What to do about bloody nipple discharge while expressing breast milk (breast pumping)?

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Last updated: May 18, 2025View editorial policy

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From the Guidelines

If you notice blood in your breast milk while pumping, don't panic as this is usually due to broken capillaries or cracked nipples and is typically not harmful to your baby. First, check your nipples for cracks or damage and apply a lanolin-based cream like Lansinoh or Earth Mama Nipple Butter after pumping to help them heal. Adjust your pump settings to a lower suction level and ensure your flanges fit properly to prevent further trauma. Cold compresses before pumping and warm compresses during pumping may help reduce bleeding. Continue to pump or breastfeed as usual, as most cases resolve within a few days. However, if the bleeding persists longer than a week, is accompanied by pain, fever, or breast inflammation, or if the milk appears consistently pink or red rather than having occasional streaks, contact your healthcare provider promptly, as suggested by recent guidelines 1. These symptoms could indicate mastitis or other conditions requiring medical attention. The blood in milk occurs because the breast tissue is highly vascular, and pressure from pumping can cause small blood vessels to break, but this temporary issue rarely affects milk quality or your baby's health. It's also important to note that, according to the Society for Maternal-Fetal Medicine 1, breast milk should be expressed and discarded if nipples are cracked or bleeding. In general, bloody nipple discharge during pregnancy or lactation may be considered a normal physiologic change, but it's essential to monitor and seek medical attention if necessary, as some cases may be due to underlying conditions 1. Key considerations for managing bloody milk while pumping include:

  • Monitoring for signs of infection or other complications
  • Adjusting pump settings and using proper flange fit to prevent further trauma
  • Applying topical creams to promote healing
  • Seeking medical attention if bleeding persists or is accompanied by other symptoms.

From the Research

Bloody Milk While Pumping

  • Bloody milk while pumping can be a sign of mastitis, which is an inflammation of the breast tissue that can be caused by infection or other factors 2, 3.
  • Mastitis can be caused by ineffective positioning of the baby at the breast or restricted feeding, and infective mastitis is commonly caused by Staphylococcus aureus 4, 5, 6.
  • The diagnosis of mastitis is usually clinical, with patients presenting with focal tenderness in one breast accompanied by fever and malaise 2.
  • Treatment for mastitis includes changing breastfeeding technique, often with the assistance of a lactation consultant, and antibiotics may be prescribed if necessary 2, 3.
  • Continued breastfeeding should be encouraged in the presence of mastitis and generally does not pose a risk to the infant 2.
  • If bloody milk is present while pumping, it is recommended to:
    • Stop pumping and consult a healthcare professional for proper diagnosis and treatment 3.
    • Apply ice to the affected area to reduce pain and inflammation 3.
    • Consider taking nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation 3.
    • Practice good breastfeeding technique, including frequent, complete emptying of the breast and optimizing breastfeeding technique 2, 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Management of mastitis in breastfeeding women.

American family physician, 2008

Research

Mastitis: Rapid Evidence Review.

American family physician, 2024

Research

Antibiotics for mastitis in breastfeeding women.

The Cochrane database of systematic reviews, 2009

Research

Antibiotics for mastitis in breastfeeding women.

The Cochrane database of systematic reviews, 2013

Research

Antibiotics for mastitis in breastfeeding women.

Sao Paulo medical journal = Revista paulista de medicina, 2016

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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