Raynaud’s phenomenon of the nipple in breastfeeding women: a report of three cases

• Autor(a) principal: Abrantes, Arnaldo
• Data de Publicação: 2016
• Outros Autores: Djokovic, Dusan, Bastos, Catarina, Veca, Patrizia
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.32385/rpmgf.v32i2.11738
• topic: Raynaud’s Phenomenon; Nipple Pain; Breastfeeding; Fenómeno de Raynaud; Dor Mamilar; Amamentação

Introduction: Raynaud’s phenomenon results from recurrent vasospasm in acral areas of the body in response to cold or emotional stress. It is characterized by pain, paresthesia, and skin colour changes, affecting most frequently the fingers and toes. Raynaud’s phenomenon is an underdiagnosed cause of nipple pain and cessation of breastfeeding. Case 1: A 39-year-old woman, G2P1 with a eutocic preterm delivery and a history of systemic lupus erythematosus, complained of episodes of intense bilateral nipple pain from the second postpartum week. The pain was associated with a triphasic colour change of the skin of the nipple skin during and after breastfeeding. The diagnosis of Raynaud’s phenomenon was made based on the history and after the performance of a provocative test causing the prompt onset of the symptoms and signs. The patient began treatment with nifedipine and was asymptomatic within 4 weeks. Case 2: A 30-year-old patient, G1P1 with a eutocic delivery at term, with no previous medical history, was seen because of episodes of pain in the right breast caused by breastfeeding. They were accompanied by blanching of the skin of the nipple with subsequent cyanosis followed by hyperemia. The patient refused medication. The use of an electric breast electric pump resulted in resolution of her symptoms. Case 3: A 30-year-old women, G1P1, had a dystocic delivery at term requiring application of the vacuum extractor. She was a smoker and had food and pollen allergies but no other relevant medical history. She presented with severe, bilateral, intermittent nipple pain caused by breastfeeding and accompanied by a triphasic change in nipple colour. Due to her disabling symptoms and without significant relief from local nipple care, she stopped breastfeeding before trying pharmacological treatment. Comment: Raynaud’s phenomenon of the nipple is a treatable cause of pain during breastfeeding. It should be recognized and treated as early as possible to prevent cessation of breastfeeding.