Witch's milk
Witch's milk or neonatal milk is milk secreted from the breasts of some newborn human infants of either sex.[1] Neonatal milk secretion is considered a normal physiological occurrence and no treatment or testing is necessary.[2] It is thought to be caused by a combination of the effects of maternal hormones before birth, prolactin, and growth hormone passed through breastfeeding and the postnatal pituitary and thyroid hormone surge in the infant.[2]
Breast milk production occurs in about 5% of newborns and can persist for two months though breast buds can persist into childhood. Witch's milk is more likely to be secreted by infants born at full term, and not by prematurely born infants.[2] The consistency of neonatal milk is estimated to be quite similar to maternal milk.[3] Its production also may be caused by certain medications.[4] In extremely rare cases neonatal mastitis may develop but it is unclear if it is related to neonatal milk secretion.[citation needed] Blood from the nipples is nearly always benign and frequently associated with duct ectasia; it should only be investigated when it is unilateral.[5]
Cultural interpretations
[edit]In folklore, witch's milk was believed to be a source of nourishment for witches' familiar spirits.[6] It was thought to be stolen from unwatched, sleeping infants. In other cultures expressing milk from the infant's breasts is supposed to contribute to a good breast shape in adulthood.[1] In the 1500s in England, milk had a religious association to nurture and purity.[7]
In some cultures, the tradition of removing the milk ("milking") has been reported. This practice can prolong milk production and other problems cannot be ruled out.[1] While breastfeeding may also contribute to prolonged milk production and breast enlargement, temporary, or permanent weaning is not recommended.[citation needed]
Factors Contributing to Witch's Milk in Newborns
[edit]Witch's milk, or neonatal galactorrhea, in newborns is primarily caused by hyperprolactinemia, which results from the decline of maternally transferred estrogen in the neonate, stimulating milk production. Maternal estrogens are essential for developing a newborn's mammary glands during pregnancy. These hormones cross the placenta and stimulate the growth of breast tissue in the fetus. After birth, the levels of maternal estrogens fall quickly since the placenta is no longer supplying these hormones. This rapid decrease can disturb the newborn's hormonal balance[8]. Consequently, the baby's pituitary gland may increase the production of prolactin, a hormone that triggers milk production. This condition, called hyperprolactinemia, can cause the newborn’s breasts to produce milk, a phenomenon known as "witch's milk." Usually, this milk production is temporary and resolves as the baby’s hormone levels adjust. However, in some cultures, the tradition of manually expressing this milk based on cultural beliefs can worsen the condition, resulting in prolonged breast enlargement and milk secretion.[9]
The paper titled "Pituitary Prolactin in Pregnancy and Normal and Abnormal Lactation" by Friesen, Fournier, and Desjardins examines the crucial function of the pituitary hormone prolactin in breastfeeding[10]. The study highlights how prolactin levels vary throughout pregnancy and in different lactation conditions. Prolactin, which is produced by the pituitary gland, is vital for starting and maintaining milk production. Its levels increase during pregnancy to prepare the breasts for milk production and stay high after childbirth to continue supporting breastfeeding. The research also explores issues related to abnormal lactation, such as inadequate milk supply or galactorrhea, which is an excessive milk flow not linked to childbirth. Fluctuations in prolactin levels can greatly influence these problems. By analyzing prolactin levels in various lactation situations, the study provides insights into how changes in prolactin affect milk production and overall lactation health. This research emphasizes the need to understand prolactin's role for better diagnosis and management of lactation issues, offering valuable information for treating both normal and problematic lactation cases.
Galactorrhea in Infant Induced by Maternal Antidepressants Use: Case Report by Érica Batalha Gomes and her team present a rare case of infant galactorrhea associated with maternal use of antidepressants, as detailed in their study published in the Brazilian Journal of Case Reports (2024). In this case, a 3-month-old infant developed nipple lesions and milk production. Initially, the condition was thought to be an infection resulting from excessive handling. However, repeated episodes led to further investigation by a mastologist, who proposed that the galactorrhea could be linked to the mother’s antidepressant medication, specifically sertraline and quetiapine. Although these medications are generally considered safe during breastfeeding, they can still affect the infant.
The study highlights the importance of considering this rare but possible side effect when diagnosing persistent galactorrhea in infants. It underscores the need for thorough monitoring and assessment of potential drug impacts on infants, particularly when common explanations for symptoms do not apply[11].
See also
[edit]References
[edit]- ^ a b c Devidayal (2005). "A Male Infant with Gynecomastia-Galactorrhea". The Journal of Pediatrics. 147 (5): 712. doi:10.1016/j.jpeds.2005.06.026. PMID 16291370. "full text" (PDF).
- ^ a b c Madlon-Kay, D. J. (1986). "'Witch's milk'. Galactorrhea in the newborn". American Journal of Diseases of Children. 140 (3): 252–253. doi:10.1001/archpedi.1986.02140170078035. PMID 3946357.
- ^ Yap, P. L.; Mirtle, C. L.; Harvie, A.; McClelland, D. B. (1980). "Milk protein concentrations in neonatal milk (witch's milk)". Clinical and Experimental Immunology. 39 (3): 695–697. PMC 1538139. PMID 7379333.
- ^ Paturi, B.; Ryan, R. M.; Michienzi, K. A.; Lakshminrusimha, S. (2009). "Galactorrhea with metoclopramide use in the neonatal unit". Journal of Perinatology. 29 (5): 391–392. doi:10.1038/jp.2008.246. PMID 19398999.
- ^ Weimann, E. (2003). "Clinical management of nipple discharge in neonates and children". Journal of Paediatrics and Child Health. 39 (2): 155–156. doi:10.1046/j.1440-1754.2003.00118.x. PMID 12603810. S2CID 34248317.
- ^ Potts, Malcolm (1999). Ever Since Adam and Eve: The Evolution of Human Sexuality. p. 145. ISBN 978-0521644044.
- ^ mhradmin. "Close To Goodness, Close to Sin: Cultural Meanings of Milk in England between 1500 and 1650 – The MHR". Retrieved 2024-07-23.
- ^ Dayal, Devi; Soni, Vimlesh; Jayaraman, Dhaarani; Sindhuja, Lakshminarasimhan; Sachdeva, Naresh (2016-09-01). "Cultural gynecomastia in the 21st century India: "Witch's milk" revisited". Pediatria Polska. 91 (5): 472–475. doi:10.1016/j.pepo.2016.04.010. ISSN 0031-3939.
- ^ R. Calzada León (2003-04-01). "Pediatric Endocrine Diseases in Pre-Hispanic Aztecs". Journal of Pediatric Endocrinology and Metabolism. 16 (4): 487–494. doi:10.1515/JPEM.2003.16.4.487. ISSN 2191-0251.
- ^ Friesen, H. G.; Fournier, P.; Desjardins, P. (September 1973). "Pituitary Prolactin in Pregnancy and Normal and Abnormal Lactation". Clinical Obstetrics and Gynecology. 16 (3): 25. ISSN 0009-9201.
- ^ Gomes, Érica Batalha; Nogueira, Camila Távora; Gomes, Arthur Lopes da Silva; Oliveira, Aline de Albuquerque; Guimarães, Mara Rocha Crisóstomo; Belchior, Heloísa Oliveira Magalhães; Guimarães, Tiago Moraes (2024). "Galactorrhea in infant induced by maternal antidepressants use: case report". Brazilian Journal of Case Reports. 4 (3): 30–34. doi:10.52600/2763-583X.bjcr.2024.4.3.30-34. ISSN 2763-583X.
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