Breast changes are a normal part of pregnancy and occur as a result of hormonal fluctuations. Changes to the breasts can occur as early as 1 week after conception and continue right up until the birth of the baby and beyond. Show
In this article, we discuss the breast changes that are most common during each trimester. We also provide some tips on easing breast discomfort when pregnant. It is important to note that breast changes vary from person to person, and not everyone will develop all of the symptoms below. During weeks 0–13 of pregnancy, symptoms may include: Tenderness and discomfortBreast tenderness is often one of the earliest symptoms of pregnancy. According to the National Institute of Child Health and Human Development, breasts may become sore, heavy, or tingly as early as 1–2 weeks after conception. The nipples may also feel sensitive or even painful to touch. These changes occur because of rising hormone levels in the body and increased blood flow to the breast tissue. Breast discomfort often subsides after a few weeks, although it may return in the later stages of pregnancy. EnlargementGoing up a cup size or two is normal when pregnant, especially during a first pregnancy. This growth can begin early on in pregnancy and continue throughout. Rapid growth can cause the breasts to feel itchy as the skin stretches. The breasts may also continue to increase in size after birth during nursing. Blue veinsBlood volume typically increases by 50% throughout pregnancy. As a result, prominent blue veins usually appear on several areas of the skin, including the breasts and stomach. These veins are necessary to carry the increasing volumes of blood and nutrients around the body to the developing fetus. From weeks 14–27, the second trimester of pregnancy may bring about the following breast changes: Darker areolasThe areolas are the colored circles around the nipples. Over the course of the second and third trimesters, the areolas often become larger and darker. Darkening areolas are likely to result from hormonal changes. Often, the areola returns to its prepregnancy color after breastfeeding, but it sometimes remains a shade or two darker than it was originally. Areola bumpsPregnancy causes small, painless bumps to appear on the areolas. These are oil-producing glands called Montgomery’s tubercles, and they lubricate the breasts and promote easier breastfeeding. Nipple dischargeSome people may notice nipple discharge during their second trimester. For others, this may not occur until the third trimester or after labor. Discharge can occur at any time but is more likely when the breasts become stimulated. This thick, yellow discharge is colostrum, a liquid that boosts the immune function of newborns in the very early stages of breastfeeding. Breast lumpsLumpy breasts affect some individuals during pregnancy. Usually, these lumps are not a cause for concern. They are often either galactoceles, which are clogged milk ducts, or fibroadenomas, which are benign breast tumors. However, it is still important to tell a doctor about any breast lumps that develop. Although the risk of breast cancer during pregnancy is low, especially in people under the age of 35, pregnancy can make it more difficult to diagnose and treat breast cancer. Weeks 28–40 of pregnancy can lead to the following breast changes: Continuing growth and other changesMany breast changes that occur in the first and second trimesters will continue throughout the final months of pregnancy. The breasts can become even larger and heavier, the nipples may continue to darken, and the colostrum might leak more regularly. Stretch marksRapid tissue growth causes the skin to stretch, which may lead to striae gravidarum or stretch marks. Research indicates that 50–90% of pregnant people develop stretch marks on their bodies, most commonly on the breasts, stomach, and thighs. These red lines typically occur in months 6 and 7 of pregnancy but can also appear before or after this time. Breast changes occur to allow the newborn baby to feed. However, people who do not experience dramatic breast changes during pregnancy should not worry about their ability to feed their babies. Nipple and breast changes are not indicative of a person’s ability to produce milk or chestfeed. After delivery, or sometimes before, the breasts produce small amounts of colostrum. This fluid helps boost the baby’s immune system. Newborn babies have very small stomachs and only require modest amounts of colostrum to meet their nutritional needs. Over the next few days, the breasts begin to produce milk instead of colostrum. Breast milk production typically starts between 5 days and 2 weeks after delivery. Anyone who has concerns about their ability to breastfeed should consider seeking help and support from a doctor, midwife, or lactation consultant. Many people experience breast discomfort during pregnancy. However, there are many ways