If your nipple turns white in the cold, it could be vasospasm.
Vasospasm happens when blood vessels tighten and go into spasm, so that blood doesn’t flow normally. It can happen in any blood vessel in the body.
It mostly occurs in fingers, a condition known as Raynaud's phenomenon, where your fingers turn white when they are cold. Nipple vasospasm is less common but can be extremely painful.
You are more likely to experience nipple vasospasm if:
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You have a family history of Raynaud's phenomenon.
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You tend to have cold fingers or feet.
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You are a thin person.
Signs and symptoms
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You may feel sharp pain, burning or stinging in the nipple which is worse when you are cold.
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You might also feel throbbing or numbness as the blood flow returns. The pain can range from mild to severe.
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Pain may occur during a feed but more often immediately after a feed, when your wet nipple is exposed to cold air. It may also happen between feeds.
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Your nipple might turn white. Then, as the blood flow returns, it may turn blue, purple or red before returning to its normal colour.
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You may notice the symptoms for a few seconds to a few minutes or longer.
What causes it?
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It may happen because of nipple trauma. You may have damaged nipples because your baby is not attaching to the breast well. The vasospasm tends to occur following breastfeeds.
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It may happen because of the cold. You may experience similar symptoms in your fingers and toes when it's very cold.
Managing vasospasm
Start by reducing exposure to the cold.
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Keep your body as warm as possible when you're preparing to breastfeed and during feeds. Breastfeed in a warm environment.
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Limit exposure of your nipples to the air or cold. As soon as your baby comes off the breast, apply some warmth. Cover your nipples quickly or use a heat pack to keep them warm.
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Avoid air-drying your nipples after feeds.
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Breastwarmers (breast pads containing reflective material) or woollen breast pads can be helpful.
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You can massage your breastmilk on your nipple after feeds, under your clothing, without exposing it to the air or cold.
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Warm your bathroom when showering or dressing.
Take care with positioning and attaching your baby to make sure they aren’t continuing to compress or damage your nipple. If your nipple trauma isn't improving, you may like to seek further support.
Smoking and drinks containing caffeine, such as coffee, cola and sports beverages, may make vasospasm worse.
If none of these things help with relieving your pain, see your doctor. There are several treatment options available.
Further information:
Nipple vasospasm fact sheet from The Royal Women’s Hospital, Victoria
Vasospasm and Raynaud’s Phenomenon by Dr Jack Newman
© Australian Breastfeeding Association May 2022