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.