for people to accommodate their changing breasts and ease discomfort during this time: Wearing breast pads for leakageFor colostrum leakage, try wearing breast pads. These are available in either a disposable or reusable form. Applying lotions and oilsApplying lotions or oils to the breasts can relieve skin tightening and itching. Many people also use these products in the hope of reducing stretch marks. However, current research suggests that topical treatments, such as cocoa butter and other oils do not prevent the formation of stretch marks. Instead, the Office on Women’s Health recommends being patient, as stretch marks and other skin changes usually fade after the birth of the baby. Treating blocked milk ductsA person can treat blocked milk ducts by applying a warm compress to painful, blocked areas of the breasts. Massage can also be helpful. Gently massage the breast from the sore area toward the nipple. Checking breasts for lumpsCarry out regular breast checks during pregnancy to look for lumps and bumps, and speak with a doctor regarding any concerns. Usually, a lump will be benign or occur due to a blocked milk duct. Bra tipsInvesting in a well-fitting and supportive bra is one of the best ways to ease breast discomfort during pregnancy. When choosing a bra, look for one that has:
Sports bras and sleep bras are comfortable options for pregnancy. Many people prefer to buy nursing bras as they approach their delivery date. Nursing bras are also suitable for use during pregnancy and while sleeping. It is a good idea to get a professional fitting for a bra during pregnancy because a person’s bra size can change several times as their breasts and chest expand. After birth, a person’s breasts will maintain their larger size due to milk production. Once they stop breastfeeding, their breasts and nipples often return to their normal size, shape, and color. For some people, this occurs quickly. For others, it can take time. However, some people may find their breasts never regain their prepregnancy appearance. Sometimes, breasts may appear droopier after pregnancy. This change is more likely in people who smoke or who have:
Anyone who has concerns about breast changes during or after pregnancy should speak with a doctor. It is essential to seek medical attention if breast lumps develop or if the nipples produce an unusual discharge that does not resemble colostrum. These symptoms are likely to be harmless, but it is a good idea to have a doctor check them. Most pregnant people experience breast changes due to rising hormones and increased blood volume. However, not everyone experiences these changes. A lack of breast changes does not signify anything about the health of the pregnancy or a person’s ability to produce milk or breastfeed the baby. Pregnancy-related breast changes can be uncomfortable. To manage symptoms, people can invest in a supportive bra, apply lotions to itchy skin, and wear pads for leakage. Most changes will reverse after the delivery of the baby or discontinuation of breastfeeding. Learn more at our dedicated pregnancy and parenthood hub. 1. Being breast aware in pregnancy 1. Being breast aware in pregnancyIt’s important to be breast aware during and after pregnancy. This means getting to know how your breasts look and feel so you know what’s normal for you. This will help you feel more confident about noticing any unusual changes. Breasts change a lot during pregnancy, so it can be difficult to notice any unusual changes at this time. If you’re unsure about any change to your breasts, talk to your midwife or GP. The breasts and nipplesBreasts are made up of lobules (milk-producing glands) and ducts (tubes that carry milk to the nipple). These are surrounded by glandular, fibrous and fatty tissue. This tissue gives breasts their size and shape. The darker area of skin around the nipple is called the areola. On the areola there are some small raised bumps called Montgomery glands, which produce fluid to moisturise the nipple. 2. How do breasts change during pregnancy?Your breasts change during pregnancy to prepare them for feeding your baby. These changes are caused by an increase in hormones, and may include the following:
From about the 16th week of pregnancy the breasts are able to produce milk. It’s not unusual for small amounts of straw-coloured fluid called colostrum to leak from the nipples. If you’re worried that it may be noticeable on your clothes, you can use a breast pad (a disposable or washable fabric pad) inside your bra. In the last few weeks of pregnancy the nipples become larger and the breasts continue to grow as the milk-producing cells get bigger. Your breasts may feel uncomfortable and sometimes painful. Wearing a well-fitting bra may help relieve any pain or discomfort. It’s fine to sleep in a bra if it’s more comfortable for you. Women are usually advised to avoid certain types of pain relief while pregnant, but if your breasts are particularly painful you can talk to your GP or midwife for advice on pain medication. 3. Are breast lumps common during pregnancy?Breast lumps sometimes develop during pregnancy. The most common ones are:
