What breast changes should I expect during pregnancy?

During pregnancy the hormonal effects, mainly estrogen, can make the breast tissue feel swollen, fuller, tender, and enlarged. The nipples can become darker, more prominent, tender and sensitive. Nipple discharge and crusty changes also occur throughout pregnancy. The areola can become darker along with the nipples. The veins of the breasts become more prominent.  Breasts enlarge 2 to 3 sizes during pregnancy and breastfeeding. The breast tissue tone can be noticeably saggy following breastfeeding. Stretch marks can be seen on the breast tissue during pregnancy due to the fast growth of the breasts.

What are some reasons my breast sizes are completely uneven and different?

Breast tissue is affected by hormonal changes, especially caused by estrogen and include puberty, the monthly menstrual cycle, pregnancy, postpartum/breastfeeding, menopause, and trauma.

There is also a rare condition called juvenile hypertrophy of the breast that causes significant breast asymmetry-uneven or different is size and shape breast tissue.

Hypoplastic, or tubular, breasts describe a condition where one or both breasts, are underdeveloped and lack glandular breast tissue. Hypoplastic breasts can be easily seen on physical exam as narrow and widely spaced breasts with swollen areolas and breast asymmetry.

Mammogram imaging often detects breast asymmetry. Radiologic imaging can also detect abnormal cells. Atypical hyperplasia is a precancerous condition found on a breast biopsy and needs to be followed closely. These precancer cells can form when breast cells become abnormal in size, shape and appearance.

What happens to my breasts after breastfeeding?

Sadly, breastfeeding and pregnancy definitely contributes to saggy breasts. For many, our breasts will never be the same after breastfeeding.  Pregnancy starts the dramatic change in breast tissue as a result of hormonal changes and in preparation for breastfeeding. Other factors that contribute to permanent sagging include the number of pregnancies, changes in weight gain or lost, genetics, gravity and age. Women can’t blame all the breast changes solely on breastfeeding. You and your partner have to understand the amazing metamorphosis you have undergone to carry, delivery and breastfed the baby that you both have created.

Honestly a woman’s body is never quite the same after having a baby. Breasts definitely are affected, some worse than others, but this is part of the cycle of life. I am sure your breasts are still sexy as ever and bet your husband still feels that way. Our mental perception has to reset a bit in the bedroom after having babies. It’s important to discuss your feelings and insecurities with your husband so he can be supportive and reassuring.

How can I minimize saggy breasts after breastfeeding?

There are many things you can do to help minimize saggy breasts after breastfeeding and they include:

Exercise including pushups, dumbbell Pull-over, and Chest press
Creams to soften the skin of the breast
Wear good bra support
Wean gradually
Breast strengthening support
Avoid sloughing

If you still are unhappy with the “battle wounds” that pregnancy leaves on your body, some women go for a “mommy makeover” once they are done devoting their body and breasts to having babies.

Is it common for nipples to change appearance with age?

During pregnancy and postpartum, the hormonal effects of estrogen, can make the breast tissue feel swollen, fuller, tender, and enlarged. The nipples can become darker, more prominent, tender and sensitive. Nipple discharge and crusty changes also occur throughout pregnancy and postpartum. The areola can become darker along with the nipples.

What causes my nipples to get sore and tender during my menstrual cycles?

During different stages of life and hormonal surges, nipples change in size and appearance. The breast tissue, areola and nipple increase in size during puberty, pregnancy and breast feeding as a result of the hormonal surge of estrogen.

Swollen, enlarged, nodular and tender breasts and nipples are part of a woman’s menstrual cycle and those suffering from PMS can have exaggerated breast symptoms, especially nipple sensitivity.  Raising hormones, estrogen and progesterone, 1 to 2 weeks before your period, stimulate nipple tissue causing painful and sometimes, unbearable symptoms.  Once you start your period, nipple sensitivity quickly disappears.

Puberty, PMS, pregnancy and menopause are times in women’s lives where hormonal changes make nipples change in size, sensitivity and appearance.

What are some of the reasons I might experience breast discharge?

In pregnancy, as the breasts prepare for breastfeeding, a discharge from both nipples is generally seen as early as the second trimester.  This thick yellow nipple discharge is called colostrum and is completely normal during pregnancy.

