Pediatric Endocrinology Expert Forum
Breast Buds
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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

My daughter is 7-1/2 months old and was born with hypothyrodism (as was I).  We were just at her Pediatric Endocrinology dr yesterday and they said she has breast buds forming under both nipples.  Is this common?  We need to keep an eye to make sure she doesn't show other signs of early puberty (pubic hair, menstration).  Any info would be greatly appreciated.
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Early breast buds under age 2 is usually benign and referred to premature thelarche-a benign process due to a little blip of the pituitary hormones in babies that usually does not progress and goes away by age 3 or so. When it worsens or lasts beyond age 3 we tend to get concerned for premature puberty, meaning the other more effective puberty hormones are secreted in an earlier than normal fashion causing estrogen effect from the ovaries. Another cause of early breast development which is rare but usually looked for in preschool girls or older is uncontrolled hypothyroidism-that is the TSH that the brain makes to stimulate the gland also cross reacts at the LH receptor causing some stimulation, once the thyroid problem is corrected this goes away.
I have not read or heard of this with congenital hypothyroidism though, but it is worthwhile making sure that the thyroid blood tests are just right and she is on good treatment.
So another cause is a simple cyst on the ovary usually found in preschoolers or early school age group with early breast, it is a benign process, needs monitored with ultrasound but can produce a little estrogen so that the breast tissue is responsive.
Now, if she is breast fed this normal little bit of premature thelarche is often seen, just from mommies hormones.
So talk with your endo and monitor her with her, if it enlarges, or if there is any vaginal bleeding noted in her diaper, these are real reasons for workup, if her thyroid is well controlled, then her peds endo can follow her with you, it sounds like a benign thing and yes we see it alot. Usually is not a problem after a year or two.
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