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Raynaud's Phenomenon (Vasospasm of the Nipple)

Raynaud's Phenomenon (Vasospasm of the Nipple)

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Raynaud's phenomenon is a term used to describe intermittent loss of blood flow to some extremities due to a spasm in the blood vessels (vasospasm). The most commonly affected areas are the fingers and toes, but it can affect the nipples as well. The constriction of blood flow causes a loss of color and severe pain. Raynaud's phenomenon is known to occur in up to 22% of otherwise healthy women of childbearing age, and is now recognized by many lactation experts as a treatable cause of painful breastfeeding.

Breastfeeding women with Raynaud’s phenomenon experience debilitating nipple pain that usually follows the feeding (although it can occur during the feeding) and may last for hours. When the warm mouth of the baby comes off the breast, the face of the nipple, or part of the nipple, will blanch white and burning pain begins. The nipple can go through several color changes (white, blue, red) and the entire breast may throb. Poor positioning and poor latch may cause nipple damage, nipple blanching and pain, and are thought by some to trigger the problem. However, the symptoms of Raynaud’s phenomenon can occur even without improper breastfeeding techniques and nipple damage. Not all nipple vasospasm is Raynaud's Phenomenon and may fully resolve if the latch can be improved and the damage healed. Exposure to cold is also a known trigger in Raynaud’s phenomenon.

Treatment Options include the following:
  • If your nipples are sore and damaged, make an appointment to see a lactation professional who can evaluate your latch technique and help you to improve it.
    Lactation Consultations are offered at The Pump Station & Nurtury®
  • Prevent or decrease any cold exposure to your breasts. Heat will usually stop the vasospasm, which will increase blood flow to the nipples and help alleviate the pain.
    • Cover breasts and keep them warm. Even your warm hands can help.
    • While nursing, keep the opposite breast covered and warm.
    • Wear hand warmers inside your bra when going out into cold air.
    • Use dry heat when experiencing pain. Try a hair dryer or heating pad to warm breasts. Wet, warm compresses will help during use, but when removed, evaporation will occur causing cooling, and the pain can start again.
    • Massage olive oil, warmed between your fingers, into the nipple when it is burning. Press forward from the base of the nipple which helps blood flow forward into the nipple.
  • Don't smoke. Nicotine is a vasoconstrictor and can increase episodes.
  • Avoid caffeine and other stimulants. Check labels to make sure soft drinks don't contain caffeine.
  • Avoid vibration. Use a good quality breast pump that has a smooth, comfortable action.
  • Reduce stess. Try a post partum yoga class, a few minutes of meditation or a little nap when the baby is sleeping. Let others help with cooking and chores if at all possible.
Medication:
  • Nifedipine. (one 30 mg., long-acting tablet/daily). This prescriptive medication is a calcium channel blocker and vasodilator used in the treatment of high blood pressure. It has been shown to be very effective in quickly relieving the pain of Raynaud's phenomenon and might be the best course of treatment. Very little of this medication enters the milk so it is considered by the American Academy of Pediatrics to be a safe option for breastfeeding women. Call your primary care physician or your obstetrician to discuss. Try Nifedipine for two weeks; if the pain returns you can go back on the medication.
  • Vitamin B6. Take 100-200 mg daily for 4 days, then 25 mg/day from then on. If pain free for 2 weeks, try weaning off altogether.
  • Fish Oil has been helpful to some women. A recent study suggests that a higher than usual dose (perhaps 12 g daily) is required to get results. Check with your physician.

Essential Breastfeeding Support and Baby Care Items
The Pump Station & Nurtury® has decades of experience providing new families with outstanding educational, breastfeeding and baby care support, including products and classes which can make all the difference to you and your baby. To see a list of some of the essential products that our Lactation Professionals have recommended, click Essential Breastfeeding and Baby Care Products
Items Our Team Recommends
breast pain relief cold compress Lansinoh Breast Therapy
Lansinoh 3-1 Breast Therapy
soothe sore breasts with warm booby tubes
Earth Mama Booby Tubes
Easier pumping with Medela Breast Pump
Medela Breast Pumps
deep latch help with nursing pillow
Luna Lullaby Nursing Pillow
better deep-latch with back pillow
The Pump Station Back Pillow
get deep latch using adjustable stool
My Brest Friend Adjustable Stool

