Many boys around your son’s age experience a small amount of breast development and sometimes tenderness. Your GP is right, it is linked to hormones.

In early puberty, testosterone, the male sex hormone, is converted to oestrogen, the female sex hormone. Boys, like girls, have oestrogen receptors in the breast area. In early puberty, testosterone levels may not have reached a level high enough to prevent oestrogen acting on breast tissue. This can be more obvious if a boy is overweight.

As puberty progresses, your son’s testosterone levels will rise and he should find that his nipple goes back to normal within a year. If the problem is very noticeable and doesn’t settle down, consult your GP again. There are some rare conditions linked to this, which might need treating.

Bowel concern
I am concerned about my children’s bowel movements. My son is 3 and sometimes has green-looking, loose bowel movements; at other times they look white. My four-month-old daughter often has yellow bowel movements, but is this linked to breast-feeding?
Name and address supplied

These all sound normal. The colour of bowel movements is due largely to the presence of pigments, mainly bilerubin, which are present in a watery green substance called bile. Bile is made in the liver, stored in the gall bladder and plays an important role in breaking down fats as food travels along the digestive system.

Breast-fed babies usually have loose, mustard-coloured bowel movements, so your baby’s nappies are fine. The colour and consistency will change when you introduce solid food. Greenish diarrhoea may mean that your son is suffering from a tummy bug and that food has travelled more quickly than usual through his gut.

In general, colour is not especially important. However, frequency and texture, which can indicate either constipation or diarrhoea, matter more and if you are concerned it’s best to seek your GP’s opinion. You should also get medical help if your child’s bowel movements contain blood or mucus as these can be signs of underlying medical problems.

Circumcision fear
Our eight-year-old son’s foreskin will not pull back over the top of his penis. Our GP says he will need to be circumcised, and that it is better to get it done soon. Is there an alternative?
James W. Macaulay, Cumbria

All boys are born with non- retractile foreskins. In the vast majority of boys, the foreskin will retract by puberty. There is a great deal of data suggesting that, in most cases, boys have a retractile foreskin by 4. But for some this won’t happen until 5, 8, even 10 or 11, and this is nothing to worry about.

Don’t be tempted to do anything to encourage the foreskin to retract. Eventually the adhesions holding the foreskin in place will begin to break down and it will gradually retract. It would, however, be reasonable to see a paediatric surgeon or paediatric urologist for advice. In the vast majority of cases the foreskin will, in time, retract naturally, without the need for surgical intervention.

Jane Collins is the chief executive and honorary consultant paediatrician at Great Ormond Street Hospital

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