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Initial assessment notes normal vital signs and no fever, lump, nipple cracks, or abnormal discharge; investigations including full blood count, milk analysis, and culture are normal. Questions address the most likely diagnosis and appropriate management, concluding with mastitis related to plugged ducts, trauma, and the need for prompt supportive care, effective milk removal, antibiotics, and analgesics.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/volume-16-clinical-quiz-mastitis-with-strawberry-coloured-breastmilk-question-and-answer/139246/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/volume-16-clinical-quiz-mastitis-with-strawberry-coloured-breastmilk-question-and-answer/139246.png","ImageObject",300,407,{"name":42,"@type":43},"Paura","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-23","2026-08-23",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",6,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the most likely diagnosis for a lactating mother with strawberry coloured breastmilk?","Question",{"text":63,"@type":64},"Mastitis of the left breast, initially starting as plugged ducts and progressing with trauma to breast capillaries from repeated pumping.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which management is most appropriate for this patient?",{"text":68,"@type":64},"Prescribe oral antibiotics, along with supportive counselling and effective milk removal; breastfeeding should be reinforced as safe for the infant.",{"name":70,"@type":61,"acceptedAnswer":71},"Why can blood appear in breast milk during lactation?",{"text":72,"@type":64},"Blood-stained milk can vary in color and may result from conditions such as rusty pipe syndrome, nipple and breast trauma, or intraductal papilloma; in this case, milk removal caused trauma after focal engorgement from blocked ducts.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},139246,1787515930,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,105,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},7,40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":106,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":30,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":80,"read_time":110},13056712833777,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Volume 16 Number 1, June 2017  \nClinical Quiz: The Strawberry Coloured Breastmilk  \nJamani NAa, Puteri Shanaz JKb  \naDepartment of Family Medicine, Kulliyyah of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200 Kuantan Pahang  \nbDepartment of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor  \nHISTORY  \nA 33 year-old Para 1 complained of strawberry coloured breastmilk for 1 day duration while expressing her breastmilk on the left breast at work. She has been exclusively breastfeeding for the past 6 months and never encountered such incident before. She also felt pain over the left breast. However, there was no lump, nipple crack,abnormal nipple discharges or fever prior to that. She expressed her breastmilk using a double mechanical electric breastpump about five times a day lasting from 10 to 20 mintues per sesion since she returned to work.  \nOn examination, her vital signs were normal and she was afebrile. Examination of the breasts revealed a lactating breast which were normal in size and shape. Her left breast showed a localized tenderness and was mildly swollen at the outer lower quadrant. No erythematous skin changes was noted. There was no palpable mass and no abnormal nipple discharges. A pink milk was seen when the nipple is expressed. The right breast and axillary region were normal.All investigations including full blood count, breast milk analysis, culture and sensitivity were normal.  \nFigure 1. Blood stained breast milk  \nCorresponding author: Nurjasmine Aida Jamani MD (UKM), M.Med (Fam Med) Department of Family Medicine, Kulliyyah of Medicine,  \nInternational Islamic University Malaysia, Jalan Sultan Ahmad Shah,  \n25200 Kuantan Pahang [Email: minaida@iium.edu.my](Email: minaida@iium.edu.my)  \nQuestion 1  \nWhat is the most likely diagnosis?  \nA. Breast abcess  \nB. Breast cancer  \nC. Intraductal papilloma  \nD. Mastitis  \nE. Rusty pipe syndrome  \nAnswer: D  \nQuestion 2  \nWhat is the most appropriate management for this patient?  \nA. Advice to stop expressing her breastmilk  \nB. Apply topical antibiotic  \nC. Prescribe oral antibiotic  \nD. Refer for mammogram  \nE. Refer for ultrasound of the breast  \nAnswer: C  \nDISCUSSION  \nBlood stained breastmilk is not uncommon but can be alarming to a nursing mother. Blood in breast milk can vary in appearance from pink, orange, red and brown. Blood stained breast milk can be due condition like rusty pipe syndrome, nipple and breast trauma, as well as intraductal papiloma.1 This patient is diagnosed to have mastitis of the left breast which intially started as plugged ducts evidenced by focal breast engorgement which, after repeated pumping, had caused trauma to the blood capilaries of the breast giving the appearance of pink milk. Lactation mastitis is an inflammatory condition of the breast which may or may not be accompanied by infection.  \nIt is a clinical diagnosis and investigations are not indicated in the initial assessment.2 It can be caused by blocked milk ducts causing milk stasis which is a potential medium for bacteria growth. Mastitis is classically characterized by unilateral or bilateral breast pain or tenderness, swelling and segmentalerythema.2 A painful, white, 1-mm bleb may also be present on the nipple, which is thought to be an overgrowth of epithelium or an accumulation of particulate or fatty material.3 However, the signs and symptoms of infectious mastitis are difficult to distinguish from non-infectious mastitis.2 Mastitis  \nVolume 16 Number 1, June 2017  \ncan give rise to blood, mucus and pus in the milk. It must be treated promptly and adequately in order to prevent breast abcess and relapse. The main principle of treatment of mastitis is supportive counselling, effective milk removal, antibiotic therapy and adequate analgesics.2 Breastfeeding should be reinforced and is safe for the infant.  \nREFERENCES  \n1. Mohrbacher N. Breastfeeding Answers Made Simple: A","cbCaieEmLKhCWZDT","https://ap.wps.com/l/cbCaieEmLKhCWZDT","pdf",211814,"English","# Clinical Quiz\n## Case Presentation\n## Questions and Answers\n## Discussion","[{\"question\":\"What is the most likely diagnosis for a lactating mother with strawberry coloured breastmilk?\",\"answer\":\"Mastitis of the left breast, initially starting as plugged ducts and progressing with trauma to breast capillaries from repeated pumping.\"},{\"question\":\"Which management is most appropriate for this patient?\",\"answer\":\"Prescribe oral antibiotics, along with supportive counselling and effective milk removal; breastfeeding should be reinforced as safe for the infant.\"},{\"question\":\"Why can blood appear in breast milk during lactation?\",\"answer\":\"Blood-stained milk can vary in color and may result from conditions such as rusty pipe syndrome, nipple and breast trauma, or intraductal papilloma; in this case, milk removal caused trauma after focal engorgement from blocked ducts.\"}]","Volume 16 - Clinical Quiz - Mastitis with Strawberry Coloured Breastmilk - Question and Answer | PDF"]