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What To Expect - When Your Breasts Change During/After Pregnancy

Among the many events during/after pregnancy is when your breasts change. Apart from being one of the earliest noticeable signs of your pregnancy, they are important - your body has already begun the necessary steps to support the baby after birth.

Are you aware of the extent your breasts may change after you have your baby? Many women are surprised to learn tgeir breast size may not return to normal for some time (if ever); or some other challenges that happen during breastfeeding.



Breasts Change During Pregnancy

Breast Changes in Early Pregnancy

And these changes happen as a result of hormones which prepare the body to carry the pregnancy and support the baby after birth.

There are several hormones working, but in early pregnancy, Estrogen & Progesterone cause the main changes.


Some Hormone Effects in Early Pregnancy

  • More blood flows to the breasts and they retain fluid so they get swollen and feel sore/ sensitive. This one of the commonest breast changes during pregnancy.
  • From 6-8 weeks, your breasts increase in size and continue growing throughout pregnancy
    • Your bra size may go up by 1-2 cup sizes. 
  • As they grow bigger, the skin over your breasts stretches which can lead to itching and stretch marks. Makin use of an emollient or hydrating oil can help reduce the development of these problems.
  • The darker area immediately around the nipples is called the areola. In pregnancy, the skin gets darker due to the pregnancy hormones which affect skin pigmentation.
  • You may notice the veins under the skin of your breasts look darker / more pronounced which happens because of the increase in blood flow to your breasts
  • From ~ 12 weeks, your breasts start producing a type of milk - a yellowish, thick substance known as colostrum (pre-milk).
    • Some women may produce colostrum earlier while others - not at all.
    • Colostrum is a sweet and watery fluid that is easy to digest making suitable, early food for the baby.
  • As the breasts get bigger, so do the nipples and areola and you might notice little bumps on the areola.
    • These are small oil-producing glands called Montgomery’s tubercles.
  • A lot of these changes such as pigmentation or breast size may be a permanent event in some women.
  • Other problems like soreness or senitivity will settle, as will most of the discomfort that you may experience with breastfeeding.


Could we be GLOSSING over how women could develop serious problems in pregnancy and childbirth? This Pregnancy Stories series is based on a discussion started on Twitter which has since generated a lot of interest. She described several complications of pregnancy and childbirth in her own personal experience. Responses have been varied - some support or in disagreement. Many comments have largely centred on surprise at the development of the complications; upset they were not warned to expect such problems.

On another strand, some comments were directed towards the poor maternal mortality rates in LMIC like Nigeria. One likened “having kids in Nigeria to soldiers going to war” referring to death as a serious complication. But some other users shared their own positive pregnancy experience to remind us about the need for balance. However, complications from pregnancy and childbirth are very real. Educating women so they have an idea of what to expect must be our priority.


Breasts Change During Pregnancy

How Your Breasts Change Immediately After Birth

Although breastfeeding is a natural way to feed baby, there could be a few issues around getting it right.

Breastfeeding is a skill that can take time to learn, there may be a few challenges before you get used to it.

If you do decide to breastfeed, you should know some of the problems that can arise:

  • Low milk supply
  • Sore Nipples
  • Breast Engorgement
  • Mastitis
  • Thrush
  • Difficulty latching on


Low Milk Supply

This is when your breasts are not making enough milk for the baby.

It could happen if you were ill before or after birth and are unable to start breastfeeding straightaway for one reason or another.

It’s important to feed your baby as often as they desire – this empties the breasts and gives your body the alert (via your hormones) to produce more milk.

Eating a regular, balanced diet and drinking plenty of vegetables helps your milk production.

Breasts Change During Pregnancy

Sore Nipples

One of the way breasts change during pregnancy is with the development of sore nipples.

They can also be a big challenge after childbirth causing you pain and may go on to affect your baby's feeding.

It usually happens if the baby is not taking in enough of the nipple and areola into the mouth.

Your baby's mouth needs to be open wide to allow a good amount of the areola around which to latch with the nipple in the centre to avoid them pulling at the nipple.

They need to exert pressure on the milk ducts within the breast/ areola to release the milk.

If your baby catches just the nipple in their mouth and is pulling at it, you can use a clean finger to gently dislodge it and reposition your breast.

When they keep sucking at the nipple, the pressure leads to cracked/bleeding nipples developing.

Treating Sore/Cracked Nipples

If you do develop sore nipples, you can rub a few drops of your breast milk over your nipple with clean fingers then let your nipples air dry after feeding. 

