Gynecomastia in Children
Gynecomastia is a condition in which male children grow breast tissue. This may cause one or both breasts to become enlarged. In most cases, this is a natural process caused by a temporary increase in the female sex hormone (estrogen) at birth or during puberty.
When it is temporary and caused by high estrogen levels, it is referred to as physiologic gynecomastia. In some cases, gynecomastia can also be a sign of a medical condition. Gynecomastia is most common in newborns and boys between the ages of 12 and 16.
What are the causes?
Physiologic gynecomastia in newborns is caused by estrogen passing from the mother to the unborn baby (fetus) in the womb. Physiologic gynecomastia during puberty is caused by an increase in estrogen.
Other possible causes of gynecomastia include:
- A gene that is passed along from parent to child (inherited).
- Testicle tumors.
- A tumor in the pituitary gland or the testicles.
- Problems with the liver, thyroid, or kidney.
- A testicle injury.
- A genetic disease that causes low testosterone in boys (Klinefelter syndrome).
- Many types of prescription medicines, such as those for depression or anxiety.
- Use of alcohol or illegal drugs, including marijuana.
In some cases, the cause may not be known.
What increases the risk?
Your child may have a higher risk for gynecomastia if he or she:
- Is overweight.
- Is a teenager going through puberty.
- Abuses alcohol or other drugs.
- Has a family history of gynecomastia.
What are the signs or symptoms?
Most of the time, breast enlargement is the only symptom. The enlargement may start near the nipple, and the breast tissue may feel firm and rubbery. Other symptoms may include:
- Tender breasts.
- Change in nipple size.
- Swollen nipples.
- Itchy nipples.
How is this diagnosed?
If your child has breast enlargement right after birth or during puberty, physiologic gynecomastia may be diagnosed based on your child’s symptoms and a physical exam.
If your child has breast enlargement at any other time, your child’s health care provider may perform tests, such as:
- A testicle exam.
- Blood tests.
- An ultrasound of the testicles.
- An MRI.
How is this treated?
Physiologic gynecomastia usually goes away on its own, without treatment. If your child’s gynecomastia is caused by a medical problem, the underlying problem may be treated. Treatment may also include:
- Changing or stopping medicines.
- Medicines to block the effects of estrogen.
- Breast reduction surgery. This may be a possibility if your child has severe or painful gynecomastia.
Follow these instructions at home:
Have your child take over-the-counter and prescription medicines only as told by your child’s health care provider. This includes herbal medicines and diet supplements.
- Talk to your child about the importance of not drinking alcohol or using illegal drugs, including marijuana.
- Keep all follow-up visits as told by your child’s health care provider. This is important.
- Talk
to your child and make sure that:
- He is not being bullied at school.
- He is not feeling self-conscious.
Contact a health care provider if:
- Your child continues to have gynecomastia during puberty for more than 2 years.
- Your baby has enlarged breasts after birth for more than 6 months.
- Your
child’s:
- Breast tissue grows larger or gets more swollen.
- Breast area, including nipples, feels more painful.
- Nipples grow larger.
- Nipples are itchier.
