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Breast Symptoms-Child

Definition

  • Breast symptoms in a young girl before puberty
  • Breast buds (the first sign of puberty in girls) are also covered

Symptoms included in this guide are:

  • Breast buds are the most common concern. Breast buds are small, disc-shaped lumps felt under the nipple and areola. Any lump found under the areola is a breast bud until proven otherwise.
  • Breast symptoms in newborns are also covered.
  • Other symptoms: breast lump, breast redness and nipple discharge.

Early Breast Development Caused by Contact with Estrogens: Prevention

  • Early breast development before age 8 can be caused by estrogens in the environment. Estrogen is a type of hormone. Parents should consider these potential exposures:
    • Estrogen in cosmetics, such as hair creams
    • Birth control pills
    • Estrogen sprays to reduce hot flashes during menopause
    • Lavender oil and tea tree oil have weak estrogen in them
  • Prevention: use and store these products carefully. Wash your hands thoroughly after applying.

When To Call

Go to ER Now

  • Fever in baby less than 12 weeks old. Caution: do NOT give your baby any fever medicine before being seen.

Call Doctor or Seek Care Now

  • Breast is painful to touch
  • Nipple discharge that is pus (thick green or yellow) or bloody
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Red area or red lump
  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Breast lump. Exception: lump right under the areola; most likely a breast bud.
  • Nipple discharge. Exception: normal milky discharge in newborn.
  • Newborn breast buds last more than 6 months
  • Breast buds or tissue with onset before 8 years old. Exception: during the newborn period.
  • Age 13 or older with no breast buds or breast tissue
  • Breast tissue only on 1 side lasts more than 3 months
  • You have other questions or concerns

Self Care at Home

  • Normal breast buds in a newborn
  • Milky discharge from nipples in a newborn
  • Normal breast buds and onset of puberty (age 8 or later)
  • Breast bud or tissue only on 1 side

Care Advice

Normal Breast Buds in a Newborn

What You Should Know:

  • Breast buds are always normal in newborns.
  • Swollen breasts are present during the first week of life in many girl and boy babies. The nipple area is always firm.
  • Cause: the passage of the mother's hormones across the placenta.
  • Normal course: swollen breasts can last for 2 to 4 weeks. In breast-fed babies, some breast swelling can last for 6 months.
  • Caution: never squeeze or massage the breast or nipple. Reason: this can cause a serious infection that needs antibiotics.

Call Your Doctor If:

  • Redness or red streaks occur
  • Fever occurs
  • Swelling lasts more than 6 months
  • You think your child needs to be seen

Normal Milky Discharge from Nipples in a Newborn

What You Should Know:

  • Swollen breasts are present during the first week of life in many girl and boy babies. The nipple area is always firm.
  • Cause: the passage of the mother's hormones across the placenta.
  • Newborn milk: sometimes, the nipples leak a few drops of milkish discharge. This is normal and can last a few weeks. Rarely lasts longer.
  • Normal course: swollen breasts can last for 2 to 4 weeks. In breast-fed babies, some breast swelling can last for 6 months.
  • Caution: never squeeze or massage the breast or nipple. Reason: this can cause a serious infection that needs antibiotics.

Call Your Doctor If:

  • Redness or red streaks occur
  • Fever occurs
  • Milk leakage lasts more than 2 months
  • You think your child needs to be seen

Normal Breast Buds with Onset of Puberty (age 8 or older)

What You Should Know:

  • Breast buds are normal, small disc-shaped rubbery lumps felt under the nipple.
  • Age: they normally occur in 8 to 12 year old girls. They are the first sign of puberty. Sometimes, they are even normal in 7 year olds.
  • Importance: the entire breast develops from the breast bud, taking 2 or 3 years to completion.
  • The first menstrual period (menarche) usually occurs 2 years after breast buds appear.
  • Symptoms: breast buds can be somewhat tender. This is normal.
  • Risks: none. Breast buds have no risk of turning into cancer.
  • Breast development is considered delayed if it has not started by age 13.
  • Have your child's doctor check the breast bud at the next regular office visit.

Call Your Doctor If:

  • No breast buds or breast development by age 13
  • You have other questions or concerns
  • You think your child needs to be seen

Breast Bud Only on One Side

What You Should Know:

  • Breast buds often start on 1 side first.
  • Breast tissue may even appear on that side. This can happen before you can feel a breast bud on the other side.
  • Most often, the breast bud will appear on the other side within 3 months.
  • The breast that has a later start will slowly catch up with the other.
  • After breasts are mature, it's normal for 25% of women to have a slight difference in breast size.
  • Risks: none. Breast buds have no risk of turning into cancer.
  • Have your child's doctor check the breast bud at the next regular office visit.

Call Your Doctor If:

  • No breast bud on other side by 3 months
  • You have other questions or concerns
  • You think your child needs to be seen

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Barton Schmitt MD, FAAP
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
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