Breast changes during pregnancy

By Jayne Leonard 

Reviewed by Cynthia Cobb, APRN

First trimester | Second trimester | Third trimester | Milk production | Ways to ease discomfort | Changes to expect after pregnancy | When to see a doctor | Summary

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 they can continue right up until the birth of the baby and beyond.

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 woman to woman, and not everyone will develop all of the symptoms below.

First trimester breast changes

During weeks 0 to 13 of pregnancy, women may experience:

Tenderness and discomfort

Breast tenderness is often one of the earliest symptoms of pregnancy.

According to the National Institute of Child Health and Human Development, women may have sore, heavy, or tingly breasts as early as 1 to 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.

Enlargement

Going up a cup size or two when pregnant is normal for many women, especially if it is their first pregnancy. This growth can begin early on in pregnancy and continue throughout. A woman's breasts may also increase in size while she is breastfeeding.

This rapid growth can cause the breasts to feel itchy as the skin stretches.

Blue veins

Blood volume typically increases by 50 percent 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.

Second trimester

From weeks 14 to 27, the second trimester of pregnancy may bring about the following breast changes:

Darker areolas

The areolas are the colored circles around the nipples. Over the course of the second and third trimesters, the areolas often become larger and darker. Some people believe that this occurs to help the newborn locate and latch onto the nipples.

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 bumps

Pregnancy 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 discharge

Some women 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 it is more likely when the breasts become stimulated.

This thick, yellow discharge is colostrum, which is a liquid that boosts the immune function of newborns in the very early stages of breastfeeding.

Breast lumps

Lumpy 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
• 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 women under the age of 35 years, pregnancy can make it more difficult to diagnose and treat breast cancer.

Third trimester

Weeks 28 to 40 of pregnancy can lead to the following breast changes:

Continuing growth and other changes

Many of the 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 colostrum might leak more regularly.

Stretch marks

Rapid tissue growth causes the skin to stretch, which may lead to striae gravidarum, or stretch marks. Research indicates that between 50 and 90 percent of pregnant women develop stretch marks on their body, most commonly on the breasts, stomach, and thighs.

These red lines typically occur in months 6 and 7 of pregnancy, but they can also appear before or after this time.

Milk production

Breast changes occur to allow the newborn baby to feed.

However, women who do not experience dramatic breast changes during pregnancy should not worry about their ability to feed their baby. Nipple and breast changes are not indicative of a woman's ability to produce milk or breastfeed.

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.

Ways to ease discomfort

Many women 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 leakage

For colostrum leakage, try wearing breast pads. These are available in either a disposable or reusable form.

Applying lotions and oils

Applying lotions or oils to the breasts can relieve skin tightening and itching. Many women 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 mark. Instead, the Office on Women's Health recommend being patient, as stretch marks and other skin changes usually fade after the birth of the baby.

Treating blocked milk ducts

A 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 lumps

Carry out regular breast checks during pregnancy to look for lumps and bumps, and speak to a doctor regarding any concerns. Usually, a lump will be benign, or it will occur due to a blocked milk duct.

Bra tips

Investing 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:

• good support
• wide straps
• adjustable closures
• no underwire
• cotton fabric composition
• seam-free design near the nipple

Sports bras and sleep bras are both comfortable options for pregnancy. Many women 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 woman's bra size can change several times as her breasts and chest expand.

Changes to expect after pregnancy

After women give birth, their 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 women, this occurs quickly. For others, it can take time. However, some women may find that their breasts never regain their prepregnancy appearance.

Sometimes, breasts may appear droopier after pregnancy. This change is more likely in women who smoked or who have:

• a high body mass index
• larger breasts (prepregnancy)
• several prior pregnancies

When to see a doctor

Anyone who has concerns about breast changes during or after pregnancy should see their 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.

Summary

Most women experience some breast changes during pregnancy 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 woman's ability to produce milk or breastfeed the baby.

Pregnancy-related breast changes can be uncomfortable. To manage symptoms, women 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 the discontinuation of breastfeeding.


SOURCE: MEDICAL NEWS TODAY