Rusty pipe syndrome in a 22-year-old primigravida at 26 weeks' gestation

Bloody Nipple Discharge Post Delivery: A Case of “Rusty Pipe Syndrome”

“…4) It is usually associated with nipple stretching exercises, such as Hoffman's procedure, which is often recommended for flat or inverted nipples. 4,5) However, in our case, the syringe technique was employed to treat the inverted nipple based on the guidelines of "session 12: breast and nipple conditions" by the World Health Organization and United Nations Children's Fund, and Baby-Friendly Hospital Initiative, 2009. 8) In addition, physical examination did not reveal any skin changes, nipple cracks or fissures, breast engorgement or lump, and fever.…”

“…2) Bloody nipple discharge during lactation occurs as a result of several factors such as cracked nipples, mastitis, trauma, or intraductal papilloma. 3,4) However, a rare physiological condition, known as "rusty-pipe syndrome", can cause painless bloody nipple discharge in pregnant and post-partum women. 2,3,5) Rusty pipe syndrome is a breastfeeding condition in which the color of the breast milk looks pink, orange, brown, or rust-colored, similar to dirty water coming out of an old rusty pipe, and hence, the name of the syndrome.…”

Rusty Pipe Syndrome, a Cause of Bloody Nipple Discharge: Case Report

“…The so-called ''rusty pipe syndrome'' is a self-limited entity associated with increased alveolar and ductal vascularization related to lactation onset, is usually painless and bilateral, and generally resolves within a few days. [3][4][5][6] It may happen during pregnancy, more often during the third trimester, when breast vascularity suffers significant increment. 5 Nipple manipulation should be discontinued, 3 but breastfeeding is safe.…”

“…2 Bloody or serosanguineous nipple discharge may also occur in some women during the onset of lactation. [2][3][4][5][6] Cracked nipples and trauma may be a cause, but pathological conditions like intraductal papilloma or fibrocystic disease should be excluded, especially before a persistent discharge. [2][3][4][5] Intraductal papilloma usually is associated with a spontaneous, painless, unilateral, and unicanalicular discharge.…”

“…[3][4][5][6] It may happen during pregnancy, more often during the third trimester, when breast vascularity suffers significant increment. 5 Nipple manipulation should be discontinued, 3 but breastfeeding is safe.…”