Your breasts go through enormous changes during pregnancy and early motherhood, so it’s important to know how to look after them. Whatever their size or shape, they’ll need some extra attention, particularly if you are planning to breastfeed.
Tender time
Sensitive breasts are often one of the first signs of pregnancy, and you may notice this even before you miss your first period. As soon as you conceive, your body is preparing to nourish your baby after birth, and by the sixth to eighth week of pregnancy, your breasts will feel firm and fuller.
If your skin is pale, you may notice the veins are closer to the surface. Tingling or even stabbing pains are also common, and the glands around your areolas (nipple area) may become raised.
‘Breast discomfort is a normal part of pregnancy,’ says M&B health visitor Jackie Walsh.
‘Your hormones stimulate the development of tiny milk glands, and from early pregnancy these will be making a form of milk called colostrum.’ This white substance may appear on the nipple occasionally but is nothing to worry about.
While you are pregnant, you will need to wear a good supporting bra –it’s well worth getting one fitted properly. Don’t wear an underwired one though, as these can interfere with milk production.
If you are planning to breastfeed, you’ll also need to be fitted for a feeding bra a month or so before the birth. Choose one that’s simple to undo, has wide shoulder straps and several sets of hooks and eyes to adapt to your changing shape.
Keep your breasts clean by washing them as normal, but avoid heavily perfumed soaps and lotions as your breasts may be more sensitive at the moment.
Sudden changes
‘During the days and weeks after your baby is born, your breasts will go through tremendous changes as they adapt to the needs of your baby,’ says Jackie Walsh.
In the first three days after labour, you will produce colostrum, which contains valuable antibodies to protect your baby against some diseases.
If you decide to breastfeed, it’s very important to get advice on positioning your baby. Problems such as sore nipples and engorgement are usually due to putting him in the wrong place. Your midwife or health visitor will be able to make sure your baby is latching on properly, and give you any help or advice you need.
Milk monitor
After about three days, colostrum is replaced by breast milk and you will notice how heavy and full your breasts feel. Many women feel very emotional at this stage, as their hormones kick in.
When your nipple is stimulated by your baby sucking, or you hear your baby cry, your milk will flood into your breasts and may even leak out. This is called the ‘let down’ reflex.
‘The size of your breasts has no bearing on how much milk you produce,’ says Jackie Walsh. ‘This is governed by hormones, a good blood supply and a healthy diet.’
Take care
Because of the added weight of your breasts, you will still need to wear a supporting bra, even at night (although, if you are not breastfeeding, your breasts should return to their pre-pregnancy size within a couple of weeks). Use absorbent breast pads inside your bra to help to contain any milk leakage.
Washing your breasts with warm water in the shower will keep them clean, you don’t need to use soap.
Troubleshooting
Once it is established, breastfeeding is an easy, enjoyable and convenient way of feeding your baby. But discomfort in the early days is common, and you’ll probably need lots of help from a midwife or breastfeeding counsellor. Below we list some of the possible problems you may encounter and how to solve them.
Engorgement
During the first week of breastfeeding it’s usual for breasts to become hard to the touch, over-full and painful. The longer you go between feeds, the more likely they are to become engorged, so frequent feeding and feeding on demand is a good idea. The pain will improve within a couple of days - but to reduce it and help your baby latch on, you can:
- Soak in a warm bath to drain off excess milk, or apply warm flannels to soften the breasts
- Put a cold flannel on your breasts after a feed to reduce swelling
- Express a tiny amount of milk by hand or with a breastpump to make the nipple stand out and the milk flow more easily
- Chill a large green cabbage in the fridge. Peel off a leaf and put one in each cup of your bra for a cooling effect.
Sore nipples
Your nipples may be very sensitive in the first week or so, particularly when your baby latches on. This eases once the milk starts flowing, but if the pain doesn’t start to decrease after a few seconds, or if your nipples become very sore, you need to check that your baby is positioned properly. You can:
- Ask a midwife to check your baby is correctly positioned
- Avoid using soap on your breasts – it removes the natural lubricating oils and leaves them more vulnerable to damage
- Express a few drops of breast milk and let it dry on your nipples to soothe them
- Change your feeding position frequently so your baby is not always pressing on the same part of your nipple
- Apply calendula cream – it’s soothing and safe.
Blocked duct
Tight clothing or engorgement can cause a blocked milk duct, which will appear as a hard red patch on your breast.
You can:
- Make sure your bras fit properly
- Encourage your baby to empty the breast when feeding, gently massaging the painful area as he feeds
- Soak in a warm bath to ease the pain
- Express a little milk by hand or pump.
Mastitis
This can be caused by an untreated blocked duct or an infection, which enters through damaged skin – perhaps a cracked nipple. As well as a sore red patch on your breast you will have flu-like symptoms.
