How Your Breasts Change During Pregnancy and After

By Tracy Wright

When you become pregnant, changes in your body are inevitable. One of the first that many women notice is the subsequent changes to your breasts soon into your pregnancy. Women may notice that their nipples become tender and their breasts become heavier.

“From the early days of pregnancy, there are hormonal changes that come into play to support the growing baby and to provide for the baby’s nourishment after delivery,” said Mary Ryngaert, MSN APRN IBCLC, lactation consultant at the University of Florida Pediatric Breastfeeding Clinic. “It’s a complex system that takes a ‘resting’ mammary gland and builds a factory that secretes first colostrum and then mature human milk as the baby is delivered.” In addition to tender nipples and heavier breasts, Ryngaert said that areolas could also be darker (which will lighten after delivery) or drops of colostrum may be felt in the bra or clothing.

After delivery, for moms who choose to breastfeed, as the placenta is delivered, the rapid decrease in the hormone progesterone allows that milk factory to go into production and a process called Lactogenesis II begins. According to Ryngaert, lactogenesis II (the surge of milk volume, also called the “milk coming in”) typically occurs around day three or four, often sooner in subsequent babies.

“Babies are designed to have all that they need from colostrum in those first few days and, unless there is a specific medical issue, do not require anything else to drink. Common early issues in new parents include breast engorgement (inflammation and increasing milk supply make breasts uncomfortably heavy) and sore nipples. When the infant is latching well and feeding on demand, these problems can usually be avoided,” Ryngaert said.

Breastfeeding can be challenging in early days if the baby is not latching well. Some women experience sore, abraded or even bleeding nipples.

“Good lactation support for latching help women to avoid these issues. If the baby has oral restrictions, like tongue tie, then it is important to identify those issues early and get the family on track for pain-free feeding in early days,” Ryngaert said.

Ryngaert suggests mothers even seeking out helpful breastfeeding YouTube videos to help guide them with techniques for latching and different types of holds for breastfeeding.

A common and more serious condition that some women who are breastfeeding experience are clogged ducts or mastitis. According to the Mayo Clinic, mastitis is breast tissue inflammation sometimes tied to an infection. Mastitis is related to milk stasis and can be prevented by feeding a baby on demand. The resulting symptoms can be fever, chills, pain, swelling and warmth on the surface of the breasts. Mastitis infections should be treated with antibiotics.

Local mom Dania Posada had mastitis twice with her second child.

“I had an excessive amount of milk to the point that I had to set an alarm to pump in the middle of the night even though baby was sleeping through the night. What worked best for me is in a hot shower I put some Epsom salt in the Haakaa hand breast pump. Fill the rest with warm/hot water from shower and attach to the affected breast. This helps to pull that clog right out,” Posada said.

With any breastfeeding problem, especially one that may cause pain or irritation, seeking the advice of a lactation consultant can be very helpful. Luckily in the greater Gainesville area, there are many lactation resources, Ryngaert said.

What about pumping and its effects on the breasts?

Pumping should also not be painful in any way, however, it’s also important for mothers do their homework on the best types of pumps for breastfeeding.

“There has been really exceptional work in breast pump research, but there are some poorly made pumps on the market. Some are too strong, some not strong enough. At a minimum, pumps should not be less than $100-$200. Always get advice from other parents or health care professionals about pumps that are effective. Choosing the correct breast shield for the nipple size, setting the suction strength and speed correctly are important for efficient and non-damaging pumping,” Ryngaert said.

Breastfeeding Resources in North Central Florida

Alachua Women Infant and Children Program (WIC)
Postpartum breastfeeding education, pumps available for medical needs and working mothers.
Free monthly meetings for breastfeeding support
Lactation services for mothers
Both UF Health and North Florida Regional Medical Center have lactation specialists and services available.