Judy,
I recently saw a mom with definate blood in her milk, bilaterally.  One breast
leaked a reddish liquid during pregnancy, the other did not.  Mom nursed first
infant without difficulty, but never needed to express.  Second pregnancy,
bleeding recurred, baby was born preterm, mom noticed blood from both breasts
upon pumping.  NICU would not feed bloody milk to the infant, though there is
no documented harm to this practice.  Mom came for a consult and pump rental.
 She had a cord shaped thickening at the base of each nipple, consistent with
intraductal papilloma.  We also talked about the possibility of rusty pipe
syndrome, some moms have blood in milk the first approx 3 days postpartum,
possibly from ruptured capillaries due to vascular congestion.  Mom pumped
clear milk for about the first 3 mins of the pumping session, then frankly
bloody milk thereafter.  I suggested collecting the clear milk seperately,
immediately removing the pump and changing volufeeds (small sterile bottles
supplied by hosp for moms bfing premies to pump into) before continuing to
pump to stimulate more milk production.  The clear milk was acceptable to the
NICU and was fed to the baby.  The bleeding lasted a week.  I referred mom to
her ob (who was mystified) and to a breast specialist.  The bleeding totally
resolved in 7 days after the consult (10 days postpartum), and mom elected not
to see the breast specialist.  The diagnosis remains uncertain.  Baby was
discharged and is breastfeeding and "fat" according to his dad.
Hope this is encouraging to your client.
Catherine Watson Genna, IBCLC  NYC  [log in to unmask]