I saw a client with sore nipples on Monday, and she was concerned when an ooze of blood appeared as the baby came off the breast.  I assured her that a little blood in the milk was fine, and she continued.  The baby has a retracted/bunched tongue so she has chosen to feed him pumped milk while doing the tongue exercises with him.  However Tuesday night she nursed him again and was horrified when he came off and vomited a whole lot of blood.  She said it seemed as if his entire meal was blood, and he kept burping up blood for a while.  I've sent her information on intraductal papillomas and vascular engorgement, and we expect this to clear within a few days (baby is now 6 days old).  No blood when pumping.

My question is - what volume of blood is too much? Can babies ingest "too much blood?"  Sadly, this has put the mother off breastfeeding rather, though she is at least reassured that she does not pump blood.  The baby has an incredibly strong suck and a tight mouth - she has difficulty breaking the suction when she wants to detach him, and I thought I wouldn't get my finger back when I felt his suck.  Beautiful latch from outside, horrible suck from inside.

Incidentally, her doctor is sending her for laser treatment for the sore nipples.  Anyone know of  success rates?  They do not look too bad - tiny lesions on tip.  Of course I believe her when she says they are painful as he sucks.

Jacquie Nutt IBCLC
Wellington, South Africa

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