Breastfeeding with ITP (Bleeding Nipples)

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Feature image from ITP&Me

Breastfeeding introduction – How it is hard and you need to feel confident and all that.  Strange new feeling like not everyone likes.

My story – I’ve been breastfeeding now (or not breastfeeding) for the last four months – what have I found.  How has the story gone…  What have I learnt and what problems have I faced?

When it gets hard…

Cracked and Bleeding Nipples?
What should I do with a low count?

Need to ask someone about this?

Lactation consultant.

What about women with bleeding disorders.

Taking care of your Nipples –

What could I do to prepare my nipples, take care of them while feeding?

Recipe from another blog about what to rub into your nipples – or perhaps just coconut oil…

So what Causes Blood in Breast Milk?

All of the breastfeeding problems listed below usually end quickly and are not considered serious…
– Cracked broken nipples and nipple blisters can cause blood in breast milk.
Read more on how to identify the cause of your cracked nipples.
– Vascular engorgement: Also called rusty pipe syndrome, due to the rusty color of the milk. This usually occurs immediately after giving birth, a first-time mommy may notice that her expressed milk is orange or pink in color. This is due to the increased blood flow to her breasts, which is needed during the development of the milk producing cells. The blood will usually disappear within a week or so after birth.

Look.  Here’s the thing.  I have breastfed a baby.  It’s a grueling if not some-what beautiful task.  I think there is a lot of romance surrounding breastfeeding to help encourage woman to continue to do it – but let me tell you it’s hard on your body, cuts into sleep time, can keep you awake for 23 hours at a stretch, saps your life and energy from your body, drains you of vitamins and minerals.

Breastfeeding is the important and special – but let’s be honest, it’s not 100% fun – not every single minute.

So when some crazy arsehole online is telling you to set aside time to soak your nipples in a saline solution – Then you’re probably going to tell them to go fuck them self.

Perhaps you might just end up doing nothing, and waiting for your nipples to heal on their own.

Please note: Although bleeding looks scary and blood may sometimes show up in your baby’s bowel motions or vomit, it is not harmful to your baby. It is quite safe for her to keep breastfeeding.

BREASTFEEDING ASSOCIATION AUSTRALIA

ITP and Miscarriage

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Miscarriage and the loss of a child during pregnancy is probably the worst, most personal, private kind of horror a woman can go through.  It is the kind of grieving where no one wants to touch you, where you look like a collapsed version of yourself and suddenly you can’t understand anything around you.  At least that’s what it felt like to me.  

As more than twice as many women than men have ITP, it makes sense to be talking about how ITP can, and does effect the ladies.  Yet there is not much information out there for women looking for help with ITP and Miscarriage.  There is not even much information for woman with ANY bleeding disorders and miscarriage!

In any natural miscarriage with a healthy mother, there is always a bleeding threat.  Yet for women with haemophilia, ITP and other bleeding disorders there is is an even greater threat.

So what are the treatments for miscarriage? I guess treatment is the wrong word.  Perhaps I should write care or care plans.  There are currently three ‘care plans’ available to a woman for a miscarriage, and none of them will save the baby.

1. The Do Nothing Method, where the woman waits for her body to naturally expel the tissue at home.  This method is claimed by many to be the most natural for the human body as it involves the least amount of intervention (None).  How it effects the mind is a whole other matter.  The Do Nothing Method can take anywhere from an hour to 4 or even 5 weeks.  If during this time the woman becomes ill or feverish, then further intervention is taken.  Also if after 5 weeks, she may be ready to talk about other ‘care’ options.  Which leads us to

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Gestational Thrombocytopenia

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Pregnant with a Low Platelet Count

Having mild thrombocytopenia or a low platelet count during pregnancy is no a reason to freak out.  Actually, it is quite a common occurrence towards the end of any regular pregnancy.  In a  prospective study of 15,000 consecutive women admitted for labor and delivery documented low platelet counts in 5% of these women.  Think of it like this… Two or three ladies from every wedding you have been to will be diagnosed with Gestational Thrombocytopenia at some point.

