Breast Cancer Awareness: What Breast Changes Happen During Pregnancy?

Breasts change a lot during pregnancy, making it challenging to notice any unusual changes. It's important to get breast aware before, during, and after pregnancy and so we’ve teamed up with Breast Cancer Now to highlight the breast changes you may experience during pregnancy, after birth, and during breastfeeding, so you can know what to expect, what’s normal, and what might be cause for concern.

Breast Cancer Now is there for anyone affected by breast cancer, providing support for today and hope for the future. Find out more at breastcancernow.org.

Your breasts will change during pregnancy. 

If you’re already pregnant then you might have noticed – your breasts change during pregnancy and that’s because of an increase in hormones to prepare them for feeding your baby. Some things you might notice include:

• Tenderness or a change in sensation of the nipple and breast

• An increase in breast size

• Changes in the color and size of nipples and areola

• Bigger and more noticeable Montgomery glands

• Some women may have occasional leakage of blood from the nipple. This is due to an increase in the number and size of blood vessels. Although this can be normal during pregnancy, it’s best to get any leakage of blood from the nipple checked by your doctor. 

• From around week 16 of pregnancy, the breasts are able to produce milk. It’s not unusual for small amounts of straw-colored fluid called colostrum to leak from the nipples. Colostrum is a thick sticky liquid that is known as “first milk” or “liquid gold” because it contains important nutrients for baby. If you’re worried that it may be noticeable on your clothes, you can use a breast pad (a disposable or washable fabric pad) inside your bra.

• In the last few weeks of pregnancy, the nipples become larger and the breasts continue to grow as your milk-producing cells get bigger. Your breasts may feel uncomfortable and sometimes painful but wearing a well-fitting bra may help to relieve this. It’s fine to sleep in a bra if it’s more comfortable for you (more on this below!). Generally, women are advised to avoid certain types of pain relief while pregnant, but if your breasts are particularly painful you can talk to your doctor or midwife for advice on pain medication.

Sometimes, breast lumps develop during pregnancy. 

Breast lumps sometimes develop during pregnancy. Breast cancer in women of childbearing age and during pregnancy is uncommon. However, you should get any new breast lump, or any changes to an existing breast lump, checked by your doctor. The most common breast lumps that develop during pregnancy are:

• Cysts (fluid-filled sacs)

• Galactoceles (milk-filled cysts)

• Fibroadenomas (which develop in the lobules of the breast). If you had a fibroadenoma before you were pregnant you may find this gets bigger during pregnancy.

These are benign (not cancer) breast conditions. 

Finding the right bra during pregnancy can help relieve pain and discomfort. 

As your breasts increase in size you should check that your bra isn’t too tight and as we mentioned earlier, having the right bra can help relieve any breast pain you may have. It’s worth having your bra size checked by a trained bra fitter, but here are a few tips from Breast Cancer Now on how to tell if a bra fits well: 

• Your breasts fill the bra without coming out at the top bottom or sides 

• The strap at the back doesn’t dig in

• The shoulder straps do not carry the full weight of your breasts, stay in place when you lift your arms above your head, and fit closely to your body without digging in

• The strap round the back and the front under band lie close to your body and are at the same level at the front and back

• With an underwired bra, the underwire lies flat against your body and supports the underneath and sides of your breast without digging in or gaping

• The bra fits on the loosest set of hooks so that when it begins to stretch with time you can tighten it

You may find it more comfortable to wear a maternity or soft-cup bra. These types of bras can also be worn in bed if you feel you need extra support while sleeping.

If you’re hoping to breastfeed, you may want to buy a couple of nursing bras, which can also be worn during your pregnancy for comfort! These have cups that unfasten and make it easier to feed your baby. The best time to be fitted for a nursing bra is a few weeks before your baby is due when your breasts will have done the majority of their growing.

Your breasts will change after birth. 

After birth, your hormone levels continue to change and you will notice more changes to your breasts as a result. Firstly, your estrogen and progesterone levels decrease quickly, and to start with your breasts will produce colostrum – as we mentioned, you might have noticed this leaking out of your nipples since around week 16 of pregnancy. Around the third day after the birth, the colostrum becomes diluted by additional fluid that makes it look much whiter and milky. 

Breast changes after birth if you’re breastfeeding:

Baby sucking at the breast will let the brain know that milk is needed. Some women find milk leaks from the nipple when they hear their baby cry, or if their breasts are full and they feel emotional. This can happen quite a lot in the first few days after you give birth and can sometimes feel embarrassing. Putting disposable or washable breast pads in your bra can help you feel more comfortable and prepared.

You’ll continue to produce milk as long as breastfeeding continues and when you stop breastfeeding it may take some time for the milk production to stop completely. If you stop breastfeeding too quickly it can lead to engorgement (more on this below!). When you want to stop breastfeeding try to gradually reduce the length and number of feeds – you may like to start by dropping one feed a day as your body produces milk on a supply-and-demand basis so this will naturally reduce the amount of milk you produce.

Milk may leak for several weeks after you stop breastfeeding if something triggers the ‘let down’ reflex (when hormones tell your breasts to produce milk). You may experience a tingling feeling in your breasts and nipples that can be quite strong, a feeling of sudden fullness, or you may notice that milk starts to leak from either or both breasts.

