Reshmi Basu, MD

The mother of a 5-week-old boy was concerned about a swelling   under her infant’s right nipple. A 2-cm, movable subareolar mass   was palpated on examination. No redness was noted around the   nipple, and no tenderness was appreciated. Gentle pressure on the   mass caused a small amount of white milky substance to exude   from the nipple.

Galactorrhea of the newborn (neonatal milk or witch’s milk) occurs   in about 5% of neonates and in both sexes.

 The term “witch’s milk” comes   from ancient folklore that fluid leaking from a newborn’s nipple was a   source of nourishment for witches’ familiar spirits.3 Galactorrhea is the result   of the influence of the mother’s hormones on the baby before birth.

 The mother’s hormones can persist in the neonate’s body for weeks. Up to   2% of infants secrete milk until 2 months of age.

 Infants with galactorrhea   have significantly larger breast nodules than infants without galactorrhea.   Galactorrhea is more likely to be seen in infants who are nursed and is relatively   uncommon in premature infants.

The condition usually resolves spontaneously within a few months. No   treatment is necessary unless the area becomes red or tender. Discourage   massage or manipulation of the breast tissue because it may force bacteria   into the milk glands, which can lead to mastitis.

This infant’s mother was reassured about the benign nature of the condition   and encouraged to continue nursing. She was also cautioned against   massaging or unnecessarily manipulating the breast tissue.

 Madlon-Kay DJ. Witch’s milk. Galactorrhea in the newborn. 

 Sanfilippo JS. Gynecological disorders of childhood. In: Behrman RE, Kliegman RM, Jenson HB, eds.  

. 17th ed. Philadelphia: Saunders; 2004:1834.  
  

Ever Since Adam and Eve: The Evolution of Human Sexuality

. Cambridge, United Kingdom:  Cambridge University Press; 1999:145.  
  

. 3rd ed. Philadelphia: WB Saunders; 1971:685-686.  
  

 Wammanda RD. Images in clinical practice: bilateral neonatal breast enlargement associated with mastitis.  

. 2004;3:45. https://tspace.library.utoronto.ca/bitstream/1807/4075/1/am04013.pdf.  Accessed September 21, 2010.

Articles

 The mother of a 5-week-old boy was concerned about a swelling under her infant’s right nipple. A 2-cm, movable subareolar mass was palpated on examination.

Reshmi Basu, MD

Articles

Galactorrhea of the Newborn (Witch’s Milk)