Why do my nipples turn white when I breastfeed?

Do your nipples turn white—and maybe even hurt—during breastfeeding? This is called nipple blanching and can be caused by a few different things. It’s usually a result of blood flow to your nipple being restricted, often because your baby is compressing your nipples because the latch is too shallow, your baby is tongue-tied, or your milk lets down so quickly that she clamps down in an attempt to slow the flow. With this type of blanching, your nipple might also look flattened, creased or pointed when your baby comes off the breast. And for some moms, it can be quite painful.

Nipple blanching can also be caused by vasospasms, a tightening of the blood vessels due to lack of blood flow and oxygen that usually occurs during and right after breastfeeding, when the baby comes off the breast. This is typically caused by latch issues, and it can be extremely painful, often searing at first, then throbbing. “Vasospasms could be your body’s reaction to the fact that your nipples were damaged early on by latch issues or, in some cases, even thrush,” says Pam Davey, a certified doula and registered lactation consultant. They will eventually go away, but you’ll need to seek professional help to correct the problem causing it, and it can take a long time for the nipple damage to heal.

Often, the key to both preventing and stopping nipple blanching from compression or vasospasm is as simple as improving the latch, says Nathalie Pambrun, vice-president of the Canadian Association of Midwives, who recommends getting help from a lactation consultant. “In the case of vasospasm, you can relieve the symptoms by keeping your body warm to avoid blood vessel constriction during nursing, and applying a hot washcloth or dry heat with a blow dryer set on low to your breasts afterwards.”

Another, although less common, cause of nipple blanching is Raynaud’s disease. This condition affects both men and women and isn’t related to being pregnant or breastfeeding. In addition to white nipples after nursing, you might have cold fingers, toes, lips or ears, changes in skin colour in response to cold or stress, and a tingling or throbbing feeling when circulation returns after a few minutes or a few hours. Blanching in this case comes with severe and searing pain, which are also symptoms of thrush and so it is often misdiagnosed. A doctor can do a blood test for the disease and, in more severe cases, may prescribe a medication to widen your blood vessels and increase circulation. To relieve symptoms of Raynaud’s, breastfeed in warm environments and wearing warm clothing, prevent a temperature change by covering your breasts with your shirt or your hand as soon as your baby has finished nursing, apply dry heat with a blow dryer set on low, or massage your nipples with olive oil to help return blood flow and soothe any lingering pain or discomfort.

Don’t hesitate to contact a lactation consultant or your doctor if you’re experiencing blanching or pain while nursing.

Read more: How to handle oversupply and overactive letdown How do I know my baby’s getting enough breast milk?