I posted three day's ago re the mother with blood in her milk.  Saw her
yesterday for the first time and am none the wiser, but rather
concerned.  Briefly, the main points:

Healthy, thriving, term  baby, 2.5 months.  Oral structure NAD.
Latch good and deep, tongue over gum line, audible swallowing.

Pain:  Bilateral breast pain experienced during (sometimes) and always
after feeding for  1 to 2 hours with varying intensity since birth of
baby.  Pain described as "pressure", "pinching", "like a contraction
that does not go away".  Pain was on the lateral aspects of both breasts
when I was with her. No burning or itching.
Nipples tender, mother wears nursing pads to protect them from
clothing.  No visible damage.  (Has tried Gentian Violet for 3 days and
later used Daktarin (miconazole), but made no difference.)

Expressing milk with a pump is not painful and the pain afterwards is
less intense.  No blood seen in EBM.

Blood:  At age 2 months, blood flecks seen in vomit.  Stools dark -
tested - paediatrician adamant it is maternal blood.  (Another stool is
at the lab at present.)

22 August - "major pure blood" vomit after a feed.  Mother very
distressed!

On my suggestion, seen by doctor at a Breast Clinic.  NAD on palpation.
Ultrasound clear.  No intraductal papilloma seen and no signs of
intraductal thrush.  (Dr said this would show on ultrasound - is this
correct?)  Also took scraping from nipple.  No blood detected in EBM.
Dr is puzzled.  Prescribed antibiotic as feels problem may be
inflammatory. Suggests weaning if pain/bleeding continues.

Mother understandably very disappointed with her breastfeeding
experience.  Had intended to breastfeed for 6 to 9 months.  Now will be
happy to reach 3 months and perhaps express and feed by bottle for
another month.  Taking one day at a time at the moment.

Any ideas would be welcome!  TIA.

Jean Ridler  RN  RM  IBCLC
Cape Town, South Africa
mailto:[log in to unmask]

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