Discovering blood while pumping breast milk can be a startling experience, raising concerns about one’s health and the safety of the milk for an infant. While alarming, nipple bleeding during pumping is a common occurrence and typically not indicative of a serious underlying condition. This article provides guidance on how to respond, what might cause it, and how to manage the situation.
Immediate Actions When Nipple Bleeds
Upon noticing blood while pumping, immediately stop the session. Gently examine the nipple and surrounding area to identify the source of bleeding, looking for cracks, abrasions, or changes in appearance. You can gently clean the area with warm water for a clearer view.
Observe the amount of blood and whether it appears to be from the surface or deeper within a milk duct. While a small amount is often not serious, persistent or large volumes warrant closer attention.
Consider resting the nipple for 12-24 hours for initial healing, especially if visible damage is present. During this time, hand express milk to maintain supply, as this can be gentler than using a pump.
Common Reasons for Nipple Bleeding
Nipple bleeding during pumping often stems from mechanical causes related to the pumping process itself. An incorrect flange size, either too small or too large, can lead to friction and trauma to the nipple and areola. Excessively high suction settings on the pump can also damage delicate blood vessels and nipple tissue. Dry pumping, without adequate lubrication, contributes to irritation and cracking. Existing nipple damage, such as cracks or fissures from previous pumping sessions or breastfeeding, can also reopen and bleed.
Physiological factors can also lead to blood in breast milk. “Rusty pipe” syndrome, or vascular engorgement, occurs in the early days postpartum due to increased blood flow to the breasts as milk production ramps up. This can cause small amounts of blood to seep into the milk, giving it a pink, orange, or brownish tint.
Less common, but possible, causes include infections like mastitis or thrush. Mastitis, an inflammation of breast tissue, can cause symptoms such as breast pain, redness, and a lump, and may sometimes lead to blood-tinged milk. Thrush, a yeast infection, can also cause nipple pain and damage. Benign growths, such as intraductal papillomas, are small, non-cancerous growths within the milk ducts that can cause clear or bloody nipple discharge, often from a single duct. Any persistent or unexplained bleeding warrants medical evaluation.
Safety of Milk with Blood
Small amounts of blood in breast milk are generally considered safe for a healthy baby to consume. Pink, red, or brown-tinged milk, including from “rusty pipe” syndrome, is typically not harmful. This temporary phenomenon usually resolves within a few days.
While the presence of blood might cause a baby to spit up more or have darker stools due to the iron content, it is generally not a reason to stop feeding. However, a healthcare provider might advise against feeding in specific scenarios. This includes cases where the mother has certain blood-borne infections, such as HIV or Hepatitis C, which could be transmitted through blood in the milk. Additionally, if the milk is discolored due to bacterial contamination, such as Serratia marcescens, feeding the milk might be contraindicated, especially for premature or immunocompromised infants. Always consult a healthcare professional for personalized guidance if concerns arise.
When to Seek Medical Advice
While minor nipple bleeding often resolves on its own, certain signs warrant prompt medical attention. Seek evaluation if bleeding persists longer than a few days, increases in volume, or is accompanied by new or increasing pain.
Signs of infection, such as fever, spreading redness, warmth, swelling, or pus-like discharge, indicate a need for medical consultation. Also, seek medical advice if blood appears to be coming from a breast duct rather than a surface injury, especially from only one breast. The presence of a new breast lump or changes in nipple shape or appearance alongside bleeding also requires immediate investigation.
Continuing to Pump and Preventing Recurrence
You can often continue pumping even with nipple bleeding, though modifications are necessary. If bleeding is due to trauma, rest the affected breast for 12-24 hours and hand-express or pump at a very low suction setting to allow healing while maintaining supply. Addressing the underlying cause is crucial to prevent recurrence.
Ensuring the correct flange size is a primary step in preventing nipple damage. The flange should fit comfortably, allowing the nipple to move freely without rubbing against the sides of the tunnel or pulling in too much areola. Re-measuring may be beneficial as nipple size can change.
Adjust suction settings to the highest comfortable level, not the maximum, to avoid trauma. Applying food-grade lubricants, such as coconut oil or specialized pumping sprays, to the nipple and flange before pumping can reduce friction and enhance comfort.
Proper nipple care involves keeping the area clean and dry between pumping sessions. Applying expressed breast milk or a nipple cream after pumping can help soothe and moisturize the skin, promoting healing.