Hi Lynn - so many interesting questions out there, if only we had the
answers!!
> I helped with latch,
> she still had milk although the breasts were definitely well into involution,
> the supply would need to be built up to sustain the baby. The baby latched
> easily and fairly well, Mom nursed exculsively for 12 hrs. when the baby spit
> up blood. She immediately removed the baby from the breast, husband was
> "freaked out" that she had  attempted at all at this point......but since I
> saw her again the next day for her wound, I examined the nipples-looked fine,
> breasts were much fuller (she hadn't nursed at this point now for > 12hrs.)
> watched the baby suckle- all looked fine so I encouraged her to try again and
> unfortunately the same thing happened. She decided at that point to give up
> entirely. Of course, I wasn't surprised BUT was and am curious about whether
> the bleeding had anything to do with the involution/apoptosis process.

I think your idea about the friability of involuting epithelium causing the
bleeding is definitely a possibility. Equally though, if she had been
feeding for 12 hours and the bleeding was not observed until then, perhaps
it was as a result of re-epithelialisation and increased vascularisation
occuring in response to the stimulus of the baby feeding. A bloody discharge
is seen in some women in pregnancy when their breasts are undergoing a rapid
period of growth. As pathology is excluded in many of these women it is
though to be the result of the rapid development of new alveoli.

Regards
Cathy Fetherston CM MSc IBCLC
Perth Western Australia

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html