That’s not thrush: it’s a vasospasm

The most commonly misdiagnosed issue in lactation is thrush. With modern research we actually know thrush is not common at all. Thrush is a yeast infection and the highest risk factor is antibiotic use and a gut dysbiosis. While it still happens, it’s not common. But the symptoms of thrush are equal to a very common issue: undiagnosed tongue tie. Has your nipple looked waxy or dull white right after baby unlatched? Did it feel like burning shard of glass or pins and needles after feeding baby? That’s because the blood vessels have gone into spasm and are not letting blood through. This is a vasospasm and it occurs because the nipple is being pinched between baby’s tongue and the hard roof of their mouth m. The arteries go into spasm and stop letting blood through.

When it happens in the nipple it really HURTS. Some say it feels like fire or ice. Others describe it as a pinchy, slicing feeling, or pins and needles. The nipple often turns pale and become painful right after the baby unlatches. It often gets misdiagnosed as thrush but will not respond to medications. So if you’ve been on multiple rounds of medications for thrush and it’s not working, you may actually be having vasospasm caused by your baby’s latch.

The two main ways to help: massage and heat.

🤲🏼Gently massaging, rubbing, or pinching the nipple helps. Immediately cover your nipples with your shirt/bra/nursing pad, then gently rub or massage them through the fabric.

🌞Heat is important because of science: evaporation is a cooling process. When liquid turns to gas, it uses heat energy from its surroundings to transition. When milk and saliva evaporate off your nipple, the skin and surface tissue cool rapidly, causing the vasospasm.

🌞To slow evaporation, place heat on your nipple as soon as baby unlatches. Use dry heat like a lavender pillow, microwaveable rice/barley/flax pack, hand warmer/Hot Hands (like you use in snowy climates for skiing), or a heating pad can help.  Leave heat on for a few minutes until the pain subsides.

🌚Avoid anything wet on the nipple as this promotes evaporation.

🌝Wearing wool nursing pads between feedings can also help keep nipples warm.