Dear doctor;

I have noticed that I get a small amount of fluid from both nipples, but mainly the right one. It has occasionally been slightly milky, but is mainly clear in colour. I had miscarriage last year but I am not pregnant at the moment. What could this be? Ann, 27.

Dear Ann,

There are multiple reasons for discharge from nipple. Hormonal changes mainly during pregnancy and lactation,  hormonal disorders such as thyroid and pituitary disorders, breast cyst, abscess, cancer of the breast, pappiloma, prolactin producing tumors are some of the reasons. Drugs such as phenothiazine, chlorpromazine, etc, used for vomiting, anxiety, among other conditions, also can cause discharge from nipples. The underlying cause is diagnosed clinically by presence or absence of associated features like swelling, redness, itching, presence of lump, pain on touching, among other symptoms. Diagnostic tests are needed to confirm suspected diagnosis. These include hormonal assays, mammography and breast biopsy. Majority of the causes of breast discharge are treatable.