Breast Changes Before and After Pregnancy

Almost from the moment of conception, a woman's body starts preparing to breastfeed. "Many women notice changes to their breasts even before they miss a period," says Sharon Mass, MD, a Morristown, New Jersey, Ob-Gyn and an editor of The Breastfeeding Handbook for Physicians (AAP). That's because the amount of fatty tissue and blood flow to the breasts increases after conception – all to help the milk ducts and mammary glands grow. Your breasts will continue to develop throughout your pregnancy and after the baby is born. Here's what to expect.

First Trimester Breast Changes

Breasts are busiest in the first trimester. During these weeks, progesterone causes milk glands to develop and estrogen stimulates growth of the milk ducts. Breasts typically expand one or two bra cup sizes and veins get darker. 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 make your breasts 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.

Breast Changes in the Second and Third Trimesters

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.

Postpartum Breast Changes

"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, 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.

Pregnancy Breasts FAQs

Will my breasts ever look the same?

After you wean, your body absorbs remaining milk, your nipples return to their regular color, and breasts return to roughly their pre-pregnancy size. Although many women claim they're left with smaller or larger breasts, Dr. Mass says that this probably has more to do with post-pregnancy 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 the loose skin may make your breasts look more saggy.

I have really small breasts. Will I be able to nurse my baby?

Breast size is largely determined by the amount of fat present in them. Except for very rare cases, even if you have small breasts, you still have enough milk glands and ducts.

Can I avoid developing stretch marks on my breasts?

Unfortunately, stretch marks are usually genetically predetermined and you can't do much to prevent them. Moisturizing will make breasts more comfortable as the skin stretches, and time will make the marks less visible.

What if I've had breast surgery?

There's usually no problem if incisions for augmentation were made in the armpit or under-breast fold. Nipple incisions, however, sometimes damage nerves that trigger hormone stimulation. Whether you can nurse after reduction surgery depends on how many milk glands and ducts were removed, whether nipples were repositioned, and if there's a clear path for milk to leave the breasts. Either way, it's worth trying.