Wednesday, November 21, 2012

Breast engorgement in Newborns : Galactorrhea or Witch's Milk

Scenario-
Concerned parents appear in the Out patient Department, with a newborn who has bilateral breast engorged and obviously secreting milk. Parents had tried to squeeze the milk out but instead the breast got further engorged.
Few months before a neonate was admitted for Intravenous antibiotics for similar problem , after parents tried to squeeze out the milk, it led to formation of an abscess that needed incision and drainage.



What is Witch's milk?
Medical Dictionaries have defined Witch's milk as "Milk resembling colostrum sometimes secreted from the breasts of newborns of either sex three to four days after birth and lasting no longer than two weeks, due to endocrine stimulation from the mother before birth."
The term “witch’s milk” comes from ancient folklore that milk from a newborn’s nipple was a source of nourishment for witches.

Why Does it occur?
Galactorrhea is the result of the influence of the mother’s hormones on the baby before delivery. It is caused by a combination of the effects of maternal hormones before birth, prolactin and growth hormone passed through breast feeding and the postnatal pituitary and thyroid hormone surge in the infant. Blood from the nipples is nearly always benign and associated with the normal growth of the ducts, rather than mastitis. In extremely rare cases mastitis may develop. Removing the milk from the breasts can prolong milk production and is customary in some cultures but considered harmful by medical professionals.
Witch's milk is more likely to be secreted by infants born at full term, than by prematurely-born infants.

While breastfeeding may also contribute to prolonged milk production and breast enlargement, temporary or permanent weaning is not recommended.


Incidence-  5% of newborns and can persist for two months though palpable breast buds can persist into childhood. Infants with galactorrhea have significantly larger breast nodules than infants without galactorrhea.



Remedy-
No treatment necessary unless the area becomes red or tender.
Avoid massage or manipulation of the breast tissue
Reassurance

Complications-
Mastitis when squeezed
Breast Abscess


Mastitis Neonatorum



Article-
Compilation By Dr Sujit K Shrestha, Pediatric Resident, TUTH

7 comments:

  1. Poor baby! I hope the breast engorgment went away.

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  2. I took my 12 day old infant son into his first appt with his peds doctor. During his exam the dr squeezed both his nipples very hard and told me some infants produce milk. Now he has lumps when prior he did not. I am furious. He didnt have breast buds. Why would a doc squeeze an infants nipples. It says if they did have buds not to manipulate the tissue in any way. My question is this a routine part of a first time check up. In my opinion je caused the lumps. Im beside myself for letting this doc do this. Like i said prior to the dr saueexing him jis nipples were small and flat.


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    Replies
    1. hi dear ,sorry to say u but there is not any such examination said to do like squeezing the neonate breast nipple unless there is a strong evidence of pus with persisting fever and redness over there. Ok and dont worry take ur baby to some safer hand for proper manegment for proper care

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  3. I have two babies and this has never happened. I find that very strange that he did that to your baby. I hope you switch your doctor.

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  4. I find that very odd that the doctor did that. I have two babies (boys) and that was never part of the examination. I hope you switch doctors soon!

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  5. This comment has been removed by a blog administrator.

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