Copyright© 2014 by The Pump Station & Nurtury®. All rights reserved. No part of this handout may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, without permission in writing from The Pump Station & Nurtury®. This article has not been prepared by a physician, is not intended as medical advice, and is not a substitute for regular medical care. Consult with a physician if medical symptoms or problems occur. Revised 01/06
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Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

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by Diana Cheng Scheible, MA, OTR/L, CLE, IBCLC

Carpal tunnel syndrome (CTS) is a condition brought on by increased pressure on the median nerve at the wrist. In effect, it is a pinched nerve at the wrist. Symptoms may include numbness, tingling, and pain in the arm, hand, and fingers. There is a space in the wrist called the carpal tunnel where the median nerve and nine tendons pass from the forearm into the hand. Carpal tunnel syndrome happens when pressure builds up from swelling in this tunnel and puts pressure on the nerve. When the pressure from the swelling becomes great enough to disturb the way the nerve works, numbness, tingling, and pain may be felt in the hand and fingers.

Fluid retention during pregnancy can cause symptoms of carpal tunnel syndrome, which often go away after delivery. However, some women report exacerbated symptoms after delivery due to continued early post partum swelling and the constant bending of the wrist in baby care. There may be a combination of causes of CTS including arthritis, fractures and irritation due to repetitive, prolonged, and/or forceful motion (for example: a roofer pounding nails, a computer user keeping wrists constantly bent).

Carpal tunnel syndrome symptoms usually include pain, numbness, tingling, or a combination of the three. The numbness or tingling most often takes place in the thumb, index, middle, and ring fingers. The symptoms usually are felt during the night but also may be noticed during daily activities such as driving or reading a newspaper. Mothers may sometimes notice a weaker grip, occasional clumsiness, and a tendency to drop things.

Treatment

The first step is to call your doctor for assessment and proper diagnosis of your symptoms. Patient education and proper body mechanics are key for minimizing carpal tunnel symptoms.

  1. Maintain the wrist in a neutral position with daily activity. After you latch your baby, avoid using your hand and wrist to support your baby's head during the feeding. Instead, use a rolled up blanket or small pillow to avoid positioning the wrist in a prolonged bent position.
  2. Since we often sleep with our wrists bent in a 90 degree angle (fetal position), wearing wrist splints at night can be very helpful to decrease pressure on the nerve and reduce swelling and symptoms.
  3. Avoid positioning the wrist in a bent position while sleeping or sleeping on your wrists, once the wrist immobilization splint is discontinued.
  4. Avoid a sustained pinch/grip and awkward motions, particularly with the wrist in a bent position.
  5. Identify and treat medical conditions such as thyroid conditions, rheumatoid arthritis, and diabetes which can be associated with carpal tunnel syndrome.
  6. Take rests and stretch breaks from activities to prevent overuse of repetitive motions.
  7. Anti-inflammatory medications, such as ibuprofen and other nonprescription pain relievers, may ease symptoms that have been present for a short time. Please consult with your physician regarding any medications especially if you are pregnant or breastfeeding.
  8. Some mothers find pain relief with the use of paraffin wax baths. Dip both hands and wrists into the paraffin wax 4-5 times and relax for 10 minutes. Home use paraffin bath units can be purchased at places like Bed Bath and Beyond.
  9. You may also feel pain relief with Contrast Baths which can be done 2-3 times per day. The purpose of contrast baths are to assist with reducing inflammation along the wrist, which may serve as the contributing factor for the carpal tunnel symptoms. In addition, the contrast baths facilitate blood flow and thus helps “pump” the swelling out of the hand and wrist.
How to set up a Contrast Bath:
  1. Prepare one basin of hot water (to your tolerance)
  2. Prepare one basin of cool water with ice
  3. Immerse your hand/wrist into the hot water for 2-3 minutes
  4. After 2-3 minutes, immerse your hand and wrist in cool water for 1 minute
  5. Repeat steps 2 & 3 two more times always ending with your hand/wrist in cool water.
  6. If pain, numbness or weakness recurs and persists, return to your physician.

