as concerned about what they are thinking or where they are looking.

3. Get into babywearing! It makes it so much easier when you are out and about. I know breastfeeding while babywearing can be difficult to figure out, but the course can help.

4. Learn how the breastfeeding laws in your state protect you. You can print them out and carry them around. You might be surprised by how much more confidence this gives you.

5. Create a support network of family and friends. It’s almost impossible to be successful at anything when the people in our lives are unsupportive. The largest section of the course is about engaging family and friends to be more supportive and finding like-minded moms to meet face to face. Moms are so good at supporting moms! 

What steps have YOU taken to become a Badass Public Breastfeeder?