Nipple Discharge: Causes and Concerns After Breastfeeding

Nipple discharge

Hello, I gave birth at the end of February and breastfed for just over three months.
I stopped breastfeeding four months ago.
Recently, for the past month or two, I've occasionally felt a sharp pain in my breasts.
Last month, while showering, I squeezed my breast and noticed a small amount of brownish milk.
A couple of days ago, I got my period, and today I felt the sharp pain in my breast again.
When I tried to squeeze my breast, I surprisingly expressed fresh blood along with a small amount of milk.
Upon initial self-examination, I did not find any lumps in my breast, but I am concerned about the possibility of a pathological condition or other issues.
Could you please provide some clarification? Thank you.

Mrs. Li, 30~39 year old female. Ask Date: 2019/10/28

Dr. Huang Jianzhong reply Obstetrics and Gynecology

After giving birth at the end of February, I breastfed for just over three months and have not breastfed for the past four months.
Recently, for the last month or two, I have occasionally felt a sharp pain in my breasts.
Last month, while showering, I squeezed my breasts and noticed a small amount of brownish milk being expressed.
A couple of days ago, my menstrual period started, and today I experienced sharp breast pain again.
When I tried to squeeze my breasts, I surprisingly expressed fresh blood along with a small amount of milk.
Upon initial self-examination, I did not find any lumps in my breasts, but I am concerned about the possibility of a pathological condition or other issues.
Answer: I need to go to the hospital for an examination.

Reply Date: 2019/10/28

More Info

After giving birth and breastfeeding, it is not uncommon for women to experience various changes in their breasts, including nipple discharge. Your description of experiencing occasional sharp pain in the breast, along with the discharge of brownish fluid and even fresh blood, raises some important considerations that should be addressed.

Firstly, it is essential to understand that nipple discharge can occur for several reasons, especially after breastfeeding. During lactation, the breast tissue undergoes significant changes due to hormonal fluctuations. After stopping breastfeeding, some women may continue to experience residual milk production, which can lead to discharge. This is often referred to as galactorrhea, which can occur even in the absence of breastfeeding. Hormonal imbalances, particularly involving prolactin (the hormone responsible for milk production), can lead to this condition.

The presence of brownish or bloody discharge can be concerning, as it may indicate underlying issues. While some causes of nipple discharge are benign, such as hormonal changes or duct ectasia (where a milk duct beneath the nipple dilates, fills with fluid, and sometimes thickens), the presence of blood warrants further investigation. Blood in the discharge can sometimes be associated with more serious conditions, including intraductal papilloma (a benign tumor in the milk duct), or in rare cases, breast cancer.

Given your situation, where you have experienced both sharp pain and the discharge of blood, it is crucial to take the following steps:
1. Self-Examination: Continue to perform regular self-examinations of your breasts. Look for any changes in size, shape, or texture, and feel for any lumps or hard areas. Pay attention to any changes in the skin or the appearance of the nipple.

2. Consult a Healthcare Provider: It is highly advisable to schedule an appointment with a healthcare provider, preferably a breast specialist or a gynecologist. They may recommend imaging studies such as a mammogram or ultrasound to evaluate the breast tissue further. These tests can help identify any abnormalities that may not be palpable during a physical examination.

3. Hormonal Evaluation: Since hormonal fluctuations can play a significant role in breast changes, your doctor may also consider evaluating your hormone levels, particularly prolactin, to determine if there is an underlying hormonal imbalance contributing to your symptoms.

4. Monitor Symptoms: Keep track of your symptoms, including the frequency and nature of the discharge, any associated pain, and any other changes in your breast tissue. This information will be valuable for your healthcare provider in making a diagnosis.

5. Avoid Self-Diagnosis: While it is natural to seek information online, self-diagnosing can lead to unnecessary anxiety. Rely on professional medical advice for accurate diagnosis and treatment options.

In summary, while nipple discharge after breastfeeding can be normal, the presence of blood and persistent pain should not be ignored. Prompt evaluation by a healthcare professional is essential to rule out any serious conditions and to provide you with peace of mind. Remember, early detection and intervention are key in managing any potential breast health issues.

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