Could this baby have a posterior tongue-tie, and mom have rather long
nipples? I have seen this happen where the tip of the nipple is
compressed and a crack is opened on the end of the nipple. The baby is
compressing the tip of the nipple and narrowing the gape perhaps to
control the force of milk spray with let-down. You could try having her
latch the baby on, then immediately lying back with the baby lying on
top of her. She should allow the baby's head to follow her breast as
she lies back. I have found this technique EXTREMELY helpful for moms
who have reynaud's-like symptoms also. The baby relaxes the jaw, brings
the tongue forward and down and the pain and/or nipple compression goes
away. First time I tried this with a mom, I helped her do this. We
called it "turtling": flipping her on her back like a turtle on his
shell! Made her laugh and it worked beautifully!
-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]] On Behalf Of Diane Perrone
Sent: Wednesday, January 31, 2007 4:55 PM
Subject: Baby spitting up blood
I had a question on the telephone today from a client I helped with her
first baby. I have not seen her with the second baby who is spitting up
blood.
Mother had sore nipples the first four weeks, but no open cracks or
nipple
trauma. In the fifth week, she became more comfortable, but the baby
began
spitting up blood-tinged milk. It rapidly progressed to spitting up
everything, everytime she nursed him and he began passing tarry stools
as
well.
He was admitted to ICU and given a full work up, but nothing abnormal
was
found. During his hospital stay, mother pumped and he was bottle fed
her
milk. There was no sign of blood in the pumped milk.
She went to her OB for her 6 week check up and her breasts were
examined;
nothing remarkable was found.
She has continued for another two weeks at home, pumping and bottle
feeding
her milk. No spitting up, no bleeding, no nipple trauma. A few days
ago,
the ped. gave her permission to begin breastfeeding again. After a few
days, she has a small crack (<1/4 inch), no pain, no blood on her bra
pad.
But her baby has again started spitting up and there is blood visible in
the
emesis. This is not just pink milk, but red clumps.
Has anyone else seen this type of situation before? Her ped is
mystified.
Is it likely that there is a small capillary that is opening up whenever
baby suckles? He does not tolerate the blood in the milk and spits up
everytime. Mother reports that he has a very strong suck, more so than
her
first child.
We talked about pumping the side with the crack while that heals. She
will
try a nipple shield on the other side when she breastfeeds to see if
that
makes a difference. Other suggestions/observations would be
appreciated.
Diane E. Perrone, RNC
Materna Wellborn
Algonquin IL US Go BEARS!
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