Bleeding Nipple: Causes And When To See A Doctor

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Medical News TodaySubscribeWhat to know about bleeding nipples

Medically reviewed by Meredith Wallis, MS, APRN, CNM, IBCLC — Written by Adrienne Stinson — Updated on May 20, 2024

Nursing conditions
Thrush
Mastitis
Non-nursing conditions
Cancer
Paget's disease
Contacting a doctor
FAQs
Summary

Causes of bleeding nipples vary, including nursing, infection, or irritation. While it is more common in females, males can also experience bleeding nipples.

Some causes of bleeding nipples relate to nursing 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 accompany them. We also consider when a person should see a doctor and what treatment approaches may be available.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Learn more.

Nursing conditions

Nursing is a common cause of nipple pain. Some people experience severe irritation when nursing, which can sometimes result in bleeding nipples.

Not all nipple pain occurs immediately after giving birth. One older 2015 study found that over one-third of people were still having difficulties with nipple pain at 2 weeks and 1 month after birth.

Despite being a common problem for people who nurse, there is a lack of research into treatments for nipple pain as a result of nursing.

Some experts believe that nipple pain occurs as a result of poor positioning during nursing 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 breast pain in 65% of cases.

However, researchers still need to do more investigations into how positioning affects nipple pain.

Nipple pain while nursing can also occur due to the following:

flat or inverted nipples
friction-causing or overly strong nursing from the baby
differences in the baby’s mouth, such as palatal anomalies including ankyloglossia, or tongue tie
milk blisters
infections
psoriasis
dermatitis
Raynaud’s phenomenon

Where friction causes nipple pain, applying vitamin A ointment or highly purified anhydrous lanolin may alleviate the pain.

The same study highlights that lying down while nursing a baby with palatal anomalies, such as cleft palate, might be beneficial. However, scientists need to carry out more studies, as the researchers only found this indication in one case.

Learn more about nursing.

Thrush

Thrush, or oral candida infection, is an oral infection that some infants might transfer to people via nursing. It is an oral fungal infection in infants, making it a potential problem for people who nurse. Nipple thrush is not nearly as common as people used to think. When a person does have nipple thrush, it can cause severe nipple irritation and possibly bleeding nipples.

Babies that have an oral candida infection will typically have white patches in their mouth and a thick white coating on the tongue that does not rub off easily.

A person with nipple thrush can experience symptoms, such as:

severe, burning nipple pain
shiny or flaking skin on the nipple or areola
sharp pains in the breast
painful breast without lumps

Treatment for a thrush infection includes practicing proper hygiene, changing the diet to reduce sugars and refined carbohydrates, and eating a variety of vegetables and nutrients. In some cases, a lactation specialist or doctor may recommend antifungal medication.

Learn more about thrush.

Mastitis

Mastitis is inflammation in the breast milk ducts, usually caused by an infection. Mastitis is most common in people who are nursing, but it can occur in those who are not nursing.

Risk factors include:

obesity
diabetes
smoking
having given birth recently

Treating mastitis in people who are nursing may involve:

treatments to drain the breast, such as continued nursing
antibiotics
painkillers, such as ibuprofen
applying warm compresses before and after feeding
resting and avoiding stress
changing feeding positions

Learn more about mastitis.

Non-nursing conditions

Sometimes, problems with the milk ducts cause bleeding nipples.

Conditions include:

Duct ectasia

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 people who are entering menopause.

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

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.

Many forms of dermatitis fall under the category of eczema. Nipple eczema most often occurs in people with a history of eczema, but nursing mothers can also develop this condition.

Learn more about ways to treat eczema here.

Intraductal papilloma

These harmless tumors found in the breast milk ducts are a common cause of bleeding from one or both nipples.

Often, intraductal papilloma appears as either one lump near the nipple or several smaller lumps spread across the breast.

These tumors can appear in people of any age but are most common in people ages 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

Cancer

While uncommon if bleeding nipples are the only symptom, sometimes bleeding nipples can be a symptom of cancer.

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

Paget’s disease

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 to 4% of breast cancer cases.

If a doctor suspects that a person has Paget’s disease, they will order a biopsy.

Learn more about Paget’s disease.

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.

Frequently asked questions

Here are some frequently asked questions about bleeding nipples.

Should I still nurse if my nipples are bleeding?

While possibly uncomfortable, it is generally safe to continue nursing a baby with bleeding nipples. It is important to get help as soon as possible if nipples are sore and bleeding while nursing, to assess and correct the underlying problem and to avoid complications such as infections. A lactation consultant or nursing counselor may be able to help. They might recommend taking time off to rest the breast and feed the baby expressed breast milk instead.

How long does it take for bleeding nipples to heal?

Cracked or bleeding nipples may take a few days, or possibly a few weeks to heal.

Why am I leaking blood from my nipples when pregnant?

Leaking discharge from nipples during pregnancy is common. However, if the discharge contains blood, speak to a midwife or doctor. Rusty pipe syndrome is a condition in which many pregnant or post-partum people leak bloody nipple discharge, and it is a rare but harmless phenomenon.

Why do my nipples leak before my period?

Hormonal times, such as before a period, can lead to nipple discharge. The causes are usually nothing serious and are mainly a product of hormone changes. However, if it continues and causes concern, speak with a doctor.

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Summary

A few different underlying conditions can cause bleeding nipples. These include nursing, irritation, allergy, infection, and tumors.

If nursing causes bleeding nipples, try to find a way to improve the baby’s latch and seek support from a lactation consultant, midwife, or 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.

Dermatology
Blood / Hematology
Pain / Anesthetics
Women's Health / Gynecology

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Medically reviewed by Meredith Wallis, MS, APRN, CNM, IBCLC — Written by Adrienne Stinson — Updated on May 20, 2024

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