Nipple discharge, abnormal

Considerations:
The likelihood of nipple discharge increases with age and number of pregnancies.

While nipple discharge is rare in men, and in women who have never been pregnant , it does occur; and when it does, it is more likely to be caused by some underlying disease (particularly when accompanied by other changes in the breast(s).

It is relatively common in women who have had at least one pregnancy. A thin, yellowish, or milky discharge (colostrum) is normal in the final weeks of pregnancy .

The nature of the discharge can range in color, consistency and composition and may occur on one side or both sides.

Witches' milk is a term used to describe nipple discharge in a newborn. The discharge is a temporary response to the increased levels of maternal hormones. Witches' milk should disappear within 2 weeks as hormone levels dissipate in the newborn.

Common Causes:
  • breast abscess (most common in lactating women)
  • trauma can cause discharge from both breasts
  • drugs such as cimetidine, methyldopa, metoclopramide, oral contraceptives, phenothiazines, reserpine, tricyclic antidepressants, or verapamil
  • prolactinoma

Note: There may be other causes of a nipple discharge. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for a nipple discharge, occurring alone or in combination with other problems.

Home Care:
Follow provider-prescribed therapy.

Call Your Healthcare Provider If:

  • there is any abnormal nipple discharge.



What to Expect:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting a nipple discharge in detail may include:

  • Are you pregnant ?
  • Are you breast feeding?
  • What type of drainage is there?
    • Does it look like milk (even though you are not breast feeding)?
    • Does it look bloody?
    • Does it look like pus?

  • Is the drainage from both breasts?
  • How much drainage is there?
    • Enough to stain the lining of the bra?
    • Enough to soak through the bra?
    • Does the discharge occur spontaneously, or only when expressed?

  • Do you perform breast self-exam? How often?
  • What medications do you take?
  • What other symptoms are also present? Especially, is there:

The physical examination will include examination of the breasts for lumps or other abnormality.

Diagnostic tests that may be performed include:

After seeing your health care provider:
You may want to add a diagnosis related to a nipple discharge to your personal medical record.


This illustration shows an anatomical cross-section, both side and front views, of the female breast.