You should:
- See your GP who will prescribe antibiotics. These are not harmful to your baby
- Take paracetmol every four hours if your temperature is up – again this will not harm the baby
- Offer your baby the sore side first to try and get milk moving through the breast
- Take warm baths and soothe your breasts with warm flannels.
Thrush
If you suddenly develop soreness or cracked nipples that won’t heal after pain-free feeding, it may be due to thrush of the nipple, which can be passed on to you from your baby’s mouth and back again. You may notice tell tale white spots in your baby’s mouth or that he has soreness around the genital area.
You should:
- See your GP who will prescribe an antifungal gel to apply to your nipples. This won’t harm the baby for whom the GP may also prescribe antifungal drops.
If you’re not breastfeeding
If you bottlefeed from the start, your breasts may feel uncomfortable and even painful for a few days after giving birth. They may also leak for a few days. This won’t last long, but paracetamol can help relieve the pain. Your breasts should return to normal after a week or so.
Time to stop
Once you decide to stop breastfeeding, take it slowly to minimise discomfort to you and upset to your baby. Drop one feed at a time, and allow at least a week before you drop another.
‘Many women find their breasts continue to leak small amounts of milk for weeks and sometimes months after they’ve stopped breastfeeding. This is quite normal and will eventually stop,’ says Jackie Walsh.
When you’ve stopped breastfeeding altogether, you may find your breasts are smaller and softer than before, although some women find their breasts are larger– there’s no way of telling how you’ll be affected.
Breast check
Checking for lumps
It’s important to check for breast lumps each month after your period. Here’s how:
1 Take five minutes in the shower or bath.
2 Raise one arm above your head and, with the other hand, gently feel around the opposite breast.
3 Starting at the outside, work up into the armpit and around, moving in towards the nipple.
4 Repeat on the other side.
5 Afterwards, sit in front of the mirror and check your breasts for any change in the colour or skin surface – look for dimpling or puckering around the nipple and for any changes in the appearance of the nipple.
If you find a lump it is very unlikely to be cancerous but get it checked out by your GP. If there is any uncertainty as to what it might be, he will refer you to the breast clinic at your local hospital and you should be seen within two weeks.
Although your breasts will feel very different when you are pregnant or breastfeeding, it’s still important to be aware of how they feel and to check them occasionally. If you are concerned, see your GP.
Help for you
The National Childbirth Trust runs a breastfeeding helpline: call 0870 444 8708 to talk to a trained counsellor.
Tender time
Sensitive breasts are often one of the first signs of pregnancy, and you may notice this even before you miss your first period. As soon as you conceive, your body is preparing to nourish your baby after birth, and by the sixth to eighth week of pregnancy, your breasts will feel firm and fuller.
If your skin is pale, you may notice the veins are closer to the surface. Tingling or even stabbing pains are also common, and the glands around your areolas (nipple area) may become raised.
‘Breast discomfort is a normal part of pregnancy,’ says M&B health visitor Jackie Walsh.
‘Your hormones stimulate the development of tiny milk glands, and from early pregnancy these will be making a form of milk called colostrum.’ This white substance may appear on the nipple occasionally but is nothing to worry about.
While you are pregnant, you will need to wear a good supporting bra –it’s well worth getting one fitted properly. Don’t wear an underwired one though, as these can interfere with milk production.
If you are planning to breastfeed, you’ll also need to be fitted for a feeding bra a month or so before the birth. Choose one that’s simple to undo, has wide shoulder straps and several sets of hooks and eyes to adapt to your changing shape.
Keep your breasts clean by washing them as normal, but avoid heavily perfumed soaps and lotions as your breasts may be more sensitive at the moment.
Sudden changes
‘During the days and weeks after your baby is born, your breasts will go through tremendous changes as they adapt to the needs of your baby,’ says Jackie Walsh.
In the first three days after labour, you will produce colostrum, which contains valuable antibodies to protect your baby against some diseases.
If you decide to breastfeed, it’s very important to get advice on positioning your baby. Problems such as sore nipples and engorgement are usually due to putting him in the wrong place. Your midwife or health visitor will be able to make sure your baby is latching on properly, and give you any help or advice you need.
Milk monitor
After about three days, colostrum is replaced by breast milk and you will notice how heavy and full your breasts feel. Many women feel very emotional at this stage, as their hormones kick in.
When your nipple is stimulated by your baby sucking, or you hear your baby cry, your milk will flood into your breasts and may even leak out. This is called the ‘let down’ reflex.
‘The size of your breasts has no bearing on how much milk you produce,’ says Jackie Walsh. ‘This is governed by hormones, a good blood supply and a healthy diet.’
