What causes bloody nipple discharge while expressing breast milk (breast pumping)?

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Last updated: May 18, 2025View editorial policy

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Differential Diagnosis for Bloody Milk while Pumping

  • Single most likely diagnosis
    • Breast trauma or nipple trauma: This is the most common cause of bloody milk, often resulting from improper latching, over-suction from the pump, or nipple cracking.
  • Other Likely diagnoses
    • Mastitis: An infection of the breast tissue, which can cause inflammation, pain, and sometimes bloody discharge.
    • Ductal ectasia: A condition where the milk ducts become widened, leading to secretions and potentially bloody discharge.
    • Intraductal papilloma: A benign tumor growing in the milk duct, which can cause bloody nipple discharge.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Breast cancer: Although rare, breast cancer can cause bloody nipple discharge, making it essential to rule out this diagnosis.
    • Pituitary prolactinoma: A tumor in the pituitary gland that can cause hormonal imbalances, leading to galactorrhea (spontaneous milk production) and potentially bloody discharge.
  • Rare diagnoses
    • Breast hemangioma: A rare benign vascular tumor that can cause bloody nipple discharge.
    • Tuberculosis of the breast: A rare infection that can cause inflammation, abscesses, and potentially bloody discharge.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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