Nipple discharge can be a very normal occurrence for non-pregnant women.  Galactorrhea is the medical term to describe a milky discharge by one of both breasts affecting 20-25% of women who are not pregnant. A clear fluid coming from the nipples can happen if they are excessively stimulated during intimacy and exercise.  During sex and intimacy, regular nipple stimulation either by the fingers or the mouth can cause a nipple discharge.  Tight tee-shirts or bras can rub the nipples also causing them to leak during exercise.  Commonly used drugs, such as the birth control pills, thyroid and psychiatric medications, can cause a normal nipple discharge as well.

Other causes of nipple discharge include breast infection, fibrocystic breasts, breast trauma, benign breast tumors, thyroid disease, illegal drugs including marijuana, and certain herbs, such as anise and fennel. More concerning causes of nipple discharge include pituitary gland tumors and a benign (noncancerous) breast growth called an intraductal papilloma and a rare form of breast cancer, called Paget’s disease of the nipple.

If I wear a bra to bed will that help prevent my breasts from sagging?

In a perfect world you would wear a bra at night to provide 24/7 breast support.  But in a practical and realistic world, your breasts need a break from being trapped in a bra all day. There is no medical evidence to show wearing a bra while you sleep is helpful in preventing saggy breasts.  The most common reasons breasts sag is pregnancy, breastfeeding, time, genetics and gravity.  If you are a firm believer that gravity is the main reason your breasts sag, you can wear a bra while you sleep but I wouldn’t encourage it.

I have breast implants. Are there any special considerations when trying to get pregnant or become pregnant?

Typically, there are no special considerations needed for women with breast implants trying to conceive, becoming pregnant or during pregnancy.

It’s always recommended to meet with your healthcare provider 6 months before getting pregnant to discuss any concerns you have regarding breast implants, pregnancy, and breastfeeding.

Will my breast size change since I have implants, during and after pregnancy?

Since breasts, with and without implants, enlarge 2 to 3 sizes during pregnancy and breastfeeding, wearing supportive and comfortable bras should always be a priority.

The hormonal changes and milk production associated with pregnancy and breastfeeding definitely contribute to sagging, less toned and, overall, changes in breast appearance. This is an individualized transformation and, with the changing of breast size and shape, will ultimately affect the appearance of the existing implant.

Will I need new implants after pregnancy or nursing?

Depending on the appearance of the breast and implant, one year after breastfeeding will determine if additional cosmetic surgery is necessary. It’s ultimately a personal decision that should be discussed with a trusted plastic surgeon.

Can I pump breast milk if I have implants?

Women with breast implants can successfully use a breast pump. Using a pump correctly is important so the appropriate amount of suction and pressure is applied to the nipple and areola. Consulting with a lactation consultant can be helpful in ensuring proper technique is being used.

Are there any risks I should be concerned about during pregnancy or nursing since I have breast implants?

Breast implants can cause infection, scarring, nerve damage affecting nipple and breast sensation, rupture, leakage, pain, and encapsulation. For the majority of people with breast implants, it is unlikely that any complications, during pregnancy and breastfeeding, can occur.  If any unusual symptoms develop, it should be brought to the attention of your healthcare provider.

Can I drink my own breast milk?

Breast milk is known to be nutritionally beneficial to a newborn baby but the benefits to the mother drinking it are uncertain. Some mothers feel an emotionally connection to consuming their own breast milk and others find it convenient to do so as well.

There does not appear to be any true risks drinking your own breast milk. If there has been any improper hygiene practices, this could lead to bacterial contamination which could be harmful to consume.

My BFF said I should drink her extra breast milk since she said it’s good for me, it that true?

Human breast milk is rich in nutrients, vitamins, and protective anti-bacterial and inflammatory properties, perfect for a growing newborn baby. Variables that affect breast milk composition include the health and diet of the person making it, storage, and proper hygienic practices.

There is limited medical research to support these health benefits for adults who consume or use breast milk topically. Some research suggests it may help people with eczema, dermatitis, arthritis, autism, and Crohn’s disease.

What would be my potential risks of me drinking someone else’s breast milk?

