Nipple discharge can occur both in men and women, but more common in women. When the nipple discharge occurs in young males, it usually due to duct ectasia. Witch’s milk is the term used for nipple discharge in a new born; it is temporary response to the increased levels of maternal hormones.

Normal nipple discharge more commonly occurs in both nipples and is often released when nipples are compressed or squeezed. Repeated squeezing will increase the discharge.

Clinically significant nipple discharge are the spontaneous, persistent and nonlactational secretion of fluid. Non clinical significant discharge occurs in women who are taking oral contraceptives.

Causes for normal nipple discharge

Pregnancy: In the early stages of pregnancy, some notice clear discharge coming from nipples. At the later stages of pregnancy the discharge will be watery, milky appearance.

Stopping of breast feeding: Even after stopping breast feeding your child, may notice milk like discharge for a while.

Stimulation: Nipple may secret fluid if it is stimulated or squeezed. It can also occur it it repeatedly chafed by the bra or during exercises like jogging.

Causes of abnormal nipple discharges

1. Fibrocystic breast changes: In this there may be clear, white, yellow or green nipple discharge.
2. Infection: Nipple discharge containing the pus may indicate an infection in the breast. It is also called as mastitis. It is seen mainly in woman who is breast feeding. Breast will be sore, red or warm to touch.
3. Mammary duct ectasia: It mainly occurs in menopausal woman. It results in thick, greenish discharge.
4. Breast cancer
5. Galactorrhea: It is a condition in which the breast secrets milk or milky nipple discharge even though she is not breast feeding.

• Certain medications like hormone and psychotropic drugs.
• Some herbs like anise, fennel.
• Pituitary gland tumors.
• Hypothyroidism.
• Illegal drugs like marijuana.

     Unilateral nipple discharge occurs in cancer, infection, cysts, benign growth, and duct ectasia.

     Bilateral nipple discharge occurs in galactorrhea, contraception or estrogen administration.

Diagnosis

• Laboratory analysis of the discharge.
• Blood tests.
• Mammogram and/or ultrasound of one or both breasts.
• A brain scan.
• Surgical excision and analysis of one or more ducts in the nipple.

If you have nipple discharge check for following things

• What is the color of the nipple?
• Are you pregnant?
• How much discharge is there?
• Does it happen in one or both breasts?
• Does the discharge appear to come from one opening in your nipple or multiple openings?
• Is the discharge spontaneous or does it happens only when you squeeze your nipple?
• Have you recently had any injury to the chest?
• What medications do you take?

Treatment:  Two drugs have been used are dopamine agonists cabergoline andbromocriptine.