Abstract
We want to appeal for a change in the current terminology and consider the phenomenon of visible red/brown colostrum colorization as a phenomenon of bloody colostrum or bloody colostrum syndrome. It is not a disease, does not require treatment, and resolves spontaneously.1–3 The existing term rusty pipe syndrome, which has become adopted in describing this phenomenon, is, in our opinion, at odds with current medical knowledge—according to anatomical knowledge, there are no tubes in the mammary gland but milk ducts, and we do not find a shred of rust in the human colostrum.
What is more, we conducted research to assess the prevalence of erythrocytes in colostrum, the erythrocyte rate, and relate this to the newborn’s milk tolerance to reduce unjustified feeding with formula in case of visually bloody colostrum in the mother. We collected colostrum samples from 137 patients. We found that from 8 to 1000 cells/mL of erythrocytes in yellow or white colostrum samples were present in 24.8% of cases (34 samples). The average number of Red Blood Cells (RBCs) in the view field was 229 RBCs and 458 RBCs/mL of colostrum. Only one sample (0.7%) was visually red (bloody), and the erythrocytes were uncountable. Due to the limitation of the cell counting method in the microscopic image, only a semiquantitative erythrocyte count of >1500/mL was determined. Regardless of the number of erythrocytes, the color of the remaining colostrum samples was white (28.5%) or yellow (66.4%). 4
Mothers need support from educated healthcare personnel. The immune cell content of colostrum and the general composition of breast milk cause even temporary cessation of breastfeeding in the case of macroscopically bloody colostrum, is not recommended and, as a routine procedure, should be considered as an unjustified and harmful action and incompatible with evidence-based medicine. 5
Footnotes
Authors’ Contributions
K.W. conceptualized and designed the study, data collection, collected samples and data, conducted data analysis, drafted the initial article, and critically reviewed and revised the article. S.P. and J.Ż. conceptualized sample analysis, contributed to interpreting the data and writing, and critically reviewed and revised the article. S.P. carried out a sample analysis. A.N., A.O., and P.M.(H.). collected the samples and data and contributed to interpreting the data and writing. M.P., M.P., and M.W. organized the study and critically reviewed and revised the article. All authors approved the final article as submitted and agreed to be accountable for all aspects of the work.
Disclosure Statement
No competing financial interests exist.
Funding Information
The presented study received funding from the Poznan University of Medical Sciences’ Student Research Committee (No. 95/2021).