"Rusty Pipe Syndrome" in colostrum

This year, I had one case of a first-time mother who had just delivered her baby and produced a bloody colostrum. She never had breast pain, breast lumps, any other abnormal nipple discharges, nor the history of breast cancer in her family. She neither had any constitutional symptoms such as appetite loss or weight loss, nor any other clinical signs which could suggest breast cancer. She wasn't had any breast engorgement at that time and didn't have any trauma to the breasts. Nipples were protractile and healthy with no cracks or ulcers.
So, what is RUSTY PIPE SYNDROME?
It is a painless condition and may go unnoticed unless the mother is expressing the milk or the infant vomits out blood, which tests positive for adult hemoglobin. The bloody discharge from the breasts is usually bilateral but may be unilateral to begin with. Most cases begin at birth or in early lactation but it may start in pregnancy also. The cause is an increased vascularization of rapidly developing alveolar with delicate network of capillaries, which get traumatized easily and result in blood escaping into breast secretion. It is commonly seen in first time mothers and is usually associated with nipple exercises like Hoffman’s procedure, which is often recommended for flat or inverted nipples.
Rusty-pipe syndrome is a self-limited condition and most cases clear within 3 to 7 days of onset of lactation. Nipple manipulation should be discontinued. If the infant tolerates milk, breast feeding can continue during this period. The discharge should be evaluated if the bleeding persists for more than one week.
It is also possible that blood in the breast milk is stemming from broken capillaries due to trauma to the breast, which includes rough treatment of the breast or nipple tissue from hand expression (expressing your breast milk by hand versus machine), or from incorrect use of a breast pump.
So, is it safe to feed the newborn with this kind of milk?
Yes, it is. If the baby is at the breast, it is equally as safe to ingest the small amounts of blood being cleared. There is no medical treatment, but it will usually clear up within a week after birth. This condition should not recur.
(Anyway, most of the nurses who in-charge of special care nursery at that time were reluctant to continue giving the "rusty" breastmilk to her baby...and I think they need another session of intensive lactation education course!!!)

Another cause of blood in the milk, although less common, may be an intraductal papilloma. If continue to see blood in milk after your first week postpartum, then a doctor should be consulted.