The breast bud consists of breast tissue that is stimulated to grow by maternal estrogens and fatty tissue which is dependent upon fetal nutritional status.
Inspect the breast to assess the size of the breast bud in millimeters and the development of the areola. Preterm newborns lack developed breast tissue. Term newborns have a raised to a full areola with breast buds that are 3 to 10 millimeters in diameter.
How to Examine Breast of the Infant
The examiner notes the size of the areola and the presence or absence of stippling (created by the developing papillae of Montgomery). The examiner then palpates the breast tissue beneath the skin by holding it between thumb and forefinger, estimating its diameter in millimeters, and selects the appropriate square on the score sheet.
Under- and over-nutrition of the fetus may affect breast size variation at a given gestation. Maternal estrogen effect may produce neonatal gynecomastia on the second to fourth day of extrauterine life.
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SIGN
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PHYSICAL MATURITY SCORE
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SIGN
SCORE
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-1
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0
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1
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2
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3
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4
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5
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Breast
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imperceptable
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barely
perceptable
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flat areola
no bud
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stippled areola
1-2 mm bud
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raised areola
3-4 mm bud
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full areola
5-10 mm bud
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