Breast Assessment using the Ballard Score

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. 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.

Breast size and nutritional factors

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.

Breast Score