Raynaud Phenomenon of the Nipple in Breastfeeding Mothers

Abstract

Most patients were treated with antifungals before presentation without resolution of nipple pain. Nifedipine appears to be an effective medication for the treatment of Raynaud phenomenon of the nipple. With appropriate management of Raynaud phenomenon,breastfeeding mothers demonstrated improvement of nipple pain. Raynaud phenomenon of the nipple should be considered in the differential diagnosis of nipple pain during lactation.

Raynaud’s Phenomenon of the Nipple in Breastfeeding

“…Pain associated with RP is usually moderate to severe and described as a sharp, shooting, or stabbing pain felt during breastfeeding and occasionally before and after feeding (Barrett et al, 2013). Mothers also experience tingling and numbness with the pain.…”

“…Mothers positive for C. albicans describe shiny, reddened, or flaky skin on the nipple and areola (Heller et al, 2012). Mothers with C. albicans mastitis will normally experience relief of symptoms within 3 days of oral antifungal treatment, whereas mothers with RP will have no relief of symptoms with antifungal treatment (Barrett et al, 2013).…”

“…The American Academy of Pediatrics recommends breastfeeding infants for the first 6 months and continuing up to 12 months or longer with the addition of foods (American Academy of Pediatrics, 2012). Approximately 96% of breastfeeding women report pain with breastfeeding during the first 6 weeks postpartum (Barrett, Heller, Stone, & Murase, 2013). Although there have been no reported indications of prevalence to date, there are reports of Raynaud's phenomenon (RP) in breastfeeding women (Buck, Amir, Cullinane, Donath, & CASTLE Study Team, 2014).…”

Labetalol for hypertension during pregnancy and nipple pain

“…Nipple pain has several etiologies. Common causes include milk letdown pain, problems with infant latch-on and positioning, plugged lactiferous ducts, dermatitis, psoriasis, secondary infections with organisms such as Candida albicans and Raynaud phenomenon of the nipple [2].…”

“…Raynaud's phenomenon is a welldescribed pathologic state, characterized by vasospasm of arterioles, causing intermittent ischemia and subsequent reflex vasodilatation. It is most commonly located in the fingers and toes but also has been shown to affect the nipple vasculature [2,4,5].…”