Blood may be noted coming from wounds, cracks or scabs on the nipple. It may be noticed as specks of red or brown on the bra or breast pad. Sometimes it is found when the baby has blood (red or brown) in the spit up. Blood may also be seen when pumping.
If there is a lot of bleeding, I recommend resting the nipple by not nursing for 24-48 hours. You may want to try a pump flange size that is slightly bigger (27mm or 30mm) so the pressure on the nipple while pumping is decreased. I also recommend using a little olive oil on the areolae and nipple shaft while pumping to decrease friction. Pump every time the baby would have fed off of that breast. Feed the expressed milk to the baby. It is fine to feed the baby with expressed milk that has a little blood or is pink tinged. If the milk is too bloody, do not feed it to the baby as it may irritate the gastrointestinal tract.
If the nipple has an obvious wound, crack or scab, follow the detailed instructions for wound healing.
- After feeding or pumping, soak nipple in warm salt water. Mix 1 teaspoon of salt in 1 cup warm water, put it in a shallow cup and dip your nipple in for 3 minutes.
- Let dry.
- You may need an antibacterial ointment. Speak with your doctor about mupirocin (Bactroban) ointment. Use 1/2 peasize of ointment on the crack after you have soaked the nipple.
- If the wound doesn't start to heal in 2-3 days, you may try using breast shells. Put them on in between feeds during the day. This allows the wound not to be touched by pads/ bra in between feeds.
- If after a week you still do not see improvement, try not nursing on that side and pump at every feeding session for 24 to 48 hours.
No Visible Wound
If there is no visible wound, the bleeding may be coming from a wound deeper in the nipples or areolae. The bleeding may occur if you had any of the following in the past few weeks:
- nipples had a visible wound that has recently healed
- the baby tugged at the nipple or bit the nipple
- you had a blocked duct deep in the breast
If you are pregnant, not currently breastfeeding, or are breastfeeding but never had any wound or trauma to your nipples and areolae and you see blood coming from the nipple, call your doctor. This is not normal and needs to be evaluated.