Dear wise friends,

I'd like to share with you a question that was asked me today by one of my
students (posted with permission).
term delivery with prolonged epidural anestisia, drowsy baby, not latching.
Mom was encouraged to start expressing within 12 hours pp to start and maintain
milkproduction while baby is "getting over" being born. {Because she is a
student I teached (  ;-)  ) I presume (but did not ask) the midwife advised mom
and baby stay together as much and as close as possible.} Mom produced fresh
blood instead of colostrum from both breasts. At second pumping midwife assisted
and observed: at least 15mls of bright red blood from one breast with a
handpump and a drop of colostrum plus a drop of blood (from different pores) from
the other breast with hand expressing.
I suggested to keep pumping/expressing and wait and see for 24 hours if
appearance of nipple discharge is changing towards more colostrum like. If so, it
will probably become better with time. If not have the breast checked for
anomalities with scan or ultrasound. Also suggested to have the pumped blood
lab-tested to see if it really was pure blood or a colostrum/blood mixture.

Now, I know that some moms can have a bit of blood in the first "servings" of
colostrum. And that probably most moms don't even notice this when baby only
feeds at breast and no-one sees what comes out of the breast. But my
experience does not go as far as bright red, seemingly pure blood.

Is this still to be considered as normal? If not, what would be the best way
to act. Doc seems to be in favour of weaning. How much blood in colostrum can
be tolerated by baby?

Warmly greeting,

Gonneke van Veldhuizen, IBCLC, LLLL
Germany - The Netherlands

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