What Causes Bleeding Nipples and what Can I Do?

1. Breastfeeding

For first-time moms, breastfeeding can take some time to master. In the first few days, your nipples may become sore and cracked. There might be bleeding cuts on the nipple or the colored area around the nipple (areola).

But breastfeeding shouldn’t be painful or cause bleeding. If your nipples continue to bleed during the first few days or weeks of breastfeeding, it may be because your baby isn’t latching properly.

Other signs of a poor latch include:

• flat, wedged, or white nipples at the end of a feed
• severe pain throughout a feed
• your baby seems unsettled or still hungry after a feed
• the bottom part of your areola isn’t in the baby’s mouth

If you’ve been breastfeeding for a few months and suddenly develop pain, it could be a sign of infection. About 10 percent of women who breastfeed develop an infection at some point.

What you can do

If you have pain during breastfeeding, try putting a finger in your baby’s mouth to break the seal, and then reposition your child. A deeper latch ensures that the nipple is deep in the mouth where the baby’s palate is softer.

A baby latched on to the nipple only will do damage quickly, so you want the baby fully latched on to the breast, with the nipple centered and deep in the baby’s mouth.

It may also be helpful to talk to a lactation specialist about effective latching techniques. The hospital where you gave birth should have one available.

You can also join La Leche League’s online peer support group to talk with other breastfeeding moms about their experiences. You baby, and your breasts, will thank you.

2. Otherwise cracked or broken skin

Bleeding can also result from skin conditions that cause dryness and cracking, such as contact dermatitis or dry skin.

Contact dermatitis happens when your skin comes into contact with an irritating substance. This could be a new soap, laundry detergent, or an industrial cleaner on a new bra.

Dry skin often results from exposure to cold and heat. For example, your nipples may be dry and cracked because of exposure to hot water in the shower. This irritation can be made worse by tight-fitting clothing.

Other symptoms may include:

• itchiness
• rashes
• scaly skin
• blisters

What you can do

Try to identify what’s causing your nipple irritation and avoid it. In general, fragrance-free products tend to be gentler on sensitive skin. Warm showers are also better than hot.

When skin cracks, it’s important to prevent infection. Keep the area clean with soap and water and apply an antibiotic ointment, such as Neosporin, until it heals. If the condition continues, see your health care provider for prescription creams.

3. Piercing or other trauma

A new nipple piercing takes two to four months to heal, during which time, it may bleed. Infections, which can develop both during and after healing, can also cause a collection of pus (an abscess) to form inside the nipple or areola.

Anything that breaks the skin can cause bleeding and lead to infection. Most nipple piercings are done under sterile conditions, but other nipple trauma may introduce bacteria. This can happen during rough nipple stimulation, especially when the skin is broken by bites, nipple clamps, or other sex toys.

Symptoms of infection include:

• redness and inflammation
• pain or tenderness to the touch
• pus or abnormal discharge

What you can do

Keep the area around your piercing or wound as clean as possible. Wash with soap and warm water or an antiseptic wash, such as Bactine. Soaking your piercing in a solution of warm water and salt several times per day can also help treat and prevent infection.

If you develop an abscess or experience severe pain, you should go to your doctor immediately. Your doctor can drain the wound and prescribe a course of oral antibiotics.

4. Infection

Mastitis is a breast infection that causes pain and redness. It’s most common in women who are breastfeeding, but it can happen to anyone. It often occurs within three months of giving birth.

Mastitis usually doesn’t cause nipple bleeding. It’s often the other way around; cracked, damaged, bleeding nipples provide an entry point for bacteria, which can lead to a mastitis infection.

Symptoms of mastitis include:

• breast pain or tenderness
• warm to the touch
• general flu-like feeling
• breast swelling or lump
• pain or burning while breastfeeding
• breast redness
• fever and chills

What you can do

If you suspect you have mastitis, see your doctor. Most cases are treated with 10 to 14 days of oral antibiotics. You should feel better within a few days, but take it easy for the next week or two.

The doctor will prescribe an antibiotic safe for breastfeeding, and breastfeeding should continue. Engorgement can make the problem worse when you are breastfeeding.

If an abscess develops near the nipple, it may need to be drained. With your doctor’s permission, you can treat pain and fever with over-the-counter (OTC) pain relievers that help reduce swelling. Popular options include ibuprofen (Advil) and naproxen (Aleve).

