Whenever we have this issue arise at our hospital, there always seems to be
one nurse who feels (and often communicates that feeling to mom!) uneasy
about the infant receiving the bloody or even, blood-tinged colostrum/milk.
Whenever this presents, I stress three different and important aspects of the
problem. Here they are:
#1 "Rusty Pipe Syndrome" in the early pp period is wnl( especially for moms
who have experienced very rapid breast tissue proliferation leading to
fragile capillary beds) and will usually clear progressively as the milk
onset time nears, most always by 5-7 days at the furthest out. I also stress
that pediatricians do not have a problem with infants receiving this output
and prefer that baby continue to get the IgA and other irreplaceable factors
in moms production, as opposed to infant not receiving this product.
#2 Mom must be factually-informed about the incidence, reason, and pediatric
stance on this problem, and to make the decision herself based on the
information provided. She needs to feel comfortable with feeding the bloody,
or blood-tinged product to her infant. Nurses should not lend their own
'feelings' about the product which can look like marbleized (red,grey,yellow)
breast milk. The frank bloodiness of this product sometimes visually 'turns
off' the personnel helping mom to pump, but in no way diminishes the potency
and beneficial factors the human breast milk affords a newborn infant. I
have had mothers feel "very" comfortable and nurses persist with
communicating negative feelings to her!
#3 Mom should be informed that IF SHE CHOOSES to continue breastfeeding, or
giving her infant the pumped product, she should realize that there is an
increased potential for infant emesis during or after a feed, and for the
infant stools to be considerably darkened still at 3-5 days pp. The darkened
stool is not a problem, but the emesis might be if infant experiences this
after each feed, leading to dehydration/weight loss.
#4 Mom should be aware that while this is normal enough in the early pp
period, especially for some case scenarios, if it does not clear within a few
(sorry to be vague) days of MILK ONSET (day 7-10?) breastfeeding should be
interrupted and MD evaluation initiated, as breast carcinoma can also present
with bloody discharge. I usually make a call to her OB or midwife and have
them jot a note that mom experienced this, even if it clears, in case she
comes in at 4-6 wks. pp with another suspicious indicator.
Just thought I'd add my 2 cents!
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