A: Brownish breast milk usually signifies broken down products of blood in breast milk and the occasional appearance of ‘frank’ blood in the case above, appears to confirm that this may be the case. The appearance of frank or altered blood in breast milk is not necessarily a serious issue but where in doubt, as usual, please see your doctor.
What would be the cause(s) of blood in breast milk?
• Growth of milk making cells: This is likely to cause blood in milk in the first few days of birth but usually does not persist beyond a week.
• Cracked nipples: This may occur due to difficulties with baby latching in to the nipple, a blocked nipple pore, biting of the nipple as the baby starts teething etc
• Broken capillaries in the breast as a result of wrong breast pumping technique, either manually or using a breast pump.
• Small breast tumours called intraductal pappilomas. These are usually harmless, occur on one side only and disappear without any treatment.
Usually during this period, the baby may pass out dark stool (due to altered blood in the stool) or vomit blood stained breast milk after feeding.
Usually, this condition would resolve with time. However, if it is too painful to continue breastfeeding at this time, breast milk should be expressed. This gives the breasts time to heal and also provides sufficient nourishment for the baby in the interim.
To prevent a recurrence,
• Prevent cracked nipples by ensuring baby latches on well, wear bras made of fabric that can breathe and clean nipples with water only.
• Be gentle with the breasts while expressing breast milk whether manually or with breast pump. For the latter, be sure to get a pump that suits your breast size.
If baby starts having bloody diarrhea or worsening jaundice, it is possible he is getting a lot of blood in the breast milk. Please take him to see his/her paediatrician.
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