Breastfeeding, Nipple Blanching, And Vasospasms

Painful, White Nipples

Woman holding her breast with a concerned look
Painful, white nipples can affect breastfeeding. Stockbyte/Getty Images

What Is Nipple Blanching?

Nipple blanching is a term used to describe painful, white nipples. Blanching can be the result of a vasospasm, when the blood vessels constrict and spasm, or from any other situation that temporarily stops the blood from flowing to the nipples. When this happens, the nipples turn pale or white, and there may be a painful, burning sensation. Then, once the flow of blood returns, the nipples may look blue, pink, or red, and the burning usually turns into a throbbing pain.

Breastfeeding and the Causes of Nipple Blanching

The most common cause of nipple blanching in breastfeeding women is a poor latch. If your baby is not latching on correctly, the pressure of her mouth against your nipple can prevent blood from flowing to the area. In most cases, if you fix the baby's latch, the blanching will not return. However, if your nipples continue to burn and turn white after you have checked and adjusted your breastfeeding technique, then there may be another underlying cause.

Other Causes of Nipple Blanching During Breastfeeding

Nipple Trauma: Damage from sore nipples or a previous breast surgery can cause blanching.

The Baby Clamping Down on Your Breast: If your baby has a very strong suck, or if he is teething or biting on your nipples, the compression can cut off the blood flow to the area.

Caffeine and Smoking: Caffeine and nicotine are drugs that cause the blood vessels to become more narrow.

Medications: Certain drugs that constrict the blood vessels can cause blanching. These drugs include antihistamines and medications that treat low blood pressure and some respiratory conditions.

Raynaud's Phenomenon: Raynaud's is a medical condition that's sometimes associated with autoimmune diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis.

When there's a change in temperature from warm to cold, it can cause blanching and pain in the fingers, toes, nose, ears, and nipples. 

Stress and Exhaustion: Fatigue and emotional stress are factors that have been linked to nipple blanching.

Unknown: Sometimes the cause is not known.

How to Treat and Prevent Nipple Blanching

  • Make sure your baby is latching on properly. If you aren't sure your baby is breastfeeding correctly, call your doctor, a lactation consultant, or a local breastfeeding group for assistance.
  • If you have sore, cracked nipples, treat them. Once sore nipples heal, blanching will often stop.
  • Try to stay warm. Breastfeed in a warm place and try to keep your breasts warm, especially after feedings. Dress in warm clothes, and place a warm compress on your nipples before and after you breastfeed.
  • If the pain becomes too much while you're breastfeeding, break the suction of the latch and remove your child from your breast.
  • Avoid caffeine and smoking. Eliminating caffeine from your diet may help. If you smoke, try to quit or smoke less, and stay away from second-hand smoke.
  • Talk to your health care provider about treatment options. Ask your doctor about vitamins, supplements, or medications that are safe to take for this condition. Calcium, magnesium, Vitamin B6, fish oil, and evening primrose oil may improve the situation for some women. Your doctor can also order prescription medications if necessary.
  • If you experience blanching, but it doesn't cause pain or interfere with breastfeeding, you may not have to do anything at all.

Vasospasms and Thrush

Thrush is a yeast infection that also causes burning pain in the breasts and nipples. Since thrush has similar symptoms but is a more common breastfeeding problem, vasospasms can be misdiagnosed as thrush. If your health care provider believes you have thrush, you will receive a prescription for antifungal medication. Thrush will get better with that treatment. However, if it's vasospasms, the nipple blanching and burning will continue. 



Lawrence, Ruth A., MD, Lawrence, Robert M., MD. Breastfeeding A Guide For The Medical Profession Eighth Edition. Elsevier Health Sciences. 2015.

Newman, Jack, MD, Pitman, Theresa. The Ultimate Breastfeeding Book of Answers. Three Rivers Press. New York. 2006.

Riordan, J., and Wambach, K. Breastfeeding and Human Lactation Fourth Edition. Jones and Bartlett Learning. 2014.

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