Occasionally a female parent may observe that her expressed breast milk, or her baby'due south regurgitated breast milk after a feed, is streaked or tinged with carmine, pink or rusty brownish suggesting the presence of blood. Is this claret from a croaky nipple or from deeper inside the breast? Could the claret exist from the infant? Is blood from the chest harmful for a baby to potable? This article looks at common causes of blood in breast milk and answers frequently asked questions.

Signs of blood in breast milk

Chest milk and colostrum tin come in a diverseness of different colours including blue, dark-green, brown, yellow, gold and clear.1 Pocket-size amounts of blood will often go unnoticed unless a mother is expressing her milk or her baby spits upwardly noticeably blood stained milk. Blood in breast milk may colour breast milk bright cerise, pink, black, olive green or a chocolate dark-brown colour.2 If substantial amounts of blood are swallowed and digested there may exist black flecks of blood in the infant's poop, or the poop may even exist black and tarry.iii In the instance of blood stained regurgitated milk or blood in stools; contacting your baby'southward physician volition help confirm whether the claret is from mother or baby (see below).

What can cause claret in chest milk?

A little claret in chest milk in the early days of breastfeeding is quite common due to the changes within the breast as milk production begins.4 five According to Mitchell et al, a temporary bloody nipple discharge may likewise be seen in up to 24% of women at any time during the form of lactation (Mitchell et al, 2019).

Persistent bleeding.Although not usually serious, whatsoever persistent blood from the nipple beyond the first few days after nativity should be reported to your health care provider with a view to further investigation (Mitchell et al, 2019). Authors Wilson-Clay and Hoover mention a copious, spontaneous nipple discharge (articulate or bloody, and usually one-sided) is one of several possible alert signs of breast cancer.half-dozen

Mutual causes of blood in breast milk

  • "Rusty pipe syndrome" when ducts and milk making cells grow and stretch afterward nascency
  • A cracked or damaged nipple that bleeds every bit infant sucks
  • Damaged capillaries in the breast due to engorgement or rough handling
  • Intraductal pailloma; a pocket-size beneficial growth on the milk duct lining which bleeds
  • Fibrocystic changes (lumpy breasts)

Rusty pipe syndrome

Rusty pipage syndrome is the name given to minor amounts of rusty coloured blood seen in chest milk during the first week or so afterward nascence. It's thought to be due to extra blood menses to the breast and fast evolution of glandular tissue causing a little blood to escape into the milk.  Information technology is discussed inDr Jack Newman's Guide to Breastfeeding:

It is non surprising that sometimes claret vessels leak a little claret into a duct, and it then comes out of the nipple. It is non dangerous for the female parent or the babe. Sometimes when a babe swallows claret he may spit it up because it irritates his stomach, simply it really does him no harm. The bleeding commonly disappears by 7 to 10 days after birth. Breastfeeding must not be interrupted.

If bleeding carries on afterwards infant is a week quondam or if bleeding happens at a later stage than the start week, keep breastfeeding but e'er check with your doctor (Newman, 2014).

Cracked or damaged nipples

If the crusade of claret in breast milk is due to a mother's cracked or damaged nipples, information technology is of import to discover the crusade of the impairment so that this tin be addressed and nipples can heal. The most frequent reason for cracked and haemorrhage nipples is when a baby is attached mostly to the nipple during a feed instead of having a big mouthful of breast tissue equally well as the nipple. See our articles on Why does breastfeeding hurt? and Causes of sore nipples or contact your IBCLC lactation consultant for help with positioning and latching your baby.

Damaged capillaries

Chest damage from rough handling such equally pressing too hard during hand expression or massage or using a pump with a very loftier vacuum could crusade bleeding from broken capillaries (tiny blood vessels) as they are very delicate.

Intraductal pailloma

Breastfeeding authors Wambach and Spencer7 say that bright-red bleeding from the breast without the presence of sore nipples could indicate an intraductal papilloma. An intraductal papilloma is a small growth in the lining of a duct virtually the nipple. It is normally noncancerous and doesn't crusade pain8 but tin can bleed into the duct when disturbed by breastfeeding or pumping and it is a mutual reason for claret in breast milk 9. Walker explains that if the baby tolerates the blood they can keep breastfeeding but if the infant keeps spitting upward, considering the blood is making them ill, the female parent may have to pump the affected breast until it is clear of blood which usually takes three-7 days. Haemorrhage oftentimes stops of its own accord without whatever treatment (Wambach and Spencer, 2021 p 302).

