Blood-Stained Colostrum: A Rare Phenomenon at an Early Lactation Stage

Abstract

The phenomenon described in the literature as rusty pipe syndrome is a rare condition (the estimated incidence is 0.1% in the population of breastfeeding women) where the prenatal milk and the colostrum are rust- or blood-colored. Due to the rare occurrence of this phenomenon and the related nature of the baby’s regurgitated discharge—green, brown or blood-stained, there is a general fear of latching a newborn or continuing to breastfeed if the regurgitation persists. In this care report, a patient’s milk was tested to determine its microbiological and morphological content. No significant abnormalities were noted in these tests. The nutritional profile of the blood-stained colostrum was normal. Breast milk has an indisputably invaluable impact on the newborn’s further development and there is no connection between rusty pipe syndrome, as described in the literature, and any clinical complications. This is crucial to encourage mothers to keep breastfeeding even if they observe blood-stained colostrum.

Grossly Bloody Colostrum—The Need for Staff Education and Maternal Support

“…Case reports already published on "rusty pipe syndrome", as well as our own experience, indicate a persistent fear or concerns among mothers and medical personnel regarding feeding the newborn with blood-stained colostrum [31][32][33][34][35][36]. A bloody colostrum composition analysis performed by Wszołek et al [35] proved that the qualitative value of such milk was not changed.…”

“…Case reports already published on "rusty pipe syndrome", as well as our own experience, indicate a persistent fear or concerns among mothers and medical personnel regarding feeding the newborn with blood-stained colostrum [31][32][33][34][35][36]. A bloody colostrum composition analysis performed by Wszołek et al [35] proved that the qualitative value of such milk was not changed. Taking into consideration colostrum values, even a short break in breastfeeding for no clear reason may be harmful for a newborn baby and is hazardous for the undisturbed lactation process [17,[35][36][37][38].…”

Rusty pipe syndrome: a case report and review of the literature

“…To date, only 16 cases diagnosed with RPS have been reported (including one in this paper) [ 3 – 16 ]. A review of RPS cases including clinical manifestations and auxiliary examinations are summarized in Table 1 .…”

“…The presence of RPS would not have a poor prognosis for neonates either. The results of the current follow-up show that breastfed babies are free from diseases such as growth retardation and breast milk intolerance [ 3 , 5 , 13 ]. Early diagnosis of this rare, self-limiting disease by obstetricians or neonatologists, followed by telling the mother that her infant would be unaffected by the small quantity of blood consumed, would be extremely beneficial in avoiding unneeded examinations and the discontinuation of exclusive breastfeeding.…”

“…Rusty pipe syndrome (RPS) is a benign physiological condition that occurs in primiparous women. RPS typically presents with brown or bloody milk mimicking flowing water from a rusty pipe; it is usually bilateral, painless, and self-limiting [ 3 ]. Most cases will clear within seven days without any medical treatment [ 4 – 16 ].…”