These are benign (not cancer) breast conditions. If you had a fibroadenoma before you were pregnant you may find this gets bigger during pregnancy. Breast cancer in women of child-bearing age and during pregnancy is uncommon. However, you should get any new breast lump, or any changes to an existing breast lump, checked by your GP. 4. Is it normal to have blood from your nipple?A few women may have occasional leakage of blood from the nipple. This is due to an increase in the number and size of blood vessels. Although this can be normal during pregnancy, it’s best to get any leakage of blood from the nipple checked by your GP. 5. Finding the right size bra during pregnancyAs your breasts increase in size you should check that your bra isn’t too tight. It’s worth visiting a department store or lingerie shop to be measured and have your bra size checked by a trained bra fitter. Or you could contact the National Childbirth Trust (NCT). A bra fits well if:
You may find it more comfortable to wear a maternity or soft-cup bra. These types of bras can also be worn in bed if you feel you need extra support while sleeping. If you’re hoping to breastfeed, you may want to buy a couple of nursing bras. These have cups that unfasten and make it easier to feed your baby. The best time to be fitted for a nursing bra is a few weeks before your baby is due when your breasts will have done the majority of their growing. For more information on finding a bra that fits correctly download our guide to a well-fitting bra. 6. How do breasts change after birth?Following the birth of a baby, oestrogen and progesterone levels decrease quickly. Around the third day or so after the birth the colostrum becomes diluted by additional fluid that makes it look much whiter. Around this time your breasts may start to leak milk. When a baby sucks at the breast it triggers nerves that carry messages to the brain that milk is needed. Some women find milk leaks from the nipple when they hear their baby cry, or if their breasts are full and they feel emotional. This can happen quite a lot in the first few days after you give birth and can sometimes be embarrassing. Putting disposable or washable breast pads in your bra can help you feel more comfortable and prepared. Changes due to breastfeedingThe changes that happen to the breasts during pregnancy prepare them for feeding a baby. The Department of Health recommends exclusively breastfeeding for the first six months of your baby’s life, if possible, and then continuing to breastfeed alongside solid foods for as long as mother and baby wish. Research shows that breastfeeding may reduce the risk of developing breast cancer. Although breastfeeding is a natural process it can sometimes take a little time to get right. If you’re finding it difficult, talk to your midwife or health visitor. Some women choose not to breastfeed because it hasn’t been possible or they simply do not feel it is the right choice for them and their baby. There is not a right or wrong decision; you just need to feel you’ve made the best decision for you and your baby. Women who’ve had breast surgery – due to breast cancer, breast reduction, surgery to the nipple or breast implants, for example – may find that they’re unable to breastfeed. This is due to the formation of scar tissue. However, some women are still able to breastfeed after surgery. You can ask your midwife, health visitor or breastfeeding counsellor for help if needed. You can find more information about breastfeeding on the NHS website. You can also call the National Breastfeeding Helpline on 0300 100 0212 for confidential breastfeeding support and information. 7. Possible breast problems after pregnancyThe following describes some of the problems you may experience when your milk ‘comes in’ (when your body begins to produce breast milk and no longer colostrum). Some of this information may apply whether you decide to breastfeed or not. Problems could include:
Sore and cracked nipplesSore and cracked nipples can develop if the baby does not attach to the breast correctly. If the baby only sucks the nipple, rather than the whole areola being in their mouth, the baby’s tongue or roof of the mouth rubs on the nipple. The nipples can quickly become sore and sometimes cracked. The nipples won’t heal if the baby does not attach to the breast properly, so if feeding is painful it’s important to get support from a midwife or breastfeeding counsellor as soon as possible. EngorgementBreast engorgement is when the breast becomes overfull of milk. Some women describe their breasts as feeling hard, warm and throbbing. Breast engorgement generally happens when milk first comes into the breasts. If your breasts are engorged and you’re continuing to breastfeed, it’s important to make sure your baby is attaching to the breast correctly. Your midwife, health visitor or breastfeeding counsellor can help you with this. Breast engorgement may be eased by:
