This is a reprint of a post by Dr Jack Newman on Facebook, dated February 13, 2014 on the subject of nipple vasospasm:
A couple of weeks ago I posted on causes of breast pain. At that time I stated I would also post on "mammary constriction syndrome". This is a new syndrome described by Edith Kernerman IBCLC of our International Breastfeeding Centre. She has discussed this on an online webinar last year and we have been working on the basis of this syndrome for a few years now. Here is how she describes it:
Many breastfeeding mothers complain of having breast pain. We know from much clinical experience and a recent study done at the International Breastfeeding Centre that almost all of these complaints of breast pain (and/or nipple pain) are due to how the baby latches on to the breast. The latching difficulties include positioning and latch and tongue tie, which can lead to a secondary problem of vasoconstriction, including vasospasm.
Vasoconstriction is the tightening of blood vessels, and this can cause a lack of blood flow and oxygen. Pain results and the mother will respond to pain with tension. For example, the mother feeling the latch may be painful may tighten her shoulders, clench her teeth, etc. This response can cause tightening of the chest muscles (and shoulder and neck), leading to squeezing of the blood vessels that go to the nipples and breast, resulting in deep, sharp, shooting, or dull pain. The pain may be throbbing or constant, itchy, tingling, aching or knife-like, burning or freezing or a combination of any of the above. Many mothers describe the pain as so debilitating they must lie down after a feeding, or are ready to quit breastfeeding altogether. We had often thought these symptoms were a sign of yeast (Candida). We now attribute these symptoms to what we have named mammary constriction syndrome (MCS), a cluster of symptoms caused by the process described above. Vasoconstriction may also affect the nipples as well as the breast and cause the nipples to change colour or blanch, and may cause a cold or hot burning sensation of the nipples, as in Raynaud’s syndrome.
To treat MCS we use a massage technique called pectoral muscle massage that is very easy for the mother to do herself. It involves rubbing the chest muscles (not the breast) quite vigorously about 45-60 seconds on the affected side. There are four places to massage: 1) above the breast against the chest wall; 2) between her breasts just to the side of the breast bone; 3) under the breast against her rib cage; 4) on the side of her body, beside her breast, against the rib cage. One of these four areas is likely to be the ideal spot for her to relieve her pain. We also urge the mother to be aware of hunching over the baby and/or carrying heavy objects including car seats. We recommend massage therapy to help ease tensions in the upper torso. Many mothers have success doing gentle pectoral muscle stretching, just before a feeding.