Background: Breast milk is the optimal nutrition for newborns. When a variation in breast milk color occurs, a lactating woman can become distressed and abandon plans to breastfeed. Timely evaluation of her milk can preserve breastfeeding as well as ensure the mother’s health. As lactation consultants who are also registered nurses, the authors encounter many variations of color in breast milk that have been determined to be normal. Diet, medicine and breast health can contribute to breast milk’s color. Appropriate assessments aid in determining safety of breast milk as well as in contributing to maternal health. Maternity nurses can renew their commitment to breastfeeding support by becoming aware of variations, using a team approach when needed, and offering emotional support to affected women.

Case: In one case, a primiparous woman with “purple” milk required an interdisciplinary approach to determine the safety of her breast milk for her near-term baby. Nipple discharge was noted in her second trimester of pregnancy and was monitored without testing. The patient delivered at 35 weeks gestation. To achieve a full milk supply, pumping was encouraged by the lactation consultant. Pumping revealed an unusual purple color and the milk was withheld from the baby at the discretion of the postpartum nurse until the obstetrical resident could evaluate and ordered a consult with the breast surgeon. The lactation consultant supported the decision and offered continued, daily guidance. An ultrasound revealed slight ductal prominence in both breasts. A final consult by the breast surgeon followed on day four at which time the mother’s milk was normal in color. The surgeon concluded the coloration was due to ectatic ducts and hormonal stimulation. She encouraged continued breastfeeding.

Conclusion: Emotional support from postpartum nurses who are often first to notice a variation in the color of maternal breast milk is imperative.  Recognize that mothers may experience high anxiety and disappointment if not able to accomplish breastfeeding goals– even with only a short-term interruption of breastfeeding. Mothers may experience stigma associated with unexpected variation of breast milk color and increased anxiety when a physician consult and/or testing becomes necessary. Reassurance may be necessary to support her use of her breast milk when it is an unusual color. Lactation consultants are part of the team in determining course of action for mothers with variations in breast milk color. They offer support to not only the mother but to nursing staff as well. 

Keywords: breast milk color, breastfeeding, lactation, lactation support, breast assessment