Breast Changes

From the beginning of your pregnancy, your breasts are changing. They are evolving and preparing for the arrival of your baby.

What changes can I expect?

Your breasts go through a number of changes during pregnancy. These changes include:

• Growth and enlargement
• Tender and hypersensitivity
• Darkening of nipples and areolas (the skin around your nipples), due to hormones that affect pigmentation of the skin
• Darkened veins along your breasts (due to increased blood supply to your breasts)
• Your breasts may start leaking a yellowish, thick substance known as colostrum
• Nipples stick out more; the areolas and nipples will grow larger
• Small glands on the surface of the areolas called Montgomery’s tubercles become raised bumps

Your hormones are the cause of these changes and you may experience some effects more than others.

How can I handle some of the changes?

Here are some helpful suggestions you can do to make some of these changes more comfortable and easier to manage.

Growth and enlargement: For some women this may be something to look forward to, as you are excited about your breasts getting bigger. For women with large breasts there may be less enthusiasm. Buying a good supportive bra can help. If your breast size increases greatly, you may want to sleep in a cotton supportive sports bra at night.

What to look for in a bra:

• Good support
• Deep band beneath the cups
• Wide shoulder straps
• Adjustable closure (back-fastening bras give you more flexibility to adjust than front-fastening bras)
• Avoid underwire bras

Sensitive and tender breasts: Hormones in your body are preparing your breasts for lactation. The milk ducts are growing and being stretched as they fill with milk early in pregnancy. All this causes your breasts to be more sensitive, particularly your nipples. This can be a bonus for your sex life or can cause you discomfort.

Colostrum: This is known as pre-milk, which is a sweet and watery fluid that is easy to digest. During your second trimester your breasts will begin to produce colostrum. Colostrum appears thick and yellow at first, and as birth draws near, it becomes pale and almost colorless. Colostrum will provide your baby with his first few meals before your milk comes in. Discharge may occur at any time, when your breasts are massaged, or when sexually stimulated. There is no need to be alarmed when this happens, and there is no need to worry if it does not happen. Women who do not experience discharge in pregnancy still produce and provide milk for their baby.

What about breast cancer?

Continuing with self-breast exams during pregnancy is important. Unfortunately, during pregnancy it is more difficult to accomplish because of all the changes your breasts are going through. Your breasts are growing in size, are tender, and sometimes may even be lumpy due to all the preparations for your baby. It is still important for you to examine your breasts during pregnancy every 4-5 weeks.

Very common lumps found among women during pregnancy are clogged milk ducts. These are red, tender-to-the-touch, hard lumps in your breasts. Warm compresses (running warm water over your breasts in the shower or applying a warm wash cloth) and massage will probably clear the duct in a few days. If you are unsure of any new lump, tell your doctor on your next visit. Keep in mind breast cancer is rare among women younger than 35.

If you are planning on having a baby and are over the age of 35, you may want to consider asking your doctor about a mammogram before you get pregnant.

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Compiled using information from the following sources:

Williams Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 30 and 57.

Planning Your Pregnancy and Birth Third Ed. The American College of Obstetricians and Gynecologists, Ch. 7.