Well, of course you should call your doctor if you see any trace of blood–either red streaks or dark brown grainy-looking stuff–in your baby’s spit-up. Blood in the digestive tract can be a symptom of something terribly wrong that needs immediate treatment. But while you are waiting for that call back from the doctor, I encourage you to do one simple thing that just might help you calm down about this very alarming symptom.
Take a look at your nipples.
(That’s if you are the baby’s mother and you are breastfeeding. If you are the father, grandmother, etc., or if you are a bottle-feeding mother, your nipples are not relevant.)
It’s very common for a breastfeeding mother, especially one who has just started nursing a newborn baby, to experience skin irritation from the pressure and pulling of nursing and/or the exposure of the skin to saliva. This can get so bad that the skin cracks and bleeds a little. It happened to me within the first week of nursing Nicholas, so I was not surprised to see little scabs on my nipples by the time Lydia was four days old. I continued applying lanolin after every feeding and taking ibuprofen to reduce the pain so that I could continue tolerating nursing, knowing that in a few weeks my skin would adjust and my baby’s mouth would grow so that it didn’t hurt so much. This is an unpleasant stage, but I got through it before and knew I could endure it again.
Then my baby spit up dark brown granules, which we knew could indicate internal bleeding. Daniel and I were very worried! We called our doctor, and he advised “caution but not panic”: Keep a close eye on her, watch for any other symptoms of digestive distress or pain, keep feeding as usual, see if it happens again. Lydia had several feedings with no spit-up or just a little bit of white . . . but then, about twelve hours after the first incident, she spat up milk streaked with quite a bit of bright red. Our doctor advised taking her to the emergency room.
I was tearfully imagining my tiny four-day-old baby with a tube down her throat, hooked up to horrible machines, when I remembered my scabbed nipples. Could it be that she was swallowing my blood?
Yes. After evaluating Lydia’s overall health, checking her organs by pressing from the outside, carefully examining the inside of her mouth, and watching us breastfeed, the ER doctors concluded that there was no sign of anything wrong inside her. In the darkness of her mouth, she had been sucking more blood out from under those tiny scabs than I had realized.
While it is disturbing that our daughter might be a vampire, we are relieved to know she does not have a life-threatening medical condition. (Also, we can see her in a mirror, which is reassuring.) I had a phone consultation with a lactation consultant as soon as we got home from the ER, and she referred me to another LC who was able to see Lydia and me in person a few days later. We got a lot of advice on how to improve our nursing habits, and it’s helping. I don’t have scabs anymore, and she hasn’t spit up any more blood. Whew!!
So, if your baby is spitting up blood, check your nipples (or, if you are not the mother, politely check the mother’s nipples) before you panic. It worked for me!