Causes of bleeding nipples And What You Can Do

Are bleeding nipples a cause for worry?

Bleeding nipples may be due to some sort of friction or trauma. For example, your nipples may bleed when they rub against shirt material or scratchy bra. Therefore, bleeding nipples are oftentimes not a cause for concern.

Abnormal nipple discharge, whether bloody or otherwise, is common and may occur regardless of whether or not you are breastfeeding.

Research shows that 5% of women seeking treatment for symptoms related to breast problems complain of abnormal nipple discharge.

This article focuses on the causes of bleeding nipples and what you can do to treat the condition.

What are the causes of bleeding nipples?

The following are the possible causes of bleeding nipples:

1. Breastfeeding

First-time mums may take time to master the act of breastfeeding. As a first-time mum, your nipples may become cracked and sore in the first few days. Bleeding cuts may occur on the nipple or the areola (the colored area around the nipple).

Normally, breastfeeding does not cause bleeding. If your nipples continuously bleed during the first few days of breastfeeding, then your baby may not be latching properly.

Here are other indications of a poor latch:

• Severe pain throughout a feed
• Flat nipples at the end of a feed
• White nipples at the end of a feed
• Wedged nipples at the end of a feed
• Failure of the baby’s mouth to hold the bottom part of the areola
• Baby is still hungry after a feed

Further, it could be you have an infection if you have been breastfeeding for a few months and suddenly developed pain. Research shows that 10% of breastfeeding mothers develop an infection.

What you can do during breastfeeding

You can ameliorate pain and nipple bleeding during breastfeeding by following these simple steps:

• Put a finger in your baby’s mouth to break the seal
• Reposition your child
• Ensure your nipple is deep in your baby’s mouth where the palate is softer

Note that latching on to the nipple only will cause damage to the breast. Therefore, ensure your baby fully latches on to the breast. Also, you w the nipple centered and deep in the mouth of your baby.

Further, it may be necessary to speak with a lactation specialist about effective techniques for proper latching. A lactation specialist may be available in the hospital where you gave birth.

You may want to join an online peer support group such as La Leche League’s support group. This enables you to interact with other breastfeeding mums and share experiences.

2. Broken or cracked skin

Skin conditions such as dry skin or contact dermatitis cause dryness and cracking and therefore can cause bleeding.

Dry skin may occur following exposure to heat and cold. For example, if you expose your nipples to hot water in the shower, you may have dry and cracked nipples. This may be made worse by tight-fitting clothing.

Other symptoms associated with skin exposure to heat and cold include: blisters, scaly skin, itchiness and rashes.

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

What you can do to prevent or manage broken or cracked skin

Try to find out and avoid what causes your nipple irritation. It is worthy of note that fragrance-free products are gentler on sensitive skin. Also, warm showers are better than hot showers.

If skin crack occurs, try to prevent infection. What you can do is clean the area with soap and water. Then apply an antibiotic ointment such as Neosporin until complete healing takes place. Try and see your doctor for treatment if the condition continues.

3. Nipple piercings or trauma

It takes two to four months for a newly pierced nipple to heal. During this time, the nipple may bleed. Also, infections may develop during or after this time, which may cause an abscess (a collection of pus) inside the nipple or areola. However, most nipple piercings are sterile procedures.

On the other hand, nipple trauma during rough nipple stimulation may introduce bacteria. This can happen especially when nipple clamps, bites or other sex toys break the skin. So, anything that breaks the skin around the nipples can cause nipple bleeding and infection.

If there is nipple infection, you can have the following symptoms:

• Redness and inflammation
• Painful or tender nipple
• A collection of pus (abscess) or abnormal discharge

What you can do to prevent infections due to nipple piercings and trauma

Ensure the area around the piercing or wound is clean. Wash the area with soap and warm water. You can use an antiseptic wash such as Bactine.

You can prevent or treat infection by soaking your piercing in a warm water and salt solution several times daily.

If you have severe pain or an abscess, speak with your doctor immediately. Your doctor will examine you to determine the next line of action. S/he could drain the wound and recommend some antibiotics.

4. Breast infection

Breast infection known as mastitis causes pain and redness. Mastitis is the most common breast infection in women who are breastfeeding. Often, mastitis occurs within three months of giving birth. However, mastitis can also happen to anyone.

It is important to note that mastitis does not cause nipple bleeding. In fact, it is nipple bleeding that causes mastitis. Damaged, cracked, bleeding nipples provide a nidus for bacterial infection which may lead to mastitis.

Breast engorgement can make mastitis worse when breastfeeding.

Symptoms of mastitis include:

• Breast redness
• Fever
• Chills and rigors
• Breast pain or tenderness
• Differential warmth
• Breast lump
• Pain while breastfeeding
• Flu-like feeling

How you can manage breast infection

Try to see your doctor if you suspect you have mastitis. Your doctor may prescribe oral antibiotics over 10 to 14 days to treat your condition. Most cases of mastitis are treated with oral antibiotics.

Though you should feel better within a few days of treatment, ensure you complete your treatment. Your doctor will prescribe antibiotics that are safe for breastfeeding. Therefore, breastfeeding should continue even as you take drugs for mastitis.

