Bleeding from the nipple in infancy: a reason for alarm?

Abstract

Thelorrhagia is a rare entity in children. For this reason and for its association with tumour pathology in adults, it is usually a cause of concern. Its most common cause is mammary duct ectasia, although we must rule out other pathologies, such as mastitis, hormonal disorders, and tumours and cysts of the mammary gland.
We report the case of a one-month-old girl, who attends consultation after having small intermittent bleeding from the right nipple. The physical examination revealed the presence of a bloody discharge when we pressed this breast, showing no hypertrophy of the gland or any palpable nodules. In view of the exploration and the results of additional tests which did not suggest the presence of any mali nant process, we adopted an expectant attitude. After a few days, thelorrhagia spontaneously disappeared and the girl became asymptomatic.
It is important to note that most diseases that result in childhood thelorrhagia are mild and self-limited. We must therefore avoid performing unnecessary diagnostic and therapeutic procedures.