Parents have been asking me some hard questions about the breast lumps they are noting in their infants or being shown or told about by their older children and teens.

So, let me see if I can keep everyone abreast about this topic.

It is quite common for newborn babies, both boys and girls, to have some swollen or enlarged breasts with lumps felt under the nipples.

These are due to hormones or, more specifically, estrogens from mother that make her breasts swell at the time of birth to help produce breastmilk. These hormones are in turn passed over to the baby causing the breast lumps to appear and are totally benign. The best course is to leave baby breast lumps alone and let tincture of time take its course while the swelling decreases in size and the breasts no longer appear enlarged.

If, however, the breasts appear red, tender or have a thicker discharge of pus, please contact your baby’s health care professional but this is a very rare occurrence.

Breast lumps are usually not noted again until the start of puberty and are more likely to be called to your attention as a problem by a male rather than a female.

Again, this problem is a result of hormonal surges occurring during puberty and, in most cases, the lump will go down in two to three years as puberty runs its course.

Of note, breast enlargement in males has also been associated with the usage of marijuana and can also be hereditary. If concerned, again, please talk to your teen’s health care professional.

As to discrete lumps versus swelling in older children, be aware that breast cancer is extremely rare before the age of 20, making up less than one in a thousand of all breast cancer cases.

If a lump is detected by your child, an ultrasound may be useful to determine if the lump is a cyst or benign lump of tissue, or if it represents an infection of breast tissue – something we call an abscess.

If such a lump is detected, consultation with your child’s health care professional is in order to determine if further treatment is needed. Teaching girls how to self-examine their breasts once puberty occurs and they begin their menstrual cycles is an important thing to do not just during adolescence but for the rest of their lives to help screen for cancer.

Hopefully, tips like these will provide you with the mass of information needed to know when to worry or not worry about your infant, child, or teen’s breast lump.

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Lewis First, MD, is Chief of Pediatrics at The University of Vermont Children’s Hospital and Chair of the Department of Pediatrics at the University of Vermont’s Larner College of Medicine. You can also catch “First with Kids” weekly on WOKO 98.9FM and NBC5.