Take care
Because of the added weight of your breasts, you will still need to wear a supporting bra, even at night (although, if you are not breastfeeding, your breasts should return to their pre-pregnancy size within a couple of weeks). Use absorbent breast pads inside your bra to help to contain any milk leakage.
Washing your breasts with warm water in the shower will keep them clean, you don’t need to use soap.
Troubleshooting
Once it is established, breastfeeding is an easy, enjoyable and convenient way of feeding your baby. But discomfort in the early days is common, and you’ll probably need lots of help from a midwife or breastfeeding counsellor. Below we list some of the possible problems you may encounter and how to solve them.
Engorgement
During the first week of breastfeeding it’s usual for breasts to become hard to the touch, over-full and painful. The longer you go between feeds, the more likely they are to become engorged, so frequent feeding and feeding on demand is a good idea. The pain will improve within a couple of days - but to reduce it and help your baby latch on, you can:
- Soak in a warm bath to drain off excess milk, or apply warm flannels to soften the breasts
- Put a cold flannel on your breasts after a feed to reduce swelling
- Express a tiny amount of milk by hand or with a breastpump to make the nipple stand out and the milk flow more easily
- Chill a large green cabbage in the fridge. Peel off a leaf and put one in each cup of your bra for a cooling effect.
Sore nipples
Your nipples may be very sensitive in the first week or so, particularly when your baby latches on. This eases once the milk starts flowing, but if the pain doesn’t start to decrease after a few seconds, or if your nipples become very sore, you need to check that your baby is positioned properly. You can:
- Ask a midwife to check your baby is correctly positioned
- Avoid using soap on your breasts – it removes the natural lubricating oils and leaves them more vulnerable to damage
- Express a few drops of breast milk and let it dry on your nipples to soothe them
- Change your feeding position frequently so your baby is not always pressing on the same part of your nipple
- Apply calendula cream – it’s soothing and safe.
Blocked duct
Tight clothing or engorgement can cause a blocked milk duct, which will appear as a hard red patch on your breast.
You can:
- Make sure your bras fit properly
- Encourage your baby to empty the breast when feeding, gently massaging the painful area as he feeds
- Soak in a warm bath to ease the pain
- Express a little milk by hand or pump.
Mastitis
This can be caused by an untreated blocked duct or an infection, which enters through damaged skin – perhaps a cracked nipple. As well as a sore red patch on your breast you will have flu-like symptoms.
You should:
- See your GP who will prescribe antibiotics. These are not harmful to your baby
- Take paracetmol every four hours if your temperature is up – again this will not harm the baby
- Offer your baby the sore side first to try and get milk moving through the breast
- Take warm baths and soothe your breasts with warm flannels.
Thrush
If you suddenly develop soreness or cracked nipples that won’t heal after pain-free feeding, it may be due to thrush of the nipple, which can be passed on to you from your baby’s mouth and back again. You may notice tell tale white spots in your baby’s mouth or that he has soreness around the genital area.
You should:
- See your GP who will prescribe an antifungal gel to apply to your nipples. This won’t harm the baby for whom the GP may also prescribe antifungal drops.
If you’re not breastfeeding
If you bottlefeed from the start, your breasts may feel uncomfortable and even painful for a few days after giving birth. They may also leak for a few days. This won’t last long, but paracetamol can help relieve the pain. Your breasts should return to normal after a week or so.
Time to stop
Once you decide to stop breastfeeding, take it slowly to minimise discomfort to you and upset to your baby. Drop one feed at a time, and allow at least a week before you drop another.
‘Many women find their breasts continue to leak small amounts of milk for weeks and sometimes months after they’ve stopped breastfeeding. This is quite normal and will eventually stop,’ says Jackie Walsh.
When you’ve stopped breastfeeding altogether, you may find your breasts are smaller and softer than before, although some women find their breasts are larger– there’s no way of telling how you’ll be affected.
Breast check
Checking for lumps
It’s important to check for breast lumps each month after your period. Here’s how:
1 Take five minutes in the shower or bath.
2 Raise one arm above your head and, with the other hand, gently feel around the opposite breast.
3 Starting at the outside, work up into the armpit and around, moving in towards the nipple.
4 Repeat on the other side.
5 Afterwards, sit in front of the mirror and check your breasts for any change in the colour or skin surface – look for dimpling or puckering around the nipple and for any changes in the appearance of the nipple.
If you find a lump it is very unlikely to be cancerous but get it checked out by your GP. If there is any uncertainty as to what it might be, he will refer you to the breast clinic at your local hospital and you should be seen within two weeks.
Although your breasts will feel very different when you are pregnant or breastfeeding, it’s still important to be aware of how they feel and to check them occasionally. If you are concerned, see your GP.
Help for you
The National Childbirth Trust runs a breastfeeding helpline: call 0870 444 8708 to talk to a trained counsellor.
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