Enlarged breast glands in a newborn or under two-year-old girl can make parents panic. But don’t worry. This is the early telarca, that is, a hypertrophy of the mammary button on one side or both which, however, does not give rise to the formation of the adult mammary gland. “It is a transitory symptom and in most cases it regresses spontaneously within the third year of life” explains Marco Cappa, head of Endocrinology at the Bambino Gesù hospital in Rome. The telarca usually defines the onset of breast development in girls around the age of eight. «The premature telarca is activated from birth or during the so-called mini-puberty, a period of physiological increase in sex hormones between three and six months. In boys this phenomenon, called gynecomastia, is much rarer – the doctor points out – and requires more in-depth investigations because it could be a sign of tumor or genetic pathologies ».
Do you enter the early pubertà?
One or both breasts take on the shape of a small bud due to premature swelling of the mammary glandular tissue. But be careful not to confuse the signals. “On palpation it is normal to detect a peanut under the nipple – explains Cappa -: it is not a lump, it simply indicates the presence of the gland”. Premature telarca is said to be “isolated” when the enlargement is not associated with pubic and axillary hair and vaginal discharge of mucus or blood. “In the presence of these symptoms we are faced with a case of precocious puberty, which most frequently occurs from four to six years, or when the premature telarca persists, or appears, after three years” continues the expert. The isolated premature telarca should not be confused with the genital crisis of the newborn, which occurs in the first days of life and is also characterized this time by breast swelling (and possible leakage of milk drops), both in males and females, caused by a high concentration of maternal hormones, especially estrogen, transmitted through the placenta.
Genital crisis of the newborn
The isolated premature telarca should not be confused with the genital crisis of the newborn, which occurs in the first days of life and is also characterized this time by breast swelling (and possible leakage of milk drops), both in males and females, caused by a high concentration of maternal hormones, especially estrogen, transmitted through the placenta. “This buildup is partly caused by the still immature liver that can’t metabolize hormones well,” explains Cappa.
Still another thing is neonatal mastitis, a bacterial infection to be treated with antibiotics. In all these cases, it is recommended that you first contact your pediatrician, who, based on the diagnosis, will decide whether or not to refer the child (or the boy) to a pediatric endocrinology center.
What caused the early telarca is unclear. It could be due to excessive stimulation by estrogen (the main female sex hormones) in the stage of minipuberty. Among the risk factors that determine it, and that the endocrinologist of the Infant Jesus invites us to consider with caution, however, there is environmental exposure to endocrine disruptors, i.e. chemicals that can alter the normal hormonal balance, such as phthalates and bisphenol: «They are released from the plastic material of games and bottles when exposed to the sun or to another source of heat. But how much will a toy be able to produce? To an irrelevant extent. Hydrocarbons also have an “estrogen-like” component, so we shouldn’t leave the house anymore? Or all infants should manifest this clinical condition ».
The frequency of early isolated telarca remains low: “From 10 to 15 per cent of infants, a stable percentage over the years”. While the onset of puberty is increasingly anticipated. “During the lockdown, from March to September 2020 – continues Cappa -, we recorded over double the cases of the same period of the previous year: 224 against 93. We are doing a research on the change of habits that could have influenced”. Some vegetables, such as carrots, cucumbers, potatoes and squash, apples, and some cereals, such as soy, rice, barley, oats and spelled also contain high amounts of (vegetable) estrogen. “Cooking denatures estrogen, so it’s better to serve these cooked foods to the baby.”
How to behave
First of all, the expert advises, “you have to be calm and be patient”. And the pediatrician is the first point of reference. “A clinical observation by the family pediatrics every six months is sufficient and if there is no associated symptom there is no need to carry out tests,” says Cappa. If, on the other hand, the telarca does not disappear after three years (or appears later) or manifests itself with hair and vaginal discharge, “blood tests should be prescribed to check the hormonal concentration, a pelvic ultrasound to identify the size of the uterus and any enlarged follicles that produce small amounts of estrogen, and, finally, an X-ray of the hand to calculate the bone age, more advanced than the chronological one in the case of precocious puberty ». Mistakes to avoid: «Preventing the child from putting the usual plastic toys in his mouth is useless. As well as removing chicken or beef from your menu. In Europe, the use of hormones in farms is absolutely forbidden, so our meat is safe ”concludes the expert.
March 13, 2021 (change March 13, 2021 | 20:56)