Following the delivery of the child, the mother’s platelet count will usually normalise within 2 to 12 weeks.  If the mother’s platelet count does not normalise quickly, then it may be a signifier of something else.

How do you know it is Gestational Thrombocytopenia and not something worse?

The diagnosis of Gestational Thrombocytopenia is considered if there is no history of preceding thrombocytopenia when you were not pregnant.  Gestational Thrombocytopenia patients tend to

  • have no previous history of abnormal bleeding.
  • have only a mild thrombocytopenia count such as 70 or above.
  • develop thrombocytopenia during or after the second trimester.

If these conditions are met, it is predicted that your platelet count would return to normal following delivery and that the newborn infant would have a normal platelet count at birth.  There is not specific diagnostic test that can distinguish the difference between gestational thrombocytopenia and mild ITP, which is why follow ups after the baby is born will help to know the exact cause.  A lot of it will be an exclusion method.  There is alway a chance that you already had ITP but it was not detected until you were testing in relation to your pregnancy.  Brenda is one such patient who discovered she had ITP while pregnant.   It is rare but it does happen.

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Breastfeeding While Taking Immune Suppresants

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Are you pregnant or trying to get pregnant while taking the immune suppressant steroid Prednisone? There is so much you need to be thinking about right now, wondering if you will able to breastfeed after the baby is born is just another consideration that needs to be investigated.

Question

Is it safe to breastfeed my baby while I am taking Prednisone?

1. The Quick Answer – Yes.

2. The Real Answer – There is a very big difference between a drug being ‘SAFE’ and and drug being ‘GOOD’ for you and your baby.  Just because a drug is classified as safe, should I still take it?  There is a very big difference between something being proven to be good for you and scientists not being able to prove it’s bad for you.

Just because it is ‘safe’ should I do it? – 

Though many drugs are quite safe for a mother to take while nursing her child there are several agents for which ‘safety’ during breast-feeding is not well-defined and may be a risk to the infant.  What is safe for one person may not be safe for another.  Prednisone, according to every medical doctor I have talked to, is safe to consume while pregnant and breast feeding.  There is evidence that a small amount of the drug can pass through the breast milk and into the blood stream of the feeding child, an amount small enough for doctors to consider the drug safe.  However, I found the contributions of MotherRisk.org quite relevant to this discussion.  ‘Even if only a small amount of the drug were to be excreted into the milk, the inherently toxic nature of these medications warrants caution with their use.’

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Breastfeeding on Prednisone

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Below is a collection of Information I have gathered from Blog posts, person comments and Medical articles from online.  While there seems to be no definitive Yes or No answer, as with many things to do with ITP, I did think this offered a great platform to begin your own research and make up your own mind about what is right for you and your baby. Continue reading

‘How I Treat Thrombocytopenia in Pregnancy’

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A Haematologists Perspective on ITP and Pregnancy.

How I treat thrombocytopenia in pregnancy

 Authors Terry Gernsheimer1,  Andra H. James2, and Roberto Stasi3

Abstract

A mild thrombocytopenia is relatively frequent during pregnancy and has generally no consequences for either the mother or the fetus. Although representing no threat in the majority of patients, thrombocytopenia may result from a range of pathologic conditions requiring closer monitoring and possible therapy. Two clinical scenarios are particularly relevant for their prevalence and the issues relating to their management. The first is the presence of isolated thrombocytopenia and the differential diagnosis between primary immune thrombocytopenia and gestational thrombocytopenia. The second is thrombocytopenia associated with preeclampsia and its look-alikes and their distinction from thrombotic thrombocytopenic purpura and the hemolytic uremic syndrome. In this review, we describe a systematic approach to the diagnosis and treatment of these disease entities using a case presentation format. Our discussion includes the antenatal and perinatal management of both the mother and foetus.

The Full Article is available from the American Society of Hematology to read online for FREE.

Simply click Here