Childbirth will bring about changes in your breasts, whether you choose to breastfeed or not after the birth. Gaining the knowledge and tools for anticipating and dealing with these changes can help make the transition a lot smoother. Your breasts will likely not be the same as they were before, but you can learn to prevent certain changes and learn to love your new post-baby body.
Breasts will swell from increased blood flow, hormonal changes, and milk production during pregnancy and childbirth, whether or not you choose to breastfeed.
Breastfeeding or pumping is recommended at least every four hours, if you decide to breastfeed your infant. Doctors recommend breastfeeding exclusively until six months old.
If you choose not to breastfeed your infant, do not pump; use ice to slow down milk production.
Nipple soreness and sensitivity are normal to expect, but watch out for unusual discharge, blood, spreading redness of the skin, fevers, chills, and other signs of infection.
Each breast is unique and will recover differently. Wear supportive bras throughout the process and do not hesitate to use pads, nipple creams, and other tools to support the process.
Whether or not you choose to breastfeed, your breasts will go through changes during and after pregnancy due to hormone fluctuations – estrogen, progesterone, prolactin and oxytocin – and changes in blood flow and milk production.
Your breasts will become more large and full from increased blood flow, known as engorgement. This can cause soreness, tenderness, heaviness, stretch marks, and more visibility of blue-ish blood vessels under the skin.
The areolas – which are the round areas surrounding the nipples – will darken in color, and the nipples may leak milky fluid or discharge. You may also notice lumps that can form from clogged milk ducts.
Your milk comes in about three to five days after delivery of your baby. Before then, your breasts produce a thick yellowish fluid known as colostrum, which is rich in nutrients and good for the baby's first few feeds. Over time, the fluid will become thinner and lighter in color as your milk comes in.
You may notice that milk may leak from your nipples in response to hearing a baby’s cry, even if it's not your own, in response to your own stress or emotions, or sometimes spontaneously for no obvious reason.
This is normal and often improves after the first few weeks, although it can last longer. You may use reusable or disposable breast pads so that the leaking does not show through your clothing.
The fullness of your breasts, from the increased blood flow and milk production, may cause discomfort, warmth, and heaviness.
Releasing milk decreases the fullness, so try to breastfeed or pump regularly, about every two to four hours, if you can. Many public facilities and offices now have pumping rooms in support of breastfeeding mothers. Your infant's hunger may also set the schedule of breastfeeding, and over time you and your baby will likely develop a rhythm.
If you choose not to breastfeed, do not pump the milk to relieve the discomfort since that encourages more milk production and further engorgement. Instead, use ice packs and tight-fitting bras to reduce the pain and heat, until your body adjusts, slows down and then stops its milk production within a few weeks.
Changes in the nipples
Other changes in breasts include sore, sensitive or cracked nipples, especially in the beginning, as you adjust to your baby's feeding behaviors. Some infants may have issues with latching on or sucking, which likely improve as you and your baby get more practice. If you still struggle, you may consult a lactation consultant or specialist.
You may also notice a tingling sensation as your baby feeds. This can come from the release of milk into the ducts, or milk let-down. Nipples may crack, blister, or bleed. You may use nipple cream, lanolin, coconut or olive oil, or breast milk to soothe the symptoms.
Warning signs and symptoms
Breastfeeding carries some risks to your body, especially infection.
If you notice greenish discharge or blood from the nipples, severe pain, bright redness of the skin that's growing in size or spreading in streaks, areas of hard swelling, or fever or chills, you may have an infection from a clogged milk duct, called mastitis, and should call your doctor, who may prescribe you antibiotics.
A yeast infection is also possible. Symptoms to watch for are itchiness, white discharge, and shooting pains after feeding. The yeast infection can affect the baby, too, and can show up as white spots on their tongue or mouth, difficulty or pain while feeding, or diaper rash.
There is also a slightly increased risk of breast cancer during or in the first year after delivery. Symptoms to watch out for would be hard, fixed or immovable lumps that feel like pebbles or stones, may be painful or painless, unusual discharge from the nipples, and dimpling or puckering of the skin.
Not all lumps are cancer. Many women experience benign (noncancerous) lumps especially at certain times of their menstrual cycle, so it may also be helpful to wait a full cycle to see if the lump still persists the next month before getting it investigated by a healthcare provider.
How long to breastfeed
Doctors recommend breastfeeding exclusively for the first six months of life. After that, you can introduce other foods into your baby's diet, and continue to breastfeed up until about two years of age, as recommended by the World Health Organization.
However, some mothers wean off breastfeeding earlier or later, and the timing varies for each mother and child.
Breasts usually do not return to exactly how they were before. They will likely look and feel different than how they were pre-pregnancy. They may be larger, smaller, less firm, sag or droop more, or have more stretch marks compared to before, and the nipples may look different as well.
This is because the increased blood flow and fullness, as well as pregnancy weight gain which is typically 25 to 35 pounds for the average woman with a healthy pre-pregnancy weight, stretches the ligaments in your chest.
Other factors that affect breast changes include age, genetics, number of pregnancies, previous breast size, amount of weight gained, and smoking status. Smoking decreases the elasticity of the ligaments so smokers are more likely to experience lasting changes in their breasts.
Whether or not you breastfeed your infant does not significantly seem to make a difference in breast changes, according to a study of 496 women. About three-quarter of the women reported breast changes, including those who had never breastfed after childbirth.
Another study of 93 women found that droopiness of breasts after childbirth was not significantly affected by whether the women breastfed or not.
Breasts are also asymmetrical, meaning they are each different and unique, and they may recover differently as well. One might have more milk ducts and become more engorged during pregnancy. Do not be alarmed if your breasts recover differently.
It's recommended to wait at least three to six months after breastfeeding for your breasts to settle into their new size and shape before buying new bras. Wearing supportive bras during pregnancy and breastfeeding can also make a difference in how your breasts will recover afterward.
Childbirth and breastfeeding are big life events. Your breasts will likely permanently change, but you can prepare for the changes with supportive bras, breast pads, nipple creams, and the knowledge of what is and is not normal to expect. You may always consult your provider or a lactation consultant for further support.