Since breast milk is a bodily fluid, there is always the risk of transmitting infectious diseases including Hepatitis B and C, HIV, Syphilis, and cytomegalovirus.

What is the difference between colostrum and white milk coming in?

Colostrum is the first nutrient-rich fluid that comes out of breast to feed a newborn during the first few days of life. It’s protective, high protein, low sugar and fat competition makes it the perfect healthy “meal” for the newborn.

Milk does not have the same rich nutrient composition that colostrum has but is around for the long-haul for a growing newborn.

Both colostrum and milk are protective from diseases, easy to digest and benefit cognitive functioning.

Is early milk different from the milk that comes in later on?

Early creamy milk, also known as transitional milk, follows colostrum. Early milk is produced for 2-5 days and lasts for 10-14 days after birth.

What are some signs my breast milk is about to come in?

Signs that breast milk is coming in is breast engorgement, warmth, tingling, pain and milk dripping from the nipples.

How can I deal with breast engorgement?

Breast engorgement can be very painful and uncomfortable. Ways to help decrease breast engorgement include using a warm compress, taking a warm shower, massaging the breasts while nursing and keeping a regular feeding or pumping schedule. Hand pumping or using a pump can help relieve engorgement as well.

Using a cold ice pack can also be helpful if there is significant or swelling.

Learning to not over pump is important since the more you pump the more you make.

What might cause your milk to be delayed?

Reasons that your milk production can be delayed include a Cesarean section delivery, postpartum hemorrhage, premature birth, retained placental tissue, infection with fever, significant stress, maternal obesity, diabetes, thyroid abnormality and the baby unable to latch properly.

What should you do if my breast milk is delayed from coming down?

If your milk is delayed it’s best to work with a lactation consultant. Use a breast pump on a regular schedule, even if it’s in the middle of the night.

Is breast feeding just hard for me or do other women suffer in silence?

Breastfeeding is extremely challenging and everyone woman experiences it differently. Frustration and nipple pain comes with the experience. Be patient, use your resources and know it does get better with time. It’s completely worth the effort for you and your baby.

Can medications transfer into breast milk?

Many medications can pass from the mother to baby during breastfeeding however most are considered safe to use.  Depending on the drug qualities (molecular weight and protein binding) will determine which drugs pass through the breast milk more easily and ultimately effect the baby.  Since it’s based on a drug-by-drug basis, each drug should be looked up on a reliable medical resource website to ensure its safety.

What cold medications (such as antihistamines, nasal decongestants, cough suppressants, expectorants) are safe to take while breastfeeding?

Most cold medications including antihistamines, nasal decongestants, cough suppressants and expectorants are generally safe to use while breastfeeding.

Ibuprofen, acetaminophen and naproxen sodium are safe to take while breastfeeding. Cough suppressants with dextromethorphan are safe to take while breastfeeding.

Always use cold medications as directed. Over medicating with cold medications can be harmful even for those approved to be safe while breastfeeding.

What specific ingredients commonly found in cold medications should you avoid taking while breastfeeding?

Cold medications containing phenylephrine and pseudoephedrine can decrease breast milk production so you could consider a safer alternative.

Some antihistamines containing diphenhydramine and chlorpheniramine cause drowsiness to not only the mom but also the baby Using a nondrowsy antihistamine is suggested.

Cold medications containing povidone-iodine may cause transient hypothyroidism of babies who are breast-fed. Medications with a high amount of alcohol should also be avoided since they may cause drowsiness in the babies.

Can you recommend any specific brands or types of medications to take while breastfeeding if you have cold symptoms?

Medications that are safe to take while breastfeeding include:

      Claritin

      Allegra

      Sudafed

      Guaifenesin-Robitussin and Mucinex

      Dextromethorpah-Alka Seltzer Plus, Tylenol Cough and Cold, Vicks DayQuil

      Chlorpheniramine-Coricidin

      Throat lozengers

      Ibuprofen-Advil and Motrin

      Acetaminophen-Tylenol

      DayQuil

      Excedrin

      Flu shot 😊

Should I always ask my doctor about a cold medication before taking it if you are breastfeeding?

It’s always best to talk to your health care provider if you have any questions or concerns when taking cold medications while breastfeeding.