Bleeding during pumping can be a startling experience for new parents, as the presence of blood in breast milk often looks more concerning than it is. While alarming, this phenomenon is often not indicative of a serious medical issue. Understanding its causes can alleviate anxiety and guide appropriate management.
Potential Causes of Bleeding
Bleeding when pumping often stems from nipple trauma, such as cracked nipples, blisters, or friction from an ill-fitting flange or excessive suction. When a flange is too small, it can rub against the nipple and areola, leading to abrasions. Conversely, a flange that is too large may pull in too much surrounding tissue, causing damage. In both scenarios, the delicate skin of the nipple can sustain tiny cuts or tears that bleed into the expressed milk.
Another common, temporary cause is “rusty pipe syndrome,” particularly in the early days postpartum. This occurs due to increased blood flow to the breasts as milk production begins. Small capillaries around the milk ducts can leak blood into the milk, resulting in a pink, orange, or brownish tint, similar to rust-colored water. This condition is painless and resolves on its own within a few days to a week after birth.
Beyond surface-level trauma, bleeding can originate from deeper within the breast. Broken capillaries, tiny blood vessels, can rupture due to strong suction from a pump or vigorous breast massage. Intraductal papillomas, which are small, benign growths within the milk ducts, can bleed when stimulated by pumping. While these growths are non-cancerous, they can be a source of blood in milk.
More serious, though less common, causes include mastitis, an infection and inflammation. Mastitis can sometimes lead to bloody nipple discharge alongside symptoms like pain, redness, fever, and flu-like symptoms. In very rare instances, conditions like breast cancer can cause bloody discharge, but this is usually accompanied by other signs such as a breast lump or unusual skin changes.
Managing the Situation
For immediate management, checking the pump setup is often the first step. Ensuring the flange fits correctly is important, as the nipple should move freely within the flange tunnel without significant rubbing or pulling in too much areola. Reducing the suction level can help prevent further trauma to the nipple and breast tissue. Pumping should not cause pain.
Nipple care plays a role in healing and prevention. Applying a small amount of purified lanolin cream, breast milk, or a suitable nipple balm after pumping can help soothe and protect the skin. Clean the nipples gently with warm water only, avoiding harsh soaps that can dry out the skin. Allowing nipples to air dry and changing breast pads frequently helps maintain a clean, dry environment conducive to healing.
Adjusting pumping technique can be beneficial. Opting for shorter, more frequent pumping sessions rather than long, intense ones can reduce strain on the nipples. Gently massaging the breasts before and during pumping can promote milk flow and reduce the need for high suction. Ensuring pump parts are clean supports overall breast health.
When to Consult a Healthcare Provider
While many instances of bleeding when pumping are benign, some situations warrant professional medical advice. If bleeding persists for more than a few days or a week despite self-care measures, it is advisable to consult a healthcare provider. Ongoing bleeding may indicate an unaddressed issue or a deeper cause that requires assessment.
Seeking medical attention is important if the bleeding is accompanied by other concerning symptoms. These include severe breast pain, fever, chills, noticeable redness or swelling of the breast, or the presence of a new lump in the breast tissue. Such symptoms could suggest an infection like mastitis or another underlying condition requiring diagnosis and treatment.
Any changes in breast appearance, such as new skin dimpling, nipple retraction, or unusual nipple discharge not related to milk, should prompt a visit to a doctor. If there is significant anxiety or persistent worry about the bleeding, even without other symptoms, consulting a healthcare provider or a lactation consultant can provide reassurance and personalized guidance.
Addressing Concerns About Breast Milk
A common concern for individuals experiencing bleeding when pumping is whether the breast milk is safe for the baby to consume. Small amounts of blood in breast milk are not harmful to infants, and the milk can still be fed. While the sight of pink, red, or brownish streaks in the milk can be alarming, it poses no health risk to the baby.
The appearance of the milk can vary depending on the amount and age of the blood. Fresh bleeding might result in pink or red milk, while older blood can give it a brown or even blackish tint. Though the taste might change slightly, most babies tolerate it well. Some infants might spit up more due to the altered taste or experience temporary changes in stool color, such as darker bowel movements.
Proper storage of breast milk should continue as usual, regardless of the presence of blood. However, if there is a known blood-borne infection in the parent, such as HIV or Hepatitis C with cracked nipples, a healthcare provider should be consulted regarding the safety of feeding the milk to the baby. In most cases, the benefits of breast milk outweigh the risks associated with small amounts of blood.