Breast changes after birth if you’re not breastfeeding: 

If you aren’t breastfeeding after birth and no milk is being expressed you’ll stop producing milk. You may find your breasts feel heavy, uncomfortable, and sore for a few days but wearing supportive bras can help. 

Breast changes after birth if you’ve had breast surgery: 

Women who’ve had breast surgery – due to breast cancer, breast reduction, surgery to the nipple, or breast implants, for example – may find that they’re unable to breastfeed. This is due to the formation of scar tissue. However, some women are still able to breastfeed after surgery and you can talk to your midwife, health visitor, or breastfeeding counselor for advice so you can decide what’s best for you and baby. 

No matter how you’re feeding baby, you will notice some breast sensitivities after birth. 

Sore and cracked nipples

Sore and cracked nipples can develop if the baby does not attach to the breast correctly. If the baby only sucks the nipple, rather than the whole areola being in their mouth, the baby’s tongue or roof of the mouth rubs on the nipple. The nipples can quickly become sore and sometimes cracked.

The nipples won’t heal if the baby does not attach to the breast properly, so if feeding is painful we recommend seeking support from your midwife or a breastfeeding expert where possible. 

Engorgement

Breast engorgement generally happens when the milk first comes into the breast and refers to when the breast becomes overfull of milk. Some women describe their breasts as feeling hard, warm, and throbbing. 

If your breasts are engorged and you’re continuing to breastfeed, it’s important to make sure your baby is attaching to the breast correctly. Your midwife, health visitor, or breastfeeding expert can help you with this.

Some things that might ease breast engorgement and pain are: 

1. Feeding your baby on demand

2. Expressing (squeezing out) or using a breast pump to release a small amount of milk so it’s easier for your baby to attach to your breast

3. Wearing a well-fitting nursing bra that does not restrict your breasts

4. If your breasts are leaking, apply warm flannels just before expressing

5. Apply chilled cabbage leaves to your breasts after feeding or expressing milk – this may help to reduce pain and swelling

Blocked milk ducts

Sometimes a milk duct becomes blocked while breastfeeding. This can also happen when you stop breastfeeding. You may experience a small, painful, hard lump or a bruised feeling.

It might help to: 

• Feed your baby more often

• Change position when you’re feeding (this may help to drain the area more fully)

• Gently massage the lump towards the nipple while your baby is feeding

• Apply warm flannels to the breast

• Ensure your bra and clothes aren’t too tight so the milk can flow freely

Mastitis

If breast engorgement or blocked milk ducts continue the breast may become inflamed or infected. This is called mastitis. The breast may be red, hot, and painful. Mastitis can cause flu-like symptoms including headaches, nausea, and a raised temperature.

It’s important to continue to breastfeed frequently, especially from the affected breast, as this helps to clear the infection and isn’t harmful to the baby.

If you think you might have mastitis you’ll need to see your doctor as it may need treatment with antibiotics or anti-inflammatory drugs.

Breast abscess

If mastitis or infection isn’t treated, some women go on to develop an abscess (a collection of pus) in the breast. Breast abscesses are not common – if you think you have an abscess it’s very important to see your healthcare provider. 

Abscesses are usually treated with antibiotics and are often drained using a needle and syringe. An ultrasound scan may be used to guide the needle into the correct place. If the abscess is large, a small cut is made in it to allow the pus to drain away. An injection of local anesthetic is usually given to numb the area first.

As with mastitis, your doctor will usually advise you to continue breastfeeding or use a breast pump to express the milk regularly.

Thrush

Thrush (candida albicans) is a yeast infection that may occur on the nipple and areola during breastfeeding. It can develop following cracking or damage to the nipple but may also happen suddenly, even when you’ve been breastfeeding for some time.

The nipple may become itchy, painful, and sensitive to touch. Some women find they have shooting pains deep in the breast that start after feeding and can last for a few hours.

Thrush can also be passed from mother to baby. Signs of thrush in your baby may include a creamy patch on the tongue or in the mouth that does not rub off. Babies may also get a sore mouth which can cause restlessness during feeding and pulling away from the breast. Nappy rash (red rash or soreness that’s slow to heal) is another symptom of thrush.

Thrush can be difficult to diagnose as many of the symptoms are similar to those caused by the baby not being latched on to the breast properly during breastfeeding.  If you think you have these symptoms, talk to your doctor or midwife. Both you and your baby will need to have treatment at the same time.

Your breasts might not look or feel the same after pregnancy and postpartum. 

After pregnancy, whether you have breastfed or not, your breasts probably won’t look or feel the same as they used to. You may have gained or lost weight, and it’s not unusual to find your breasts have altered in size and shape compared with before pregnancy.

These changes are part of the normal changes your breasts go through at different stages in life. It’s important that you get to know how your breasts look and feel now so you can be aware of any new changes. You can find out more on Breast Cancer Now’s Checking Your Breasts page.

Changes to your breasts during and after pregnancy can make you feel anxious or you aren’t in control. If you’re finding it difficult to cope, talk to your doctor, or in the UK you can call Breast Cancer Now's Helpline and talk to an expert.

---