Newborns can experience various types of breast disorders, which are usually transient. Some of them affect only on the breast, while other can affect both breasts and the soft tissue just beneath the nipples. They can range from enlarged breasts (neonatal mastauxe), accumulation of milk in the form of a cyst (neonatal galactocele), inflammation of the breast tissue (neonatal mastitis), neonatal breast abscess (inflammation of the breast tissue with pus accumulation) to breast tumors. Although breast tumors are rare in newborns, they should still be ruled out.
Neonatal mastauxe is considered a physiological state in newborns in which the breasts get enlarged due to the effect of maternal hormones. Estrogen is the main hormone responsible for this phenomenon, and it happens to some extent in about 70% of newborns. Normally, the enlargement should not exceed 1-2 cm and it should be bilateral (on both sides), and evenly distributed. However, this is not always the case, as some parts of the breast tissue can respond stronger to the influence of estrogen, making it look asymmetrical or even bump-like. There are also cases with symmetrical but exaggerated breast enlargement. This condition is called giant mastauxe.
Cystic breast enlargement is common in women during breastfeeding. For unknown reasons, these cysts have been sound in some infants with normal hormonal status and without any other accompanying abnormalities. Finding of milky fluid during needle biopsy is a usual diagnostic approach. Interestingly galactocele can be found in both boys and girls and can be unilateral or bilateral. Surgical excision solves this issue, usually with no consequences.
Neonatal mastitis is an inflammation of the breast tissue in newborns. It is not very common, but it is more frequent in neonates having breast enlargement. This condition may be painful for the baby and should be diagnosed and treated with antibiotics as soon as possible.
Neonatal Breast Abscess
This is also a type of breast tissue inflammation, only with pus accumulation in one particular region. It can be hard or fluctuating on touch, and it can be painful for the baby. Abscesses can occur due to local infections or neonatal mastitis which is localized in one particular region. The diagnosis is usually easy and the treatment depends on the severity. Small abscesses can be treated with antibiotics and topical creams, while larger bumps should be surgically removed.
In newborns, breast tumor is a very rare finding. Still, they need to be taken into consideration on occasions when a hard mass is found anywhere in the breast area of an infant. Infantile neurofibromatosis is one of the most common breast tumors in newborns. It is a benign tumor and can be presented in the form of solitary or multiple lesions. Sometimes it can grow substantially and affect the skin above it and internal organs beneath it. Although it is a benign tumor and it does not give metastases, its growth can be very intensive and in that sense, it can affect other organs. The cause of infantile neurofibromatosis is still unknown, and the treatment requires a multidisciplinary approach, especially if the tumor has grown large.
Of all these conditions, slightly enlarged breasts (neonatal mastauxe) is the most common, and parents should not be concerned about it. Any other bumps and lumps, either solitary or multiple, should be examined in detail by pediatrician.
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