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Breast Changes Before and After Baby

"Almost from the moment of conception, a woman's body starts preparing to breastfeed," says Sharon Mass, MD, a Morristown, New Jersey, ob-gyn and an editor of The Breastfeeding Handbook for Physicians (AAP). "Many women notice changes to their breasts even before they miss a period." So a swelling chest may be your first cue that you're pregnant.

Right away, the amount of fatty tissue and blood flow to the breasts increases, all to help the milk ducts and mammary glands grow. Most women experience increased tenderness as their breasts get bigger and heavier. The swelling might make veins more noticeable underneath your skin. Another conspicuous effect: Your nipples may stick out more and the areola will begin to get larger and darker, which experts believe serves to guide the baby to the breast. To try to make yourself more comfortable:

  • Buy a new, less constricting bra.
  • Limit your salt intake to reduce swelling and water retention.
  • Grin and bear the tenderness. It's tempting to take over-the-counter pain relievers, but they won't offer much relief and it's best to steer clear of unnecessary medications.

"I'd heard that my breasts would get larger, but that still didn't prepare me for what I've experienced. I've gone from 'Wow -- look at me!' to 'This is a joke, right?'" says Denise Chas, of Smyrna, Delaware. "They keep getting bigger every week, and yet people say, 'Wait until your milk comes in.' I'm a little scared!"

As you approach the halfway point of pregnancy, breast tenderness usually eases and your breasts gain the capacity to provide milk. Some women experience leakage from their breasts, which is normal. The fluid you see is colostrum, the precursor to breast milk. You may start to notice stretch marks on your breasts, and the Montgomery glands (those small bumps dotting the areola) begin to enlarge. Your breasts (and your belly) might also start to itch as the skin stretches. To soothe them, apply a moisturizer after showering and at bedtime.

"Immediately after the placenta is delivered, your body begins to release the hormone prolactin to signal to your breasts that it's time to make milk," explains Dr. Mass. "The breasts are further stimulated by the baby's sucking, so if you plan to nurse, start breastfeeding right away."

Since it usually takes two to three days for breast milk to come in, your baby will receive colostrum when he or she first begins to nurse. When your milk does come in, expect your breasts to swell significantly, feel lumpy and heavy, and, most likely, to ache. To ease this engorgement:

  • If you plan to breastfeed, keep nursing. Around-the-clock feedings (8 to 12 times over a 24-hour period) in the first few days keep engorgement to a minimum and help you develop a good milk supply. If you need further help, try standing under a hot shower to let some of the milk flow out.
  • If you don't want to breastfeed, it's as simple as not nursing, says Dr. Mass. Hospitals used to give women drugs to prevent milk from coming in, but that practice is out of favor. Instead, Dr. Mass suggests donning a tight sports bra within 24 hours of giving birth and wearing it continuously for a week to signal to your breasts that they don't need to produce milk. You can also apply a cold pack (or a bag of frozen peas) to alleviate discomfort.

After you wean, your body absorbs remaining milk, your nipples return to their regular color, and breasts return to roughly their prepregnancy size. Although many women claim they're left with smaller or larger breasts, Dr. Mass says that this probably has more to do with postpregnancy weight than with the effects of pregnancy or nursing. Since the skin on your breasts has been stretched, however, you may notice stretch marks and -- sad but true -- the loose skin may make your breasts look more saggy.

The right bra makes all the difference in keeping you comfortable. Choose one that's supportive with a flexible underwire. After the birth, a nursing bra with no underwire gives you the most room to grow. So while your bra size may continue to be a moving target, here's how to determine what you need now:

  • Measure the diameter of your rib cage under your breasts (this is your bra's band size).
  • Measure around your chest over the fullest part of your bust.
  • Determine the cup size by taking the difference between the two measurements.

    1/2 to 1 inch = A cup

    1 to 2 1/2 inches = B cup

    2 1/2 to 3 1/2 inches = C cup

    3 1/2 to 4 1/2 inches = D cup

    4 1/2 to 6 inches = DD (E) cup

    6 to 7 inches = DDD (F) cup

You'll need to repeat this process a few times throughout your pregnancy because your breasts and even your rib cage size can keep expanding.

 

Originally published in American Baby magazine.

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