Gynecology And Obstetrics-

Pus from the nipple

Definition - What is pus from the nipple?

Pus is a yellowish to greenish, thin or viscous secretion, which is usually an indication of a bacterial infection. If the chest is inflamed (mastitis) or the nipple there may be a discharge of pus from the nipple, this discharge can occur on one or both sides. It affects women who are breastfeeding as well as young women or women after menopause. Purulent discharge must be differentiated from bloody and milky discharge; all forms can also occur in women who do not breastfeed. A doctor should always be consulted if the discharge is purulent or bloody.

causes

First of all, a purulent secretion of the nipple must be accompanied by a milky secretion (Galactorrhea) are delimited. Depending on the nature of the secretion, this is not necessarily obvious. A common cause of purulent secretions from one or both nipples is inflammation of the mammary gland. This often occurs in the puerperium of breastfeeding women. Here, a milk blockage leads to bacterial inflammation of the mammary gland and the nipple.

Read more on the topic: Milk congestion - what can you do? Weaning - what is the best way to do it?

Inflammation of the breast can also affect non-breastfeeding women of all ages, and smokers are particularly likely to suffer from this painful inflammation. In the case of an inflammation of the mammary gland, in addition to the purulent discharge, reddening, swelling and tension pain in the chest occur, triggered by bacteria such as staphylococci. Injuries to the nipple caused by the child's teeth while breastfeeding or, for example, piercings can lead to the ingress of pathogens and a purulent discharge from the nipple.

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Other causes of secretion from the nipple, which are often difficult to distinguish from pus on the outside, are benign and malignant changes in the breast (breast cancer should always be excluded, especially with unilateral secretion).

Read more on the topic: Symptoms of breast cancer

Breastfeeding

When breastfeeding, e.g. Suboptimal application through the smallest cracks in the skin on the nipple allows bacteria from the child's oral flora or the mother's skin to penetrate. The sore nipples can easily become inflamed, in the worst case it can lead to an encapsulated accumulation of pus (abscess) come in the nipple area.

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Aided by micro-injuries during breastfeeding and milk congestion if the mammary gland is not completely emptied, it can also lead to inflammation of the breast during the puerperium (Puerperal mastitis). Here too, staphylococci are the most common pathogens. In both cases, the therapy is antibiotic and pain medication such as ibuprofen. An abscess usually has to be relieved surgically.

More information can be found here: Inflammation of the mammary gland while breastfeeding

Weaning is usually not necessary, as there is no risk of infection for the child (these are mainly germs that can also be found in the oral flora of a healthy baby).

Read more on the topic: Chest pain in pregnancy

With the man

Inflammation of the nipple in men is generally much less common than in women, but can have similar causes (such as piercings or the rare inflammation of the mammary gland in men). Benign and malignant tumors of the male breast are also conceivable (albeit rare) and should be excluded, especially in the case of unilateral secretion. A milky discharge is also to be distinguished from a purulent discharge in men. This can be caused by various hormonal disorders and then usually affects both nipples.

Read more on the topic:

Lump in the man's chest
Chest pain in men
How do you recognize breast cancer in men?

diagnosis

The doctor usually makes the diagnosis of a purulent discharge from the nipple as a visual diagnosis. The underlying cause, such as inflammation of the mammary gland or infection of the nipple, can usually be determined without extensive diagnostics. In some cases, a smear test can help determine the exact bacterial species and antibiotics that may be used. In the event of inflammation, parameters such as leukocytes or CRP can be determined in the laboratory. Ultrasound or other imaging diagnostics (MRI, mammography) are used to detect complications such as abscesses or to exclude suspected tumors.

Concomitant symptoms

Since a purulent secretion is an indication of bacterial inflammation, there are usually other signs of inflammation in addition to the purulent discharge. If the nipple is inflamed, it appears red and swollen and can be very painful. Often small cracks are visible in the skin through which the causative bacteria can penetrate and thus trigger an infection. In the case of inflammation of the entire mammary gland, reddening and painful swelling of the breast occurs on one or both sides. Furthermore, the axillary lymph nodes can be painfully swollen and a fever can occur. The breast is overheated and, if an abscess forms, may have localized and fluctuating swelling.

Treatment / therapy

If the secretion of pus from the nipple is caused by inflammation of the nipple, this should be treated with disinfecting poultices or ointments in combination with antibiotics. In the case of breastfeeding women, the breastfeeding technique can also be optimized in order to minimize the mechanical stress during breastfeeding. Pain relieving drugs such as ibuprofen are also used.

Read more on the topic: Homeopathy for breast inflammation, painkillers for breastfeeding

It is similar with the therapy of an inflammation of the mammary gland, the main components of which are also pain relief and antibiotic therapy. In most cases, weaning is not necessary (see below). On the contrary, especially in the case of inflammation of the mammary gland, the breast should be emptied regularly and completely, since a blocked milk has a predisposing effect to an inflammation. This can also be made possible through temporary pumping.

Read more on the topic: Problems during breastfeeding for the mother, problems during breastfeeding for the child

If there are complications such as a breast abscess, minor surgery may be necessary.

Can I still breastfeed?

In general, if the nipple or mammary gland is inflamed, which is accompanied by purulent secretion, it is not necessary to wean. The infection is usually triggered by bacteria, which are also found in healthy infants as part of the natural oral flora. In addition, the mother can be given pain-relieving and antibiotic medication that the baby can also tolerate.

Read more on the topic: Medication during lactation, behavior during lactation

However, these recommendations must be viewed individually and discussed with the treating doctor, as e.g. other recommendations may apply to premature babies or children with chronic diseases. In this case it may be necessary to express the milk and discard it. After the infection has subsided, breastfeeding can continue, so weaning is rarely necessary and recommended.

Learn more about the topic at: First aid for wounds

Duration

The duration of a purulent discharge from the nipple depends on the cause. Purulent inflammation of the nipple or mammary gland is usually due to an infection with staphylococci. The treatment is antibiotic, below which there should be a clear improvement within 3 to 5 days. If antibiotic therapy does not respond, other diagnoses should be considered; an abscess usually has to be relieved surgically.

If the discharge is resistant to therapy, benign and malignant breast tumors should also be excluded.

Additional information