I had a client with one-sided bleeding last week. Well, to tell the truth,
we don't know if the bleeding is one-sided (since she sees no blood when
pumping, only in her baby's spit up), but severe nipple pain developed on
one side, so we are mainly watching that breast.  Mother is exclusively
breastfeeding a 5.5 month old (after 6 weeks exclusive pumping initially
till we were finally able to get the baby to latch on).

There was blood in her baby's spit-up now and then over a few days, and
when the nipple pain developed, the mother decided to seek help. While she
was coming to the offices, I got together everything I could on papilloma,
ductal ectasia, breast cancer, eek.

However when I looked at her nipple, I could see something odd at the very
tip, like a black splinter or thorn under the skin. When she hand
expressed, I could see that milk was coming out from other ducts, but
nowhere near that area.

I asked her if she had had any injury to her nipple, and she mentioned that
she'd had a "pimple" on her nipple when newly delivered, and the nurse had
given her a sterile needle to break the skin.  This didn't look like a
bleb, but we went on to discuss the treatment for blebs, and she reported
later that she had managed to get some "gunk" out and the pain was gone.
No more blood since then either.

Obviously we are keeping an eye on this, but I'm wondering if blebs can be
associated with bleeding due to that extra pressure on a papilloma in
another duct?

Please keep us posted, Jacalyn.

Jacquie Nutt IBCLC

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