Speaking of nipple outflow, we all know that after the birth of a baby new mother, milk secretion is normal, but if there is milk secretion during the non-breastfeeding period is normal? Or is it normal for milk to flow from the nipples during breastfeeding? Today we talk about “nipple overflow”. The literal meaning of nipple overflow is nipple water, this water can be milk-like, watery, bloody, plasma, and pus, etc., and the color can be milky white, yellowish, brown, bright red, dark red, coffee, black, green, colorless, etc. There may be water from one milk duct or multiple milk ducts, and there may be water from one nipple or both nipples. How can you tell if nipple discharge is normal? How can you tell if nipple overflow needs to be treated? Let’s start with the overflowing breast, including physiological, secondary and pathological. Physiological overflow, in most cases, occurs bilaterally at the same time: 1, a small amount of milk in some newborns; 2, a small amount of milk is secreted during the first menstrual period and menopause; 3, a small amount of colorless liquid or milk is secreted when squeezing the breasts during late pregnancy; 4, milk is secreted during breastfeeding; 5, milk can flow out after stimulating the breasts after weaning, which is because some women think they should not have milk after weaning or This is due to the fact that some women think that they should not have milk after weaning or that the so-called “discharge of residual milk” is a constant stimulus to the breasts. Therefore, it is recommended that mothers do not stimulate their breasts, especially their nipples, after weaning, and most of them do not stimulate their nipples for six months to one year after weaning. Secondary breast overflow is mostly caused by drugs, and in most cases, it occurs bilaterally at the same time: taking some drugs can cause breast overflow, such as: certain oral contraceptives (contraceptives contain estrogen and progesterone, and the inhibition of the hypothalamus causes increased prolactin secretion), anti-hypertensive drugs, sedative drugs (phenothiazine-like complexes, reserpine derivatives, amphetamines and opioids, valium, tricyclic antidepressants, etc. can cause breast overflow by inhibiting the hypothalamus (and cause overflow), domperidone, metoclopramide, etc. Generally, in this case, the symptoms will disappear automatically after changing the medication or stopping it. Of course, it is important to follow the advice of a medical professional on how to change or stop the medication. Pathological overflow is mostly caused by pituitary lesions, and in most cases it occurs bilaterally: when the pituitary gland has a tumor or pituitary gland hyperplasia, it is often accompanied by an increase in serum prolactin levels. In this case, a breast specialist should give a reasonable recommendation: a blood test for prolactin or an MRI of the pituitary gland to give a treatment plan based on the test. Other factors: thyroid-adrenal pathology (hypothyroidism, chronic kidney disease, hyperalgesia, chronic renal failure) chest wall pathology (chest scars, trauma, surgery, cervical spondylosis and cervicothoracic herpes zoster, long-term and high-intensity sucking stimulation of the nipple, etc. via the neurological reflex leading to increased prolactin overflow) What diseases are likely to cause nipple overflow? The overflow caused by dilated milk ducts depends on whether the milk ducts are open or not, whether there is bacterial infection or not, and other factors that determine the amount, color, nature and odor of the overflow. Nipple indentation is a common cause of dilated milk ducts, and the overflow can be milky white toothpaste or red and bloody. It is necessary to consult a breast specialist for reasonable advice: breast ultrasound, correction of nipple depression, milk duct irrigation, anti-infection treatment or a combination of Chinese and Western medicine. This kind of overflow is almost never bloody, but is mostly clear and yellowish, clear water, light milk-like, etc. Sometimes the symptoms will disappear after adjusting emotions, lifestyle or after some time, but it is still recommended that the doctor decide whether to perform breast ultrasound, lactoscopy or medication intervention. The overflow caused by intraductal papilloma is determined by the location of the tumor, whether it is in both breasts or in a single breast, or in one or more ducts, and the amount, color and nature of the overflow are also very variable: the breast is like an orange, and the duct is similar to the orange petal. The papilloma is a seed that grows in the orange flap, either in one flap or in several flaps. When such a “seed” appears in the milk ducts, it needs to be removed because it can cause nipple discharge or even cancer in the breast. This requires specialized breast examination (breast ultrasound, ductoscopy, nipple smear, mammography, etc.) or surgery by a breast specialist. Hemorrhagic discharge is a red flag! The main cause of hemorrhagic discharge is intraductal papilloma, which is a benign lesion but has a 10%-30% chance of becoming malignant, so surgery is required in most cases. The color of the overflow is related to the length of time the bleeding remains in the milk ducts – the longer the bleeding remains in the milk ducts, the darker or even blacker the overflow; the shorter the bleeding remains in the milk ducts, the brighter the color of the overflow; and the lighter the color when the bleeding is small and mixed with other overflows. The amount of blood spill is related to the size and depth of the tumor in the duct, sometimes it is bloody, sometimes mucus, sometimes more, sometimes less, sometimes continuous, sometimes even no spill at all, and patients often find blood or fluid stains in their underwear by chance and go to the doctor.