Blood in breast milk

Why do I have red blood in my milk?

If mothers have blood in their milk, it is most likely from damaged nipples. If the nipples are not damaged and the blood is coming from only one breast, it may be from an intraductal papilloma, a small, non-cancerous growth in a milk duct, or a breast abscess. Breast tumours or cancer can also show up as bloody milk from one breast. A baby who takes in blood by the mouth may have blood or black bits in the spit or very dark or black stools. Blood can also come from bleeding inside the baby. Mothers should see their health-care providers if they notice blood in their milk, on their nipple, or the baby’s spit-up or stool.

A) Finding blood in breast milk

Mothers may notice blood in their milk when:  

B) Sources of blood in breast milk

Blood in breast milk can have a number of causes.

1) Nipple damage

The most common origin of blood in breast milk is damaged nipples.

2) Intraductal papilloma

If the milk from only one breast has blood and the nipple is not damaged, you may have an intraductal papilloma. This is a small raspberry-shaped growth in a milk duct that can bleed. It is not cancerous.

3) Breast abscesses

Breast abscesses can cause the milk to become bloody. This is even more likely after surgical treatment.

4) Breast cancer

Breast tumors or cancer may show up as bloody milk from one breast.

5) Rusty pipes

Some mothers make bloody colostrum; this is known as rusty-pipes syndrome.

C) Effects on the baby

Babies can swallow blood if it is present in breast milk or from breastfeeding on damaged nipples

In general, there is no need to stop breastfeeding if the mother has blood in her colostrum. Some authorities recommend that a mother who has blood in her milk and a hepatitis B or C infection should avoid breastfeeding and express and throw out her milk until her nipples have stopped bleeding but there is not enough research to make a firm recommendation.   

Taking in large amounts of blood can upset the baby’s stomach but is unlikely to cause any other problems if the mother is otherwise healthy. Some premature babies may have difficulty digesting large amounts of blood.

To remove the blood, milk can be expressed, placed in a covered container, and left to sit in the refrigerator for 18 – 24 hours. During this time the red blood cells settle to the bottom and the colostrum can then be poured off or collected with a syringe and given to the baby. Alternatively, the milk can be frozen for later use.

D) Blood loss by the baby

If your nipples are not damaged and there is no blood in the expressed milk or on the nipple, the blood in a baby’s spit, vomit, or stool may be coming from the baby.

An Apt test can determine whether red blood is from a newborn baby or the mother. 

Please see your health-care providers if the blood may be coming from the baby. If your baby is suddenly sleepy, weak, or irritable after passing black or bloody stool or vomiting blood, see a provider urgently.