If you choose to breast-feed your baby, you might expect a few bumps in the road. You may know about the possibility of breast engorgement where your breasts overfill with milk, and you may be aware of latching problems. These problems can be bothersome, but they may not be as alarming as finding blood in your breast milk.

Some breast-feeding mothers panic and think there’s a serious medical problem after seeing blood in their milk supply. But finding blood in your breast milk doesn’t always indicate a serious problem.

In fact, this is common in first-time breast-feeding moms. Spots of blood may appear in your pumped milk, or your baby may have a small amount of blood in the mouth after breast-feeding.

You probably don’t need to stop breast-feeding your baby or see your doctor. But it does help to recognize common causes for blood in breast milk.

1. Cracked nipples

Cracked nipples can be a side effect of breast-feeding. In a perfect world, babies latch onto nipples effortlessly and breast-feeding doesn’t have complications. But unfortunately, breast-feeding can be difficult for mom and baby. If your baby doesn’t latch on properly, this can irritate your breasts and cause cracking and pain. Bleeding is a result of this cracking.

Breast-feeding isn’t supposed to be uncomfortable. If you have cracked nipples, changing your baby’s position can make latching easier. If this doesn’t help, another option is consulting a lactation consultant for support. These professionals can teach you how to breast-feed and help resolve common breast-feeding problems. Your nipples will begin to heal once you’ve fixed latching issues.

Here are tips to ease discomfort and pain while nipple cracking heals:

  • breast-feed from a breast that isn’t sore or tender
  • take a pain reliever such as acetaminophen
  • apply a cool or warm compress to your nipples after breast-feeding
  • don’t wait until your baby is overly hungry to feed (it can cause your baby to feed more aggressively)
  • wear a breast shell inside your bra to protect your nipples
  • apply purified lanolin to nipples after each feeding

2. Vascular engorgement

Blood in your breast milk can also be caused by rusty pipe syndrome, or vascular engorgement. This results from an increase in blood flow to the breasts shortly after giving birth. Your first milk or colostrum may have a rusty, orange, or pinkish color.

There is no specific treatment for vascular engorgement. The bleeding usually disappears within a week of giving birth.

3. Broken capillaries

Your breasts have small blood vessels. Sometimes, these blood vessels break due to an injury or trauma. If you’re expressing breast milk, either by hand or a breast pump, be gentle. Expressing is a way to remove milk from your breasts without breast-feeding.

If using your hands for expressing, cup your breasts with one hand and gently squeeze to release the milk. Only squeeze your breast, not your nipple. You can express into a bottle to empty your breasts. If your milk flow stops or slows down, don’t force it. Instead, switch to your other breast. If you’re too rough when handling your breasts and break a blood vessel, blood can leak into your breast milk.

When using a breast pump, follow the instructions and use the breast pump properly to avoid damaging your breasts. Electric pumps allow for the adjustment of speed and suction. Choose a speed and suction that’s comfortable and doesn’t irritate your breast.

4. Benign intraductal papilloma

Sometimes, bleeding is caused by small, benign tumors on the lining of your milk ducts. These growths can bleed and cause blood in your breast milk. If you touch your breasts, you may feel a small growth behind or next to your nipple.

Detecting a lump can be scary, but having a single intraductal papilloma isn’t associated with a higher risk of breast cancer. The risk for cancer increases if you have multiple papillomas.

5. Mastitis

Mastitis is a type of breast infection that can occur while breast-feeding. The condition can cause different symptoms, including:

  • swelling
  • redness
  • breast pain
  • fever
  • chills

Some women also have nipple discharge with mastitis, and streaks of blood appear in their breast milk. This type of infection is triggered by an accumulation of milk in the breasts. It can develop as a result of missed feedings or improper latching.

Mastitis is treatable. Getting plenty of rest and staying hydrated can help improve the condition, as well as taking an over-the-counter pain reliever like acetaminophen to reduce pain and fever.

It’s OK to breast-feed your baby while you wait for the condition to improve. In the meantime, wear loose-fitting clothes to avoid irritating your breasts and nipples. Consult a doctor if your condition doesn’t improve with home treatment. Your doctor may prescribe an antibiotic to clear the infection.

To prevent mastitis, breast-feed your baby more often. You may want to schedule an appointment with a lactation consultant if your baby has trouble latching onto your breasts. You can also reduce mastitis by letting your baby breast-feed until satisfied.

Finding blood in your breast milk can be scary, especially if you’re a first-time breast-feeding mother. But keep in mind that this is a common issue. Most cases of blood in the breast milk are treatable and don’t require medical attention.

If you notice blood while breast-feeding, pumping, or expressing for longer than a week, see a doctor. In rare cases, blood in the breast milk may be a symptom of breast cancer.

It’s usually OK to continue your breast-feeding routine with small amounts of blood in your breast milk. But if you have an illness that can spread to your baby through blood, such as hepatitis C, stop breast-feeding as soon as you spot blood and consult your doctor.

Q:

What are some reasons your doctor might recommend antibiotics for blood in your breast milk?

Anonymous patient

A:

A doctor may recommend antibiotics for blood in breast milk if you experience breast pain and redness along with fevers, chills, body aches, and other flu-like symptoms. These symptoms may signify a more serious infection that will need a 10 to 14 day antibiotic course.

Alana Biggers, MD, MPHAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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