If the baby is spitting blood there are two immediate questions.
1. Is it baby's blood or mom's
2. if is baby's blood is there a large bleed.

first question 1. baby's or mom's
If this is a neonate an Apt test can be done with the spit up to determine
if its mom's or baby's. It differentiates fetal from maternal hemoglobin.
If not but mom has a cracked nipple and the amount is small and baby acts
well its reassuring and one could possibly watch and wait while mom heals.
Or maybe just use the other side to feed.
 2. if baby's is it a lot?
I assume this is red blood so either a high gi bleed in baby or its mom's. A
large amount of blood will cause black tary stools. One caution is this can
happen if baby intakes a lot of mom's blood.
I don't see a reason to stop breastfeeding here.
To be  thorough one could feed on the non cracked side and have GI see the
baby. I believe its Maryelle Vonlanthen MD whose alleged answer to
everything is "Have mom keep breastfeeding and I'll scope the baby"
-Rob


Rob Cordes, DO, FAAP, FACOP
general pediatrician
Wilkes Barre PA
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