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Breast changes during pregnancy

Many of my patients do not realise the vast changes that their breasts go through during the nine months of pregnancy.

The breasts play the most crucial role in nourishing your baby after delivery, so it is to be expected that they will change dramatically as your body prepares them to fulfil this important responsibility. Each trimester will bring new and different developments, some subtle and some significant. In this article, I will describe what you can expect during your pregnancy.

First trimester

Long before your stomach expands, before you feel the quickening of a heartbeat within your womb, your breasts will give you the first telltale sign of your pregnancy – they will feel slightly sore or tender to the touch at four to six weeks of pregnancy. The tenderness is caused by hormonal changes that increase the blood flow to your breast tissues and cause them to become more sensitive.

The feeling is similar to the symptoms of premenstrual syndrome (PMS), and some women may mistake it for their impending cycle, until they discover that they are pregnant. The feeling varies from mild tenderness to severe soreness, especially when you are wearing a bra. It is normal for women to experience such symptoms, within either extremes. It is usually most intense only during the first three months of pregnancy, and will subside later. Towards the end of the first trimester, you may also feel your breasts starting to grow, as the tissues inside the breasts prepare for lactation.

Second trimester

Your breasts will continue to get bigger over the next three months, marking one of the most significant changes during your pregnancy. Your breasts may grow by four to six inches, and your bra size may increase by one or up to three cup sizes. Even your nipples and your aureolas will grow larger as well, even up to double its original size. These changes may remain even after delivery. The increased blood flow to your breasts will also cause your nipples and aureolas to become darker than its original pinkish-brown colour.

Third trimester

Your breasts will continue to expand with your growing tummy in the final trimester. They will start to feel even heavier when you begin producing colostrum, which is the first milk that your newborn baby needs. This colostrum is yellowish in colour and is rich with antibodies and nutrients to provide your newborn with the vital minerals for the first few days of life. Some women may leak colostrum from their breasts during the last stage of pregnancy, although this doesn’t happen to all women.

You may have noticed that you have little bumps around your aureola. These bumps are actually glands called Montgomery’s tubercles. During this last trimester, the bumps will become more obvious as they prepare to produce an oil to make breastfeeding more comfortable when you begin nursing.

Coping with the changes

Choosing the right bra will help you to cope with some of the changes to your breasts, including the discomfort and the changes in size. Avoid wearing bras with underwires, as these will only exacerbate the tenderness. Wear soft cotton bras that do not have seams near the nipple. By your second and third trimester, you will want to wear a maternity bra that provides extra support for your growing breasts. You may want to consider investing in a nursing bra already, since you will also need it when you begin breastfeeding.

Remember that your bras should have room to grow, since you may increase by several cup sizes throughout the duration of your pregnancy. When buying bras, make sure they can fit comfortably when the clasp is on the tightest setting, and then gradually move on to the looser clasps as your breasts grow bigger.

Breastfeeding changes

After the nine months of pregnancy, your newborn arrives and it is time to begin breastfeeding. This is the ‘job’ that your breasts have been preparing for, and they will provide your baby with nourishment for the best start in life. Breastfeeding will not be the same for every woman, and it can be as challenging as it is rewarding. One of the most common breast problems faced during this time is breast engorgement, as it is difficult to nurse as often as you produce milk. Applying chilled ice packs to your breast between feeding, and taking a warm shower right before nursing will help to slow down the milk production and minimise the pain.

Some women also have flattened or inverted nipples, which can make breastfeeding troublesome. If this is the case for you, teach your baby to latch on to your whole aureola, as this will encourage the nipple to express milk. Many of my patients have come to me complaining of cracked and bleeding nipples. This is caused by improper positioning or latching-on by the baby. As before, you should ensure that your baby is taking the whole aureola into his mouth, not just the nipple.

Clogged milk ducts can also occur quite commonly, causing pain and difficulty in nursing. Use a warm compress on your breasts before you nurse, massage the ducts and let your baby nurse as much as possible, even if it is painful. Whew! With all these that your breasts have to put up with, will they be able to take it? Rest assured that your breasts are well-equipped to help you with the first part of motherhood, and will be well up to the task if you provide appropriate care and support for the changes they are going through.

Star newspape. Nov 12, 2011
By Datuk Dr Nor Ashikin Mokhtar