If you’re like many women, your breasts told you of your pregnancy long before the line on a home pregnancy test turned solid. Seemingly overnight they grew larger, became tender, felt lumpier than usual, and appeared to have more veins below the surface of the skin. That’s because the hormones estrogen and progesterone are encouraging mammary growth—meaning, almost immediately these hormones trigger the production of milk, ensuring the breasts' primary role after pregnancy: the nurturing of the newborn child.
How Milk Is Made
Even before you became pregnant, your breasts were equipped to produce milk. In the center of each breast are 15 to 20 lobes, a series of clusters like bunches of grapes. Within each lobe are 20 to 40 lobules (the "grapes"), where the milk glands are located. Within the lobules are alveoli, the tiny cells that produce the milk, which then moves, via a series of ducts, from the alveoli into the lobules and then through the lobes to the nipples.
Your breasts can begin making milk—or its precursor, colostrum—as early as the fourth month of pregnancy. Some women become aware of this change as they undress and notice that their bra smells slightly of milk. Sometimes taking a warm shower will cause milk to leak from the breasts. It's also normal, however, not to experience any leaking.
Noticeable Changes
Other changes are more universal. Your nipples probably will be larger and more erect, and you'll notice tiny bumps on the areola, the dark area surrounding the nipple. These are Montgomery's glands, or tubercles, which produce oil to keep the skin of the nipple and areola soft. In fact, because your breasts are producing their own kind of lubricant (which also acts as a cleanser), it's important not to wash them with soap during pregnancy and to stay away from soap while nursing, too.
Increased blood flow to the breasts is responsible for the prominence of the veins under the skin. This is all completely normal and nothing to worry about.
You’ll notice that as your belly gets bigger, so will your breasts. That’s because estrogen and progesterone cause the lobes to grow and the lobules to swell to almost double their usual size. In preparation for the demands of feeding a baby, fat stores increase throughout your body, including in your breasts.
Most women can expect to gain a pound to a pound and a half per breast during pregnancy. This weight usually translates into more of an increase in cup size than in band size. What if your breasts don't grow much? Don’t sweat it. Probably the biggest myth out there is that small breasts won't nourish a baby well, and that’s just simply untrue. Milk production isn't based on breast size. Larger breasts simply may have more fat.
You can take comfort in knowing that your breasts won't change as much during the last part of pregnancy as they did during the first two trimesters. They should ache less and stop growing as your due date approaches, though they probably will again increase in size temporarily once your milk comes in a few days after the baby's birth.
Regardless of what size your breasts end up becoming, you should take pride in the metamorphosis they undergo during pregnancy. It's just one of the many little miracles that take place as your body prepares to give birth to another human being.
Writer Leah Ingram has long retired her nursing bras and blogs these days about raising eco-conscious kids on The Lean Green Family (formerly Suddenly Frugal) at http://suddenlyfrugal.blogspot.com.
Latching Issues
When a newborn is learning how to latch on to the breast, it helps if the nipple stands erect, but not all nipples do. In fact, up to one third of first-time moms have fairly flat nipples, which could make breastfeeding more of a challenge for them and their baby.
“Most moms can breastfeed regardless of the shape of the nipple, since babies should latch onto more than just the nipple anyway,” says Becky Saenz, of Mississippi Breastfeeding Medicine Clinic. “Occasionally, an adjustment in latching technique might be necessary. If a mom is having a problem, she should seek help from an International Board Certified Lactation Consultant—most hospitals that deliver babies have at least one on staff.”
For some new moms with flat nipples, doctors may suggest women wear breast shells for several hours a day during the last months of pregnancy. Available at maternity stores or through breastfeeding catalogs, breast shells are plastic domes that exert gentle pressure on the areola and help draw out the nipple. Once your baby is born and learns how to latch on, her suckling will encourage the nipple to stay erect and you should be able to stop using the breast shells.
“Breast shells can help, but aren't necessary if the mom’s breast tissue is distensible,” says Saenz. “If a mom's flat nipples are caused by excess fluid retention, she might need to be seen by a Breastfeeding Medicine specialist (MD who specializes in Breastfeeding issues), for assistance.” No matter what the issue, a new mom facing feeding difficulties should seek help. “If a baby is having trouble latching, it's important to get help early, rather than waiting, to avoid problems with plugged ducts, mastitis, and decreasing milk production," says Saenz.
