Hello, Jessica.
       Wow!  These parents have really been in a tough bind.  Three
possibilities come to my mind as to the staining.  If a person is anemic, they will
bleed more because they do not have enough clotting factor.  I got extremely
anemic during my first pregnancy and had horrible bruising from my son's birth.
Between the forceps delivery and the anemia, all kinds of blood leaked into my
tissues and *all* the nurses who checked my episiotomy stitches remarked about
what horrible bruising I had.  I also lost more blood than usual after the
birth, again due to the anemia.  Where this is going is, perhaps after four
pregnancies, this mother has gotten somewhat anemic, causing increased bleeding.
I find that a hemoglobin blood test is not usually accurate in a breastfeeding
mother, because these moms are usually still taking their prenatal vitamins.
Unless they are *very* anemic, the vitamins will cause the hemoglobin to
register as normal.  A more valid test in a breastfeeding woman is the serum
ferritin, which measures the stores of iron.  These stores can be depleted by
pregnancy and other stressors.  She may be slightly anemic, which may allow for
staining.
       Also with my first child, his birth caused the cervix to turn somewhat
inside out.  (Sorry, I can remember the description but not the technical
term.)  This caused increased discharge.  For me, the discharge kept the vaginal
more moist than usual and I got an infection, but it took two months and a new
OB to figure out what was going on.  I ended up needing cryosurgery to remove
the "inside out" part and stop the discharging.  Since her staining stops
once she quits breastfeeding, this is *probably* not what's going on, but she
might want to be sure that someone has actually checked for the condition and
ruled it out.
       When my daughter was 14, she started bleeding after 7 months without a
period.  Once she started, it wouldn't stop.  She bled for 112 days.
Although she was not anemic when it started, she was before we were able to find
someone who could help her get it turned off.  The fourth doctor finally figured
out that she was low in progesterone, though not in estrogen.  Low progesterone
is natural for breastfeeding, so would not affect this mother's ability to
make enough milk.  But perhaps after the early weeks, when if I understand
correctly, progesterone levels begin to rise again somewhat, maybe this mom's
progesterone levels haven't risen to a normal level for a several-months postpartum
mother.  While my daughter needed to be on a progesterone-only pill for a
while, perhaps this mother wouldn't need quite so much.  If bloodwork indicates a
low level, perhaps something like the herbal creams we have for menopausal
symptoms (like yam cream) would stop the staining yet not interfere too much
with milk supply.
       I will be interested to see what ideas others have.
       Dee

Dee Kassing, BS, MLS, IBCLC
Collinsville, Illinois, in central USA

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