Pink breast milk: clinical implications and case report

Abstract

Introduction: The composition of breast milk undergoes physiological variations throughout lactation; however, marked chromatic changes are rare and may signal pathological conditions. Pink-colored milk is an uncommon finding, generally associated with mammary traumas or colonization by pigmented microorganisms, such as Serratia marcescens. Objective: To report the case of a breastfed infant with inadequate weight gain associated with breast milk contamination by S. marcescens, highlighting the importance of early microbiological investigation and appropriate management to ensure neonatal safety and the continuity of breastfeeding. Case Description: We report the case of a breastfed infant with inadequate weight gain, whose mother identified pink coloration in the expressed milk and in the components of the breast pump. Microbiological investigation confirmed contamination by S. marcescens. Management included antibiotic therapy for the dyad (mother and infant) and rigorous reinforcement of hygiene measures, resulting in resolution of the color change and resumption of the growth curve ascent in the child. Discussion: The persistence of pink milk requires immediate microbiological investigation to rule out opportunistic pathogens. Inadequate weight gain in infants exposed to this condition should be interpreted as a critical warning sign, demanding thorough evaluation. Early identification of S. marcescens is fundamental for neonatal safety. Therapeutic conduct should be individualized, considering the presence of clinical repercussions or specific infectious risks, ensuring continuous support for the safe continuity of breastfeeding.