You may also find the following helpful:
Blocked milk ductsSometimes a milk duct becomes blocked while breastfeeding. This can also happen when you stop breastfeeding. You may experience a small, painful, hard lump or a bruised feeling. Things that may help include:
MastitisIf breast engorgement or blocked milk ducts continue the breast may become inflamed or infected. This is called mastitis. The breast may be red, hot and painful. Mastitis can cause flu-like symptoms including headaches, nausea and a raised temperature. It’s important to continue to breastfeed frequently, especially from the affected breast, as this helps to clear the infection and isn’t harmful to the baby. If you think you might have mastitis you’ll need to see your doctor as it may need treating with antibiotics or anti-inflammatory drugs. Breast abscessIf mastitis or an infection isn’t treated, some women go on to develop an abscess (a collection of pus) in the breast. Breast abscesses are not common – if you think you have an abscess it’s very important to see your GP. They may refer you to a breast clinic. Abscesses are usually treated with antibiotics and are often drained using a needle and syringe. An ultrasound scan may be used to guide the needle into the correct place. If the abscess is large, a small cut is made in it to allow the pus to drain away. An injection of local anaesthetic is usually given to numb the area first. As with mastitis, your doctor will usually advise you to continue breastfeeding or use a breast pump to express the milk regularly. ThrushThrush (candida albicans) is a yeast infection that may occur on the nipple and areola during breastfeeding. It can develop following cracking or damage to the nipple but may also happen suddenly, even when you’ve been breastfeeding for some time. The nipple may become itchy, painful and sensitive to touch. Some women find they have shooting pains deep in the breast that start after feeding and can last for a few hours. Thrush can be difficult to diagnose as many of the symptoms are similar to those caused by the baby not being latched on to the breast properly during breastfeeding (see Sore and cracked nipples). Thrush can also be passed from mother to baby. Signs of thrush in your baby may include a creamy patch on the tongue or in the mouth which does not rub off. Babies may also get a sore mouth which can cause restlessness during feeding and pulling away from the breast. Nappy rash (red rash or soreness that’s slow to heal) is another symptom of thrush. If you think you have these symptoms, talk to your GP or health visitor. Both you and your baby will need to have treatment at the same time. 8. What happens if I do not breastfeed, or want to stop?If you choose not to breastfeed and no milk is being expressed you’ll stop producing milk. You may find your breasts feel heavy, uncomfortable and sore for a few days. Wearing a supportive bra and taking pain relief may help. Women continue to produce milk as long as breastfeeding continues. When you stop breastfeeding it may take some time for the milk production to stop completely. If you stop breastfeeding too quickly it can lead to engorgement. When you want to stop breastfeeding it’s best to gradually reduce the length and number of your breastfeeds. You may like to start by dropping one feed a day. Your body produces milk on a supply-and-demand basis so this will naturally reduce the amount of milk you produce. Milk may leak for several weeks after you stop breastfeeding if something triggers the ‘let down’ reflex (when hormones tell your breasts to produce milk). You may experience a tingling feeling in your breasts and nipples that can be quite strong, a feeling of sudden fullness, or you may notice that milk starts to leak from either or both breasts. When you stop breastfeeding your breasts will slowly reduce in size. 9. Your breasts after pregnancyAfter pregnancy, whether you have breastfed or not, your breasts probably won’t look or feel the same as they used to. You may have gained or lost weight, and it’s not unusual to find your breasts have altered in size and shape compared with before pregnancy. These changes are part of the normal changes your breasts go through at different stages in life. It’s important that you get to know how your breasts look and feel now so you can be aware of any new changes. You can find out more on our Checking your breasts pages. 10. Further supportChanges to your breasts during and after pregnancy can make you feel anxious or you aren’t in control. If you’re finding it difficult to cope, talk to your GP or you can call our Helpline and talk to one of our experts on 0808 800 6000. |