I had a mom with a 37 week baby presenting with rusty pipe syndrome. She was able to pump 5 ml at each feeding, but the color was a dark burgundy rust color so the NICU opted to have mom save the colostrum instead of giving it. Her breast milk cleared up this morning for 2pump sessions, then as mom is moving into Lactogenesis stage II the rusty color has returned milk is the color of a rusty strawberry milk on one side and almost chocolate milk color on the other. There is no visible nipple damage, no pain in breasts, mom is pumping with the correct flange size. My stab in the dark is maybe there is still some old blood that is being cleared? We are 5 days postpartum. Has anyone seen rusty pipes return after clearing up? 
Mom also notices that the rust color comes at the end of pump sessions.

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