Gynecomastia refers to a syndrome of abnormal feminization with swelling of the breast tissue in boys or men, caused by an imbalance of the hormones estrogen and testosterone. 29 Gynecomastia is common during puberty in boys and can be seen in older males due to increased estrogen level-related obesity (increase aromatase activity), decreased hepatic clearance, estrogen ingestion, and estrogen producing tumors. Asymptomatic gynecomastia is common in older men, but individuals who present with gynecomastia of recent onset associated with pain and tenderness may require clinical workup. 29 Gynecomastia and other signs of male feminization may be caused by an absolute increase in E2 and/or E1. The testes may directly secrete too much estradiol due to a Leydif-cell or Sertoli-cell tumor. They may also secrete estradiol indirectly through the stimulatory effects of a human chorionic gonadotropin-secreting tumor of gonadal or extragonadal germ-cell origin. 29
In the UK and other countries where women can formula feed safely, you are advised only to feed your baby with formula milk from birth. This is different to advice in other parts of the world, where breastfeeding is recommended for women with HIV. This is partly because safe clean water, bottle sterilising equipment and appropriate formula milk may not be available. In addition, in many poorer parts of the world, breastfeeding may be lifesaving as it can significantly reduce infant mortality (deaths) by protecting against dangerous infections in infants and babies. This is not the case in the UK where babies who are formula fed also grow up to be strong and healthy. Ask your healthcare team or support organisation if you have any questions or if you have difficulty meeting the cost of formula and the equipment needed, as financial and other help may be available.