The Ballard Score Maturational Assessment of Gestational Age in Newly Born Infants

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 Assessment using the Ballard Score


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 size and nutritional factors


Breast Score

SIGN PHYSICAL MATURITY SCORE SIGN
SCORE
-1 0 1 2 3 4 5
Breast imperceptable barely
perceptable
flat areola
no bud
stippled areola
1-2 mm bud
raised areola
3-4 mm bud
full areola
5-10 mm bud
                          
Breast Score