Breast milk has natural healing emollients and of course, is readily available.

Alternatively, you can get breast emollient cream containing Lanolin to apply to your breasts after feeding. This can help keep them from cracking/ bleeding

You should also be careful with some bras – synthetic fibres could irritate the nipples leading to damage to the nipples.

Breast Engorgement

When your breasts become too full of milk, they are engorged.

This condition makes the breasts become hard, heavy and painful.

It's most likely to happen in your first week of breastfeeding while you adjust to your baby’s needs or demand.

The milk ducts or channels in the breasts can become blocked.

Firstly, if there are long gaps between feeding, engorgement can develop. Secondly, a poorly fitting bra or even a car seatbelt could put pressure on the ducts and lead to engorgement.

Having engorged breast also plugs up your ducts further reducing milk supply.

If the breast is hard and the nipple flattened, the baby cannot latch on properly too.

Preventing Breast Engorgement

To prevent your breasts filling up with excess milk, make sure you breastfeed, pump or hand express as soon as possible.

One recommendation is to nurse (feed baby) eight times or more in 24 hours, for at least 15 minutes for each feed, to prevent engorgement.

To prevent engorgement, allow your baby to breastfeed as often and as long as he/she desires.

If you are working, you can also plan ahead, use a breast pump or hand express at the same time you will normally feed.

Treating Breast Engorgement

If you do get engorged breasts, breastfeeding often or expressing your milk will help.

Alternate taking warm showers followed by cold compresses to help to relieve the discomfort.

If engorgement persists, mastitis may develop, a painful condition where there is inflammation in the breast tissue.


Breasts Change During Pregnancy

Mastitis

Mastitis (inflammation of the breast) is quite common – 1 out of 5 women could develop it.

It’s more likely to happen with one of the following conditions:

  • Nipple damage,
  • Over-supply of milk,
  • Use of nipple shields and
  • If your nipple carries the germ Staphylococcus aureus, the risk of mastitis is higher

How Mastitis Develops

In some cases, mastitis may happen because of an infection and it very commonly progresses from blocked ducts or engorgement to mastitis and then breast abscess.

Infection is more likely if you have a cracked nipple. 

The infection affects the (fatty) tissue of the breast and causes swelling which pushes on the milk ducts causing pain and often a lump developing in the breast.

Your treatment may include antibiotics if early symptoms haven'tsettled after a day or so.

You may develop a fever, headache, feel tired and generally unwell.

Mastitis may progress into an abscess and require drainage in hospital as well as antibiotics.

If possible, you should continue breastfeeding (or pumping to relieve breast engorgement) while receiving treatment.


Thrush

This is when there is a yeast infection of the nipple.

Most often, your baby may have thrush in the mouth at the same time – and you both will usually be treated together.

You may have a burning pain around the nipple or deep pain in the breast but no signs of mastitis or engorgement

It's treated with an antifungal cream, applied to the breast, and oral antifungal to baby’s mouth.

Some mums may need to use oral antifungals if they are not getting better or the infection keeps coming back.


Difficulty Latching On

Many mums describe a big challenge when it comes to latching on.

As this is a key event happening within days or hours of birth, it can be quite traumatic.

You may also be battling with other issues like an episiotomy cut, recovering from anaesthesia after surgery.

Remember that getting breastfeeding right is a skill which can be learned, so don’t get your self down.

Some people around you may be flippant about just letting it happen, but such advice is usually unhelpful.

A lactation counsellor or your midwife can both demonstrate and show you feeding and latching positions.

Check out this link for a great video demonstration for breastfeeding positions and techniques.


Conclusion

Almost all women will observe their breasts change during pregnancy; some may simply occur without illness.

Others may get one or more of the complications we describe here, but as you can see, they can be addressed with a good amount of success.

We'd love you to share your experience of any changes you experienced while pregnant or breastfeeding in the comments below.

Just knowing how other women got through such a challenge can help expecting/new mums.

More Reading:

Editing by AskAwayHealth Team

Disclaimer

All AskAwayHealth articles are written by practising  Medical Practitioners on a wide range of health care conditions to provide evidence-based guidance and to help promote quality health care. The advice in our material is not meant to replace the management of your specific condition by a qualified health care practitioner.
To discuss your condition, please contact a health practitioner or reach us directly through info@askawayhealth.org

Image Credits: Canva

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