Cultural gynecomastia in the 21st century India: “Witch's milk” revisited

Despite the common cultural practice of expressing breast milk in neonates, the resulting gynecomastia is rarely reported probably because it is considered benign and short lasting. To determine the clinical course of gynecomastia–galactorrhea resulting from the cultural practice of expressing breast milk, we performed a retrospective analysis of data of 20 infants (14 girls) diagnosed as cultural gynecomastia at a tertiary care pediatric hospital over the past decade. The mean age at presentation and at the time of first noticing was 8.0 ± 9.3 months (range 0.25–27 months) and 54.6 ± 93.9 days (range 2–365 days) respectively. The average duration of breast manipulation was 39.0 ± 66.9 days (range 3–270 days). All infants cried during the process of breast manipulation. The mean age at complete resolution was 16.9 ± 8.9 months (range 4–36 months). Gynecomastia resulting from the cruel cultural practice of milking of neonatal breasts exists in modern times and may persist for long time during infancy.