From the Guidelines
Galactorrhea in infants is primarily caused by the influence of maternal hormones, particularly estrogen, that cross the placenta during pregnancy and stimulate the infant's breast tissue. This condition is generally a benign, self-limiting condition that doesn't require treatment. The discharge typically appears within the first week of life and resolves spontaneously within a few weeks to months as the maternal hormones clear from the infant's system. Some key points to consider in the management of galactorrhea in infants include:
- Parents should be advised against squeezing or manipulating the infant's breasts as this can introduce infection.
- No medications or interventions are needed for typical cases.
- However, if the discharge persists beyond 2-3 months, is bloody, purulent (containing pus), or is accompanied by other concerning symptoms like breast redness, warmth, tenderness, or fever, medical evaluation is warranted to rule out mastitis or other pathological conditions.
- These cases may require antibiotic treatment if infection is present.
- It is also important to consider other potential causes of galactorrhea, such as galactosemia, although this is relatively rare and typically identified through newborn screening 1.
- The American Academy of Pediatrics provides guidelines on breastfeeding and the use of human milk, which may be relevant in the context of galactorrhea in infants, although the provided evidence does not directly address the condition 1.
- The key is reassuring parents about the benign nature of this physiological phenomenon while monitoring for any signs that would indicate a need for medical attention.
From the Research
Causes of Galactorrhea in Infants
- Galactorrhea in infants can be caused by hyperprolactinemia, which is often induced by medication or associated with pituitary adenomas or other sellar or suprasellar lesions 2, 3.
- A specific case study found that galactorrhea in a 3(1/2)-month-old infant with trisomy 21 was caused by the use of metoclopramide, a medication commonly used in the neonatal intensive care unit (NICU) 4.
- The underlying cause of galactorrhea in infants should be treated when possible, and the decision to treat patients with galactorrhea is based on the serum prolactin level, the severity of galactorrhea, and the patient's fertility desires 5.
Diagnosis and Treatment
- Diagnosis of galactorrhea in infants involves measuring the prolactin level, ruling out pregnancy, and assessing thyroid and renal function 2, 3.
- Treatment of galactorrhea in infants typically involves discontinuing any medications that may be contributing to hyperprolactinemia, and in some cases, using dopamine agonists such as bromocriptine or cabergoline 5, 3.
- In cases where the cause of hyperprolactinemia is unclear, magnetic resonance imaging (MRI) of the pituitary gland may be necessary to rule out any underlying pituitary tumors or other lesions 2, 3.