What to know about bleeding nipples
Some causes of bleeding nipples relate to breastfeeding or the milk ducts. Other causes include irritation, infection, and less frequently, specific diseases.
In this article, we examine several causes of bleeding nipples and the symptoms that may occur alongside them. We also look at when a person should see a doctor, and what treatment approaches may be available.
Breastfeeding can result in bleeding nipples.
Breastfeeding is a common cause of nipple pain. Some women experience severe irritation when breastfeeding, which can sometimes result in bleeding nipples.
Not all nipple pain occurs immediately after giving birth. One study found that over one-third of women were still having difficulties with nipple pain at 2 weeks and 1 month after birth.
Despite being a common problem for people who breastfeed, there is a lack of research into treatments for nipple pain as a result of breastfeeding.
Some experts believe that nipple pain occurs as a result of poor positioning during breastfeeding or babies latching incorrectly to the nipple. One study indicated that teaching babies between 4 days and 12 months old how to latch correctly stopped the breast pain in 65% of cases.
However, researchers still need to do more investigations into how positioning affects nipple pain.
Nipple pain while breastfeeding can also occur due to the following:
- flat or inverted nipples
- friction-causing or overly strong sucking from the baby
- differences in the baby's mouth, such as palatal anomalies including ankyloglossia, or tongue tie
- milk blisters
- Raynaud's phenomenon
Where friction causes nipple pain, applying vitamin A ointment or highly-purified anhydrous lanolin may alleviate the pain.
One small study highlights that it might be beneficial to lie down when breastfeeding a baby with palatal anomalies, such as cleft palate. However, scientists need to carry out more studies, as the researchers only found this indication in one case.
Thrush, or oral candida infection, is an oral infection that some infants might transfer to people via breastfeeding. It is the most common oral fungal infection in infants, making it a widespread problem for people who breastfeed. Severe irritation could result in bleeding nipples.
Babies that have an oral candida infection will have white patches and painful, shiny red patches in their mouth.
A person with nipple thrush can experience symptoms, such as:
- severe, burning nipple pain
- flaking nipple or areola skin
- sharp pains in the breast
- painful breast without lumps
Treatment for a thrush infection includes practicing proper hygiene, changing the diet to eliminate sugars and refined carbohydrates that feed candida infections, and eating a variety of vegetables and nutrients. In some cases, a doctor may prescribe medication.
Mastitis is an infection caused by ectasia, or the widening of the breast milk ducts. Mastitis is most common in women who are breastfeeding, but it can occur in women who are not breastfeeding and also in men.
Risk factors include:
Treating mastitis in women who are breastfeeding may involve:
- treatments to drain the breast, such as continued breastfeeding
- painkillers, such as ibuprofen
- applying warm compresses before and after feeding
- resting and avoiding stress
- changing feeding positions
Non breastfeeding conditions
Sometimes, problems with the milk ducts cause bleeding nipples.
Duct ectasia is most common in women in their late 40s and 50s.
Ectasia is a noncancerous condition that occurs when the breast milk ducts become wider. Milk ducts sometimes become blocked, and this can lead to infection.
Ectasia is most common in women in their late 40s and 50s.
Other potential symptoms include:
- tender or painful breasts
- nipples that go inward
- sticky nipple discharge
- a lump behind the nipple
- an abscess or fistula
People can sometimes treat ectasia with warm compresses. Ectasia can also occur due to an infection, such as mastitis. If this is the cause, a doctor may prescribe antibiotics.
Dermatitis can also cause bleeding nipples. This refers to inflammation of the skin. Dermatitis may appear as an itchy, scaly, red rash on either the nipple or the darker area surrounding the nipple, the areola.
Irritation, infection, or allergy can also cause dermatitis.
Objects that can trigger dermatitis include irritating fabrics, detergents, and soaps. Avoiding scented products and choosing hypoallergenic products without chemicals, perfumes, and dyes can help prevent symptoms of nipple dermatitis.
These harmless tumors found in the breast milk ducts are a common cause of bleeding from one or both nipples.
Often, intraductal papilloma will appear as either one lump near the nipple or several smaller lumps spread out across the breast.
These tumors can appear in people of any age but are most common in women aged between 35 and 55 years old. They can also occur in men but are much less common.
Intraductal tumors are more likely to develop according to individual risk factors, such as:
- contraceptive use
- hormone therapy
- estrogen exposure
- family history of breast tumors
Bleeding nipples can be a symptom of cancer, but they are rarely the only symptom.
Other symptoms that might suggest cancer include:
- a lump occurring alongside discharge
- nipple discharge that does not improve with hygiene and cleanliness measures
- breast pain
- swelling of some or all of the breast
A rare condition associated with breast cancer, Paget's disease has symptoms that are similar to eczema or psoriasis. A red, scaly rash will appear on the nipple, and bleeding may occur. The nipple may be sore and can become scabby. This condition appears in 1–4% of breast cancer cases.
If a doctor suspects that a person has Paget's disease, they will order a biopsy.
When to see a doctor
Anyone experiencing new symptoms should see a doctor, particularly if they come on quickly. When a person has bleeding nipples, they should see a doctor, especially if the symptoms are painful or if they have other symptoms, such as a lump in the breast. While lumps are not usually serious, it is important to see a doctor for an examination.
A few different underlying conditions can cause bleeding nipples. These include breastfeeding, irritation, allergy, infection, and tumors.
If breastfeeding causes bleeding nipples, try to find a way to improve latching or speak to a doctor.
If an allergy is causing the problem, a doctor may recommend a steroid cream. In the case of an infection, doctors typically prescribe antibiotics.