Neonatal breast enlargement is sometimes common. Because At the end of pregnancy, there is a fall in estrogen levels. It triggers the neonatal pituitary gland to secrete prolactin. It can happen up to 70% of cases. But that’s not the problem. It regresses usually within a few days. But the problems occur as illiterate people try to squeeze the breast. They think milk will come out. And they invite infections. That’s when mastitis occurs.
Neonatal mastitis is uncommon in educated well-developed countries. It is very common in the rural area. This is very common in day-to-day pediatric practice. But If you have no idea you might get frightened. Sometimes neonates present with a breast abscess. Staphylococcus aureus is most commonly responsible here.
Mastitis neonatorum is called the infection of neonatal breast tissue.
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Male or Female gets more affected?
Neonatal breast enlargement can occur equally in both sexes. It is generally bilateral means both breasts swells simultaneously. But sometimes unilateral swelling may present. If it is unilateral, breast abscess or mastitis is more prone to happen.
There is enlarged breast tissue without any tenderness or discharge. Neonatal breasts are slightly swollen at birth. It continued to grow larger.
Treatment of Neonatal Breast Enlargement
This condition is self-limited and requires only observation for the development of signs of infection. The general condition of the baby needs to be monitored.
Neonatal breast enlargement usually occurs during the first week of life. It generally resolves within a few weeks but may persist for several months in rare cases.
Hot compression is helpful.
The enlarged breast may discharge milky or clear liquid which is sometimes called “Witch’s Milk”.
Parental reassurance is most important.
Sign Symptoms of Neonatal Mastitis
In the case of mastitis developed, there will be the following conditions
- Reddish
- Painful
- Crys on touch
- Common in female
- Purulent discharge
- Induration
- Same-sided lymph node may be enlarged
- Usually unilateral
- There may be suppurative lesions elsewhere.
- Usually occurs after the first week of life.
How to Manage if Mastitis or Abscess develops?
If there is purulent discharge the baby may need hospital admission and parental antibiotics. Needle aspirations usually are done. Incision and drainage in severe cases may cause a permanent scar.
Oral antibiotics may have a lower success rate. Sometimes secondary neonatal septicemia may develop.
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Essential Reading on Neonatal Breast Enlargement
Neonatal Mastitis PediatricEducation.org
Mastitis Neonatorum: An Interesting and Uncommon Condition Seen in Infants Journal of Neonatal Biology
Neonatal Breast Enlargement www.nejm.org
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