Fibrocystic changes

Fibrocystic breasts is the name used for a group of symptoms in the glandular breast tissue including chest pain, solid lumps and cysts. Breastfeeding A Guide for the Health Profession discusses that fibrocystic breasts are a cause of a discharge of claret from the nipple in pregnancy and lactation in approximately a third of cases merely it is not a contraindication to breastfeeding. The authors mention one case where fibrocystic breasts were found to exist the cause of an infant airsickness due to the volume of blood in breast milk (Lawrence and Lawrence, 2016).

Frequently asked questions

Can I feed my baby breast milk that has blood in it?

Wambach and Spencer country that a infant will not be harmed by drinking minor amounts of blood but consuming larger amounts may cause them to regurgitate the blood (Wambach and Spencer, 2021, p 303). Jack Newman, Canadian paediatrician and breastfeeding skilful explains:

Taking the babe off the breast is ofttimes suggested if the female parent'southward nipples drain from a cleft or chafe. But blood in the milk is not a reason to take the baby off the breast. The issue is the pain the mother feels, not the claret. Blood in the babe's breadbasket can cause spitting up merely is not dangerous. If nosotros can make the mother's hurting tolerable, even if the nipples continue to bleed, let's keep the babe on the breast. If the damage is minimized by fixing the mode the baby takes the chest, the abrasions/cracks will heal and the bleeding will end.

Check with a doctor

If your baby has drunk a lot of blood stained breast milk they may take very dark coloured poop in add-on to spitting upwardly claret-stained milk. The Australian Breastfeeding Association recommend checking with your doctor;

Occasionally a baby may pass nighttime bowel motions or may spit up claret-stained milk. This is usually a result of the baby drinking claret-stained breastmilk rather than the blood coming from the babe. Information technology oftentimes looks like a lot of claret because the blood tin can form 1 big lump in the stomach, which the baby spits up. Swallowed blood will not harm the babe, but tends to irritate the stomach and makes airsickness more probable. Still, it is always worthwhile seeking immediate medical advice in these situations.

Could the blood exist from my infant?

Your wellness professionals will be able to decide whether the blood is from baby or the chest by checking the regurgitated claret for foetal or developed haemoglobin ten. The hemoccult test identifies adult haemoglobin and tin dominion out babe gastrointestinal bleeding (Wilson-Clay and Hoover, 2017, p 36).

Other causes of pink breast milk

Food pigments may colour chest milk

Sometimes a food in mother's diet may colour her breast milk pink east.one thousand. beetroot. In Baby Poop: What Your Pediatrician May Not Tell Yous author Linda Palmer says that the pigments from natural foods such as beets are usually adept antioxidants and don't need to exist avoided. She adds that if if the pigment has coloured the milk this ways it has passed through mother's arrangement undigested and volition probably go through baby's system the same fashion.

Leaner can color milk pinkish

Thomas Hale describes another possible cause of pink/crimson milk that may non be blood is a bacteria called Serratia marsescens. Although S. marsescens is commonly harmless and unremarkably found in children'due south gastrointestinal tracts it can exist the cause of infection, especially for premature babies.

It is unlikely that a baby feeding straight from the mother'due south breast volition consume enough bacteria to crusade disease. However improper handling of breast milk may allow the bacteria to multiply to numbers capable of producing disease. Refrigeration of breast milk and breastfeeding equipment is unremarkably sufficient to foreclose Serratia from multiplying and generating paint.

The author advises never feeding a baby pink-carmine discoloured breast milk until cleared by a doctor. See the full commodity for farther information.

Expressed breast milk and pump

Summary

A lilliputian blood in chest milk is not harmful to your breastfed baby and is a mutual occurrence in the offset week or so after a baby's nascency. Reasons for brusk periods of claret in breast milk include rusty pipe syndrome, cracked bleeding nipples, broken capillaries in the breast or an intraductal papilloma. Any blood in breast milk that continues past the outset week after birth, or claret in chest milk that arrives after during lactation should exist discussed with your doctor but in most cases breastfeeding can continue.