Some people find that a rehabilitation program designed by Occupational Therapy Hand Specialists which include education of ergonomic principles particular to their daily activities, nerve glides, stretching, splint fabrication and treatments such as paraffin wax treatments, ultrasound, and electric stimulation can minimize carpal tunnel symptoms. Additionally, alternative therapies including acupuncture and chiropractic care have benefited many people.

The Pump Station & Nurtury® has decades of experience providing new families with outstanding educational, breastfeeding and baby care support, including products and classes which can make all the difference to you and your baby. To see a list of some of the essential products that our Lactation Professionals have recommended, click Essential Breastfeeding and Baby Care Products


See Other Breastfeeding and Baby Care Help Topics

© 2006 American Society for Surgery of the Hand. Developed by the ASSH Public Education Committee. Reprinted with permission of the author. All rights reserved. No part of this handout may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, without permission in writing from The Pump Station & Nurtury®. 11/07
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Breast Pumping Guidelines

Breast Pumping Guidelines
There are many reasons women pump their breasts to provide milk for their babies. Some are separated from their hospitalized newborns and must pump to provide the many benefits of mothers' milk. Others must return to the workplace but want their babies to continue receiving breast milk. Whatever the reason, mothers have many questions about the pumping process. Continue reading

Video: How to Increase Milk Supply

Video: How to Increase Milk Supply

Corky Harvey, RN, MS, IBCLC explains why so many women worry that they aren't making enough milk for their babies and what they can do about it.

 

 


Essential Breastfeeding Support and Baby Care Items

The Pump Station & Nurtury® has decades of experience providing new families with outstanding educational, breastfeeding and baby care support, including products and classes which can make all the difference to you and your baby. To see a list of some of the essential products that our Lactation Professionals have recommended, click Essential Breastfeeding and Baby Care Products

 

See Other Breastfeeding and Baby Care Help Topics

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Videos: Common Questions About Breastfeeding

Videos: Common Questions About Breastfeeding

 

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How do I know if My Baby is Getting Enough to Eat?

Published on August 2014
Corky Harvey, MS, RN, IBCLC answers a common question from nursing mothers, "How do I know if my baby is getting enough?"

 



When to Start Pumping?

Published on August 2014
Wendy Haldeman, MN, RN, IBCLC answers a common question from nursing mothers, "When do I start pumping?"

 



How to Increase Milk Supply While Working?

Published on August 2014
Barbara Zimmermann, RN, BSN, IBCLC, CEIM answers a common question from nursing mothers, "How can I increase my milk supply while working?"

 



Does it Matter if you Mix Breastmilk with Formula?

Published on August 2014
Wendy Haldeman, MN, RN, IBCLC answers the question: Can you combine breastmilk and formula?

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Breastfeeding including classes, support groups, breast pumps, certified lactation consultants and more.

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Video: How to Breastfeed - Deep Latch Technique

Video: How to Breastfeed - Deep Latch Technique

 

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Originally Published from Fit Pregnancy Magazine:

A step-by-step video with tips on "How to Use the Deep Latch Technique" from Corky Harvey, RN, MS, IBCLC a lactation consultant at The Pump Station & Nurtury™

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Breastfeeding including classes, support groups, breast pumps, certified lactation consultants and more


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Video: How to Use a Breast Pump

Video: How to Use a Breast Pump

 Originally published in Fit Pregnancy Magazine:

A step-by-step video guide on "How To Use a Breast Pump" from Corky Harvey, RN, MS, IBCLC 

 

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Breastfeeding including classes, support groups, breast pumps, certified lactation consultants and more.

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Video: How to Breastfeed in Public

Video: How to Breastfeed in Public

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Breastfeeding including classes, support groups, breast pumps, certified lactation consultants and more. 

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Published on 2008:
A step-by-step video with tips from Corky Harvey, RN, MS, IBCLC and Wendy Haldeman RN, MN, IBCLC 

 



Published 2009:
Answers from Corky & Wendy about nursing clothing and gear:
  • What are the easiest clothing options for breastfeeding moms?
  • What's a nursing cover-up?
  • How do I use a blanket if I want to cover up while breastfeeding in public?
  • How can I use my sling as a nursing cover-up?
  • How does a built-in nursing bra work?
  • and more
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