Nipple discharge

Overview

Nipple discharge is any fluid that leaks from one or both nipples. It can happen on its own or when you squeeze the nipple. Most cases are not serious and are caused by normal changes in the body.

Yes, nipple discharge is common, especially in women of childbearing age and during pregnancy or breastfeeding.

Nipple discharge can affect people of any age or gender, but it is most common in women. Men and children can also experience it, though this is less common.

Symptoms

Common symptoms

• Fluid leaking from one or both nipples on its own
• Fluid that comes out when you squeeze the nipple
• Discharge that is clear, milky, yellow, green, or brown
• Bloody or pink discharge

Symptoms in children

• Mild, clear, or milky discharge that usually goes away on its own
• Sometimes caused by touching or rubbing the nipple area

Symptoms in older adults

• Discharge may be related to hormone changes or certain medicines
• Bloody discharge or discharge from one breast only should be checked promptly

Causes

Main causes

• Hormonal changes (like during puberty, pregnancy, breastfeeding, or menopause)
• Certain medicines (such as antidepressants, blood pressure drugs, or hormonal therapies)
• Infection or inflammation in the breast (mastitis)
• Benign growths inside the milk ducts (such as a papilloma)
• An underactive thyroid or other hormone imbalances
• Breast cancer (rare, especially if discharge is only from one breast and is bloody)

Risk factors

• Being a woman of childbearing age
• Having given birth or breastfed recently
• Using certain medications
• Having a family history of breast cancer (for rare cancer causes)
• Having a condition that affects hormone levels, like polycystic ovary syndrome

When to see a doctor

See a doctor urgently if:

• Bloody discharge from one nipple
• Discharge that appears suddenly and is only from one breast
• A lump in the breast along with discharge
• Discharge that is sticky and has a foul smell (possible infection)

Book a routine appointment if:

• Mild, clear, or milky discharge from both nipples that has been present for a while
• Discharge that seems to come and go and does not worry you
• Discharge that started after starting a new medication

Diagnosis

Your doctor will ask about your symptoms and do a physical exam of your breasts and nipples. They may also check for any lumps or skin changes.

Tests that may be done

• Breast ultrasound (a painless scan that uses sound waves to look at breast tissue)
• Mammogram (an X-ray of the breast, especially if you are over 40 or have a lump)
• Ductography (a special X-ray of the milk ducts if discharge is from one duct)
• Blood tests (to check hormone levels or thyroid function)
• Swab of the discharge to check for infection or abnormal cells

What to expect at your appointment

The tests are usually quick and painless. If the discharge is caused by a benign (non-cancerous) condition, no further treatment may be needed. Your doctor will explain the results and discuss next steps with you.

Treatment

Treatment depends on the cause. Many cases need no treatment at all. If the discharge is bothersome or caused by an underlying problem, your doctor can suggest options to help.

Self-care at home

• Avoid squeezing or pressing the nipple to check for discharge, as this can make it worse
• Wear a supportive bra to reduce irritation
• Keep the nipple area clean and dry to prevent infection
• If you are breastfeeding, make sure your baby is latching well to prevent blocked ducts

Medical treatments

If the cause is an infection, your doctor may prescribe a course of antibiotics. For hormonal causes, adjusting or stopping certain medications (only under a doctor's guidance) can help. Sometimes a short course of medication to balance hormones is used. If a benign growth like a papilloma is found, it may be removed in a minor procedure.

When is surgery considered?

Surgery is rarely needed. It may be recommended if a benign growth inside a milk duct is causing symptoms and does not go away, or if the discharge is linked to a suspicious lump that needs removal.

Living with this condition

Nipple discharge is often harmless and does not affect daily life. If the discharge is persistent, you can wear a soft bra pad to absorb any moisture. Most people can continue their normal activities without worry.

Lifestyle tips

• Watch for any changes in the color, amount, or side of the discharge
• Keep a note of when the discharge happens and what you were doing
• Tell your doctor about any new medicines or health changes

Diet and exercise

There is no specific diet or exercise that affects nipple discharge. Eating a balanced diet and staying active is good for overall health.

Mental health and emotional wellbeing

Worrying about nipple discharge is natural, especially since it can be linked to breast cancer in rare cases. Most causes are harmless, but if you feel anxious, talking to your doctor can help ease your mind.

Prevention

Most cases of nipple discharge cannot be prevented, especially those caused by hormones. However, you can reduce the risk of infection by keeping the nipple area clean and avoiding irritation.

Vaccines

omit

Screening programmes

Routine breast self-awareness (knowing what is normal for your breasts) and regular breast cancer screening (such as mammograms) as recommended by your doctor can help detect rare serious causes early.

Complications

If left untreated

• If caused by an infection, it could lead to a breast abscess (a collection of pus) that may need draining
• Rarely, if the discharge is due to cancer and left untreated, the cancer can spread

Long-term outlook

For the vast majority of people, nipple discharge is a temporary and harmless condition. Even when it is caused by a benign growth or infection, treatment is usually simple and effective. In the rare case of cancer, early treatment gives the best chance of a good outcome. Your healthcare team will support you every step of the way.

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