Seeing pink, red, or brown-tinged milk can be alarming. This discoloration is due to the presence of blood, which may appear as streaks, a light pink hue, or a dark, rusty color. In the vast majority of cases, the underlying cause is temporary and completely harmless. Understanding the source of the bleeding can provide reassurance and guide your next steps in continuing to nourish your baby.
Understanding the Most Frequent Reasons
Minor trauma to the nipple and areola is a primary reason for blood to appear in breastmilk. A poor latch, incorrect flange size when pumping, or aggressive suckling can cause tiny breaks in the skin. These small abrasions allow minute amounts of blood to mix with the milk, appearing bright red or pink when expressed or seen in the baby’s spit-up. The bleeding usually subsides quickly once the source of the friction or trauma is corrected, often with the help of a lactation consultant.
“Rusty pipe syndrome” is another frequent cause, especially in the first few days postpartum. This occurs as the milk-producing cells (alveoli) and surrounding blood vessels rapidly expand to accommodate the incoming milk supply. The increased blood flow and fragile capillaries can leak old blood into the milk ducts, giving the colostrum or early milk a dark brown or rust-like appearance. This condition is self-limiting and typically resolves within a week to ten days as the breast tissue stabilizes. The milk’s appearance shifts from brown to pink, and then back to its typical color without intervention.
Is it Safe to Feed the Baby?
For common causes like nipple trauma or rusty pipe syndrome, the milk remains safe for the infant to consume. The small amount of blood entering the milk supply is generally not harmful to a healthy, full-term baby. Continuing to breastfeed or offer the expressed milk helps maintain the milk supply and prevent engorgement.
The presence of blood may alter the taste of the milk, causing some babies to become fussy or temporarily refuse the breast. If the baby consumes a noticeable amount of blood-tinged milk, their stools may appear darker or even black, which is due to the digested iron in the blood. In rare situations, such as if the parent has a bloodborne illness like HIV or Hepatitis, a healthcare provider should be consulted immediately to determine if feeding should be paused. Otherwise, the benefits of breastmilk typically outweigh the minimal risks associated with the small amount of blood.
When the Cause is More Serious
While most bloody breastmilk cases are benign, persistent or severe bleeding signals a more complex issue requiring medical attention. Mastitis, an inflammation of the breast tissue, can sometimes lead to blood in the milk due to increased pressure and damage to the capillaries. This condition is usually accompanied by distinct symptoms, including fever, body aches, a painful lump, and significant redness and swelling of the breast.
Intraductal papilloma, a small, benign growth that forms within a milk duct, is another less common cause. These growths are often painless but can spontaneously bleed into the duct, resulting in a bloody or clear discharge. Papillomas typically affect only one breast and require a medical diagnosis to rule out other conditions. Although extremely rare, a persistent bloody discharge unrelated to nipple damage can, in some instances, be a sign of a more serious underlying pathology, such as breast cancer.
When to Contact a Healthcare Provider
A consultation with a medical professional is warranted if the blood in your breastmilk continues for longer than 48 to 72 hours, especially if the nipples are not obviously cracked or sore. Bleeding that is copious, bright red, or appears to be coming from deep within the breast rather than a surface abrasion should prompt a call to your doctor.
It is important to seek evaluation if the blood is coming from only one breast, as this is a common characteristic of an intraductal papilloma or other unilateral growths. Any accompanying symptoms like a firm, new lump, unexplained fever, or severe breast pain suggest an infection like mastitis that needs prompt treatment. Monitoring the baby’s feeding behavior and output is also important; call your pediatrician if the baby is refusing to feed, vomiting significantly, or showing signs of distress.