Red flags & when to go in person for Nipple Discharge - Triage

Audience: pediatric

Nipple discharge in children can have many causes, most of which are not serious. It often occurs due to hormonal changes or minor infections and may resolve on its own. Telemedicine can help evaluate symptoms, provide advice, and decide if further care is needed. However, some signs require urgent in-person evaluation to rule out serious conditions. These include bloody or persistent discharge, signs of infection like redness and fever, or a lump in the breast. Caregivers should watch for these red flags and seek immediate medical care if they appear. Telemedicine visits can guide you on how to monitor symptoms, when to seek urgent care, and how to manage mild cases at home.

Red flags — go in person / ER

• Bloody nipple discharge or discharge from only one breast — seek immediate in-person evaluation.
• Presence of a hard lump or swelling in the breast — urgent medical assessment needed.
• Redness, warmth, swelling, pain in the breast area, or fever — get urgent medical care.

What telemedicine can do

• Initial assessment of nipple discharge symptoms in children.
• Providing advice on symptom monitoring and home care.
• Determining if symptoms require urgent in-person evaluation.

What telemedicine cannot do

• Physical examination to assess lumps or breast tissue.
• Performing diagnostic tests like imaging or lab tests.
• Treating severe infections or other urgent conditions requiring hands-on care.

What is Nipple Discharge in Children?

Nipple discharge is any fluid coming from the nipple. In children, it can be caused by normal hormonal changes, minor infections, or irritation. It may be clear, white, or sometimes yellowish. Most nipple discharge in children is harmless and temporary.

When Can Telemedicine Help?

Telemedicine can be useful to discuss symptoms, review pictures or videos of the discharge, and provide advice on care. A healthcare provider can help decide if the discharge is typical or if you need to see a doctor in person. Telehealth is good for mild symptoms without other concerning signs.

Red Flags That Need In-Person Care

Certain signs mean your child needs to be seen by a healthcare provider right away:

If you notice any of these, seek urgent medical evaluation.

How to Prepare for a Telemedicine Visit

Before your tele-visit, try to:

This information helps the provider assess the situation better.

After the Telemedicine Visit

Follow the healthcare provider's advice carefully. This may include:

Keep notes on any changes to share in follow-up visits.

How to prepare for your tele-visit

• Observe and note the color, amount, and frequency of nipple discharge.
• Check for other symptoms such as fever, pain, or swelling.
• Take clear photos or videos of the nipple area if possible.
• Have your child's medical history and any previous breast issues ready to share.
• Prepare a list of questions or concerns to discuss during the visit.

After your tele-visit

• Follow the healthcare provider's instructions on monitoring symptoms.
• Schedule an in-person visit if advised or if symptoms worsen.
• Keep the nipple area clean and dry as recommended.
• Seek emergency care if red flag symptoms appear after the tele-visit.
• Maintain records of symptom changes for follow-up visits.

FAQs

Is nipple discharge common in children?

Yes, nipple discharge can occur in children, often due to hormonal changes during growth. It is usually harmless and resolves on its own.

When should I worry about nipple discharge in my child?

You should seek urgent medical care if the discharge is bloody, comes from only one breast, or if your child has a lump, redness, pain, or fever.

Can telemedicine diagnose the cause of nipple discharge?

Telemedicine can help assess symptoms and advise on next steps but cannot replace a physical exam or diagnostic tests needed to determine the exact cause.

What should I do if my child has nipple discharge but no other symptoms?

You can start with a telemedicine visit to discuss symptoms and receive guidance on monitoring. Most cases without other symptoms are not urgent.

How can I prepare my child for a telemedicine visit about nipple discharge?

Gather information about the discharge, take photos if possible, and be ready to describe any other symptoms or changes you have noticed.

Sources

1. Nipple Discharge — MedlinePlus | U.S. National Library of Medicine.
2. Breast Problems in Children and Adolescents — American Academy of Pediatrics.
3. Evaluation of Breast Masses and Nipple Discharge — Mayo Clinic.
4. Breast Discharge: When to See a Doctor — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational and triage purposes only. It is not a substitute for professional in-person medical evaluation, diagnosis, or treatment. If you have concerns about your child's health, especially if red flags are present, seek immediate in-person medical care.