Literature review for - Flourish Paediatrics

Raynaud’s Phenomenon of the Nipple
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The initial search of the databases included 12 references on Raynaud’s phenomenon of the
nipple. The detailed search is included in a separate document on searches. Data were
extracted from three studies (3 case-series) but the evidence was insuffiecient to develop a
body of evidence statement. The information gathered from the three case series have been
summarised below.
Notes on Raynaud’s phenomenon of the nipple
The case-series by Anderson and colleagues reported 12 cases of Raynaud’s phenomenon of
the nipple in breastfeeding women (Anderson, Held et al. 2004). Symptoms common to all 12
cases included extreme nipple pain, blanching of the nipple with breastfeeding followed by
redness or bluish coloration accompanied by intense throbbing pain, and precipitation of
symptoms with environmental cold temperature.
The literature on Raynaud’s phenomenon of the nipple indicates that the condition can occur
during, following, or in between feedings and the mother does not have to have a history of
Raynaud’s phenomenon in other parts of the body. The pain caused by Raynaud’s
phenomenon of the nipple can mimic Candida albicans infection therefore it is often
misdiagnosed and inappropriately treated (Morino and Winn 2007; Walker 2008). Anderson
and colleagues advise health professionals to consider Raynaud’s Phenomenon of the nipple
as a possibility in breastfeeding women who present with severe breast and nipple pain
(Anderson, Held et al. 2004).
The first-line management of Raynaud’s phenomenon of the nipples is provision of warmth
to the breasts and entire body. Mothers should also avoid vasoconstrictors such as caffeine
and nicotine. If symptoms do not improve nifedipine (a calcium channel blocker with
vasodilating effects) may be have beneficial effects (Walker 2008).
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