Breast Symptoms-Child

Is this your child's symptom?

• 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 for Breast Symptoms-Child

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 for Breast Symptoms - Child

Normal Breast Buds in a Newborn

1. 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.
2. 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

1. 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.
2. 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)

1. 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.
2. 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

1. 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.
2. 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

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

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

Last Reviewed: 10/11/2023

Last Revised: 12/30/2022

Copyright 2000-2023 Schmitt Pediatric Guidelines LLC.