5. Intraductal papilloma

Intraductal papillomas are one of the most common causes of a bleeding nipple, especially if blood is flowing out of the nipple, similar to milk. They’re benign (noncancerous) tumors that grow inside the milk ducts.

These tumors are small and wart-like. You may be able to feel one behind or next to the nipple. They’re usually quite close to the nipple, which is why they cause bleeding and discharge.

Other possible symptoms include:

• clear, white, or bloody nipple discharge
• pain or tenderness

What you can do

If blood is flowing directly out of your nipple, see your doctor. Your doctor can diagnose your symptoms and advise you on next steps. If you’re dealing with an intraductal papilloma, they may recommend surgically removing the affected ducts.

6. Is it breast cancer?

Nipple discharge is traditionally regarded as a symptom of breast cancer, but this symptom isn’t that common.

About 3 to 9 percent of women treated at breast cancer clinics present with nipple discharge. It isn’t clear whether this includes bloody discharge. However, a lump or mass is usually present in these cases.

Current research is exploring the potential relationship between nipple discharge color and cancer severity. Although one 2016 study suggests that blood-colored discharge may be associated with malignant (invasive) breast cancers, more research is needed to confirm these findings.

Intraductal carcinoma

The type of breast cancer that someone has is determined by the specific area where it starts:

• Carcinomas are tumors that can grow in organs and tissues throughout the body.
• Ductal carcinomas are tumors that start inside the milk ducts.
• Intraductal carcinoma, also called ductal carcinoma in situ (DCIS), is the most common type of noninvasive breast cancer. About one in five new breast cancers are DCIS.

DCIS is noninvasive because it hasn’t spread beyond the milk duct to the rest of the breast. But DCIS is considered pre-cancer because it could eventually become invasive, though this is unlikely. DCIS usually doesn’t cause symptoms. It’s typically discovered during a mammogram.

Lobular carcinoma

The lobules are the glands in the breast responsible for producing milk.

• Lobular carcinoma in situ is another type of pre-cancer that doesn’t spread to the rest of the breast.
• Invasive lobular carcinoma is cancer that has spread beyond the lobule, potentially to the lymph nodes and other parts of the body.

Invasive lobular carcinoma is relatively rare. About 8 out of 10 invasive breast cancers begin in the milk ducts (invasive ductal carcinoma), not the glands.

Early lobular carcinoma has few symptoms. Later, it may cause:

• an area of thickening in the breast
• an unusual area of fullness or swelling in the breast
• a change in the texture or appearance of breast skin (dimpling or thickening)
• a newly inverted nipple

Paget’s disease

Paget’s disease of the breast is a rare type of breast cancer that starts on the nipple and extends to the areola. It most often affects women of age 50 or older.

Paget’s disease most often occurs in conjunction with another form of breast cancer, usually ductal cancer in situ (DCIS) or invasive ductal carcinoma.

Symptoms of Paget’s disease include:

• crusted, scaly, and red nipple and areola
• bleeding nipple
• yellow nipple discharge
• flat or inverted nipple
• burning or itching nipple

How breast cancers are treated

Doctors consider many different factors before recommending a certain breast cancer treatment. This includes:

• the type of breast cancer
• its stage and grade
• its size
• whether the cancer cells are sensitive to hormones

Many women choose to undergo surgery for breast cancer. Depending on the size and grade of your tumor, surgery may involve removing the lump (lumpectomy) or removing the entire breast (mastectomy).

Surgery is often combined with additional treatments, such as chemotherapy, hormone therapy, or radiation. In its early stages, some breast cancers can be treated with radiation alone.

When to see your doctor

If bloody nipple discharge lasts for more than a day, make an appointment to see your doctor. Your doctor will run imaging tests to look for anything abnormal inside the breast. This may include an ultrasound, MRI, or mammogram.

See your doctor immediately if you notice any of the following:

• a new lump or bump
• dimpling or other texture changes
• newly inverted or flat nipple
• peeling, scaling, crusting, or flaking of the areola
• redness or pitting of the skin on the breast
• changes in the size, shape, or appearance of the breast

Cuts, cracks, or other damages to the skin on your breast don’t necessarily require immediate treatment. If symptoms don’t improve or if you notice signs of an infection, call your doctor. Signs of infection include:

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