If my address says James, I'm not James, I'm Kathryn!  I'm a new
subscriber -- a CNM on "Indefinite Sabbatical" while I nurture my four
cherubs here in the rich farmlands of southern Minnesota.  As a new LC
I would appreciate help with a problem I've never seen before.

A 24 y.o. primigravida in excellent health experienced intermittent
bright red spotting from both breasts at 33 wks.  There was no
cracking, redness or tissue damage to the breast or nipples, and no
pain.  Now at 36 wks she wakes up every morning with quarter-sized
blood spots bilaterally, one side more than the other.  She states
that if she squeezes her nipples bright red blood is expressed.

She is on no meds except vits.  Total weight gain is 55 pounds and she
has significant generalized edema, which leads me to consider
intraductal swelling as a contributing factor.  What else should I
consider?  What further data do I need to gather?  What reassurance
should I give her about the eventual resolution of this?  Might her
porcelain skin, white-blonde hair, and green eyes have anything to do
with this?

Thanks so much for any wisdom you can share with me.

Kathryn Colestock-Burke, CNM, LC