Episode 181     Rusty Pipe Syndrome

I thought it would be fun to talk about one of those”nice to know if it happens to you” breastfeeding issues. This may be well known amongst the Lactation Consultants community, but not so commonly known by the new mother.

Let’s start with one that I love talking about. Years ago, before there were many lactation consultants working in the hospitals, I use to get calls about Rusty Pipe Syndrome all the time.

You are already trying to visualize… a rusty pipe… and are thinking…. what do rusty pipes and breastfeeding have in common. Where is the link?

Interestingly enough, the name given for this syndrome is a perfect description. Let me explain.

Rusty pipe syndrome is a condition where the color of the breastmilk looks pink or orange or brown or rust colored. Almost looks like dirty water from an old rusty pipe. I keep getting a picture in my head of the garden hose in the backyard and all the rust around the edges of one end of it. I also picture in my minds eye a pipe that was coming that the garden hose attaches to. Can you picture that in your minds eye?

The first thing I want to get out right here is that while this might seem dangerous or scary or painful, it is none of the above.
Perhaps weird or gross or unbelievable might be other adjectives which I can appreciate, however, it is not dangerous for you or your baby and it is a temporary condition.

Okay, now that I have settled you down and you know that you don’t need to worry too much about this, now you can probably catch your breathe, open your eyes and hear the rest of the rusty pipe syndrome story.

This rusty color that you can see when you pump or hand express comes from a small amount of blood that mixes with the colostrum ( which is another name for the early breastmilk you are making. This happens more in first time moms and tends to happen in the very early first few days of breastfeeding. Which is exactly why I would get phone calls from my RN friends who worked in pp and labor and delivery.

They are likely to see this with moms who are removing the milk via hand expression or pumping. It often appears to be worse when pumping because you see this blood tinged milk dripping or spraying into the very bottle that is now looking like a pool of watery blood and while you were planning on feeding this to your baby, you are now thinking how quickly you can dump this milk. You are also starting to get anxious thinking there is something gravely wrong. NO, don’t dump your milk and No, nothing is gravely wrong. If rusty pipe syndrome is causing this, you are in the clear and this milk is fine to feed your baby. It is also common to see this rusty colored looking milk when a newborn spits up. Now I think we can all appreciate why people who don’t know about this would freak out at the site of your baby spitting up blood.

Let me explain to you why this happens. Once you have a better understanding about rusty pipe syndrome, you will have a greater comfort level if this should happen to you.

For right now, I will give you a brief overview which can easily lead us into our current discussion about rusty pipe syndrome.

Your breast, your beautiful mammary gland, goes through an amazing transformation during pregnancy. You may have felt and observed common changes – tender, swollen, darkened nipples and areolas, which is seen as the circle of skin around your nipple. There are four hormones working in harmony that help your breasts make milk and the delivering of the milk to your baby. – estrogen, progesterone, prolactin and oxytocin. You also have an intricate network of cells and ducts that grow in number and size during pregnancy.

When you are pregnant, there is an increase of blood flow to your breasts as the ducts and glands that produce milk grow and develop. Inside this whole intricate network are ducts branching off and eventually we come to what is called a lobe. Very simply put, I like to think of all this as many straws in your breast, that all lead to the nipple opening, where the milk flows through. Interestingly enough, your milk supply has proteins and sugars and fats which come directly from your blood supply. Some of this blood stays in the ducts and eventually presents itself during the early days of breastfeeding.

I like for you to know that your milk comes from your blood supply. Of course, there are many more nutrients in your breast milk however, when you know that your milk comes from your blood supply, this gives you the confidence that your milk is all good and you will never dump your milk. It is totally safe for your baby. This actually happens more than you will know. Think about it. When your baby is latched on and getting milk directly from the source, you do not get to see what color it looks like? Or judge how much fat is in your milk. Or check the volume. You only get to see this when you pump or hand express.

This milk is totally safe for your baby so do not throw it out. I have had so many calls from RNs who have told me that they threw it out, and called me later to ask me what this was all about and what can they tell the moms? Or moms who were told that their breast milk is bad. The only thing that is bad about that? Is they threw away their precious colostrum and some have even replaced it with formula? Since this can last for a few days or more, some babies are given a lot of formula when it truly was unnecessary.

Well, you don’t know, what you don’t know. However, now that I have enlightened you, save your milk for your baby.

Rusty Pipe Syndrome –

What can you do about it? Not much except to be aware that this sometimes happens. If you realize that the blood in your milk is from RPS, and your baby has been checked out to be medically fine and you are sure there are no other medical issues,

Do not be concerned if your babies bowel movements are darker than expected.

Do not be concerned if your baby spits up some blood. Both are fairly normal.

If not RPS, what else could this be?

Nipple or breast trauma from a baby or a pump and rusty pipe syndrome are the first things I would consider if you notice
blood coming from your breasts. There are a few other reasons, which are the least likely in a newly postpartum breastfeeding
mother, however I will mention them here.

Breast Cancer is the “go to” for many, however, this is the least likely reason.

Small growths called papillomas also can cause blood to enter your breastmilk.

If what you believe to be is Rusty Pipe Syndrome and you were told it is Rusty Pipe Syndrome and it is not gone by the time your baby is 2 weeks old, you will want to discuss this with your physician.