Hi!  I hope someone can help me.  I did a search of the archives but didn't
locate anything.  I have a client who is 27 weeks pregnant and experienced
preterm labor 2 weeks ago related to a urinary tract infection.  She was
treated with steroids and antibiotics and is up ad lib.  Her problem she
states is that since then she has been experiencing what sounds like some
colostrum leakage, but also drops of blood from one breast.  She further
states that since the preterm labor experience, she periodically feels like
her breasts are full of pressure and warm in sensation.  She denies any
localized redness or warmth or lumps. Her physician is sending her for a
breast ultrasound today and gave her the name of a surgeon.  Needless to say,
by the time she spoke to me today about the situation over the phone, she is
hysterical.  I discussed the possibility of perhaps some mild ductal
irritation and asked her if her nipples were flaky or crusty.  She said
sometimes they are a little crusty, so I suggested application of Lansinoh
cream onto the nipples and that perhaps there's some mild irritation as I
stated earlier.  Has anyone heard of anything like this?  The midwife in the
practice stated to her that there's no possibility of nipple dryness.  This
practice supposedly refers to me, so I'd like to get some information
together so that I can approach them and REMIND them that I'm available as a
breast specialist and I'd like to offer some treatment regimens to them so
that this doesn't happen to anyone else.  She was literally scared to death
that she had breast cancer.  They told her they never saw anything like it
before.  I listened, offered her reassurance that the breast ultrasound won't
hurt to view the breast tissue and internal structures, but also informed her
that breast cancer rarely presents as blood drops from the nipple.  I also
told her that I'd have tried a little Lansinoh cream initially to see whether
it is some mild tissue trauma that's causing the bleeding.  Then if I saw no
resolution within a day or two, perhaps go on from there.  I welcome ideas
here!  I'll talk to her tomorrow.
Thanks!
Carol Chamblin, RN, MS, IBCLC
Breast 'N Baby Lactation Services, Inc.
Geneva, Il

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