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Question: Neonate

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An 8 day old male is brought in with bilateral breast enlargement. They seem slightly tender, but there is no redness, fluctuance, or fever. The parents have noted discharge of a milky substance.

What should you do next?

pemsou5_wp • January 9, 2018

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  1. Kelly January 9, 2018 - 10:28 pm Reply

    E) Reassure and educate the parents
    This patient has physiologic neonatal breast enlargement due to falling levels of maternal estrogen triggering prolactin release in the newborn. This occurs regardless of the infant’s sex. 5-20% may secrete milk, which is sometimes called “witch’s milk.” The condition will resolve spontaneously over the next few weeks. Parents should not squeeze or manipulate the breast tissue as this sends feedback to the pituitary to release more prolactin and can also seed an infection / mastitis. For more info check out

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