An abscess near the nipple should be drained. Your doctor may recommend that you take over-the-counter (OTC) pain relievers for your pain and fever. These drugs help reduce swelling. The most common and popular pain relievers include ibuprofen and naproxen.

5. Intraductal papilloma

One of the most common causes of bleeding nipples is intraductal papilloma. With intraductal papillomas, blood flows out of the nipple, similar to milk. However, they are noncancerous tumors growing inside the milk ducts.

Intraductal papilloma is wart-like and small. You can feel it behind or next to the nipple. It causes bleeding and discharge because it is usually close to the nipple.

Other possible symptoms of intraductal papillomas include:

• Pain or tenderness
• Clear, white nipple discharge
• Bloody nipple discharge

What you can do about intraductal papilloma

Try to see your doctor immediately you notice blood flowing directly out of your nipple. Your doctor will examine and diagnose your condition. Then s/he will advise you on the next steps. If it is intraductal papilloma that you have, your doctor may recommend surgical removal of the affected ducts.

6. Breast cancer

Though nipple discharge is regarded traditionally as a symptom of breast cancer, it is not a common symptom. A few women being treated for breast cancer have nipple discharge.

In fact, about 3 to 9% of the women for breast cancer treatment present with nipple discharge. In these cases, a breast lump is usually present. However, it is not clear if the nipple discharge is also bloody.

Research explored the connection between the color of nipple discharge and cancer severity. Also, one 2016 study revealed that blood-colored discharge may be linked to malignant breast cancers. However, more research should be done to confirm this claim.

Types of breast tumors

1. Intraductal carcinoma

Breast cancer type is determined by the specific area where it starts. Carcinomas are tumors that grow in tissues or organs throughout the body. Ductal carcinomas are tumors occurring inside the milk ducts.

Intraductal carcinoma is the most common type of noninvasive breast cancer. It is also called ductal carcinoma in situ. About one out of five new breast cancers are ductal carcinoma in situ (DCIS).

DCIS does not spread beyond the milk duct to the rest of the breast. So it is non-invasive. Note that though DCIS is considered pre-cancer because it could become invasive, it is unlikely.

DCIS is typically discovered during a mammogram, and usually does not cause symptoms.

2. Lobular carcinoma

Lobules are the breast glands responsible for milk production. Lobular carcinoma in situ is a type of pre-cancer tumor that does not spread beyond the breast lobules.

On the other hand, invasive lobular carcinoma is a cancer that has spread beyond the lobule. It can spread to the lymph nodes and other body parts. However, it is relatively rare.

Most invasive breast cancers do not begin in the glands. For example, about 8 in 10 invasive breast cancers start in the milk ducts, called invasive ductal carcinoma.

Early lobular carcinoma may cause few symptoms including:

• An area of swelling or fullness in the breast
• A newly inverted nipple
• A dimpling or thickening of the breast skin (change in the breast skin texture and appearance)
• A thickened area in the breast

3. Bleeding nipples due to Paget’s disease of the breast

Paget’s disease is a type of breast cancer that begins on the nipple and spreads to the areola. However, it is a rare type of breast cancer. Paget’s disease of the breast affects mostly women aged 50 years or older.

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

What are the symptoms of Paget’s disease? They include:

• Inverted nipple
• Flat nipple
• Scaly, crusted and red area and nipple
• Burning or itching nipple
• Bleeding nipple
• Yellow nipple discharge

How to treat breast cancers

Doctors take into consideration many factors before they recommend a particular treatment for breast cancer. The factors to consider include:

• The breast cancer type
• Cancer stage and grade
• Cancer size
• Sensitivity or not of the cancer cells to hormones

Surgical treatment options include lumpectomy (removal of breast lump) or mastectomy (removal of the entire breast). Many women choose to have surgical treatment for breast cancer. The doctor chooses between lumpectomy and mastectomy depending on the size and grade of the tumor.

In addition, doctors usually combine surgery with other treatments such as radiation, chemotherapy or hormone therapy. Some breast cancers in their early stages can be treated with radiation alone.

When do you see your doctor?

Try to make an appointment to visit your doctor if you have bloody nipple discharge lasting more than a day. Your doctor will run imaging tests including ultrasound, mammogram or MRI to look for abnormality inside the breast.

Also, try to talk to your doctor immediately you experience any of the following symptoms:

• A breast lump or bump
• Newly flat or inverted nipple
• Breast skin texture changes including dimpling
• Scaling, flaking, peeling or crusting of the areola
• Changes in the shape, appearance or size of the breast
• Pitting or redness of the breast skin

Damages to the skin on your breast including cracks or cuts do not necessarily require immediate treatment. However, if your symptoms fail to improve or if you feel signs of an infection, speak with your doctor.

Finally, the following are the signs of an infection you should watch out for:

• Pain or severe tenderness on the breast
• Breast redness
• Fever
• Chills and rigors
• Breast hot to the touch

Conclusion

It is evidently clear how bleeding nipples occur and what you can do to prevent and/or treat the underlying cause(s).

The hallmark of effective treatment of bleeding nipples is prompt medical intervention. So, be on the lookout for unusual symptoms in your breast and immediately report same if present to your doctor.

Finally, do not be alarmed if you experience bloody nipple discharge. Rather take action by calling your doctor whose duty it is to diagnose the cause and recommend appropriate treatment.

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