Pediatric Endocrinology Expert Forum
Breast Buds in a 15 month old
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Questions in the Pediatric Endocrinology forum are answered by Dr. Deanna L Aftab Guy. Topics covered include adrenal problems, diabetes insipidus, menstrual irregularities, obesity, parathyroid abnormalities, pituitary abnormalities, puberty concerns, rapid growth, rickets and bone disease, short stature, and thyroid.

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Breast Buds in a 15 month old

At 15 months I noticed that my daughter had lumps underneath each of her nipples.  When I brought it to the attention of my family doctor she talked to a Ped. Endo. and we had an Estriol level done and a CBC.  She has been 75% on length, 50-75% on height, and 50% for her head measurements.  All of her labs came back normal.  Her growth x-ray of her wrist was on target for her age.  
They told me that this was probably cause from tiny cysts that temporarily raised her estrogen level causing some breast development.  They called it Precosious(sp?) puberty. So far I haven't noticed any change in the buds they are neither bigger nor smaller she is now 18 months.  They told me they could go either way, but to watch for hair development, rapid growth, discharge, or any other signs of puberty.
I am to take her back to the Ped. Endo. every three months so they can monitor her growth.
I am wondering if this is something you have seen before?? Wouldn't she have been in pain from cysts?  Is their something else that could have caused this.  Should we do more testing.  I am just concerned that they are not doing enough by just ruling it out as a freak thing that happens.  Thanks for your time.
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breast buds prior to age 8 is premature thelarche, precocious puberty is proof that there is true early signalling of the pubertal hormones, your doc is very careful and I too would follow her perhaps every 4 months, the only thing is that a bone age before age 2 is really better to do of the knee. The estradiol, free T4, TSH, LH and fsh levels are good to help us decide if it is early puberty, but ultimately if it progresses a special test to measure the brain's puberty hormone response needs to be done. I would consider a pelvic ultrasound  to look for a cyst on the ovary if things do not get smaller, but your ped endo is on top of things and will monitor her. It may take up to age 2 even almost 3 for things to resolve if this is benign premature thelarche, especially in a breast fed baby
She should be just fine, sounds healthy in every way. Work with your docs, you are in good hands.
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