Everything That Happens to Your Breasts When You Get Pregnant
If you’re reading this, you’re probably pregnant or know someone who is. You're likely preparing for a host of changes, including those in the body. Most women know that in addition to a growing belly, they’ll probably experience a more voluptuous set of boobs while pregnant. But what is actually going on beyond the blatant cup-size jump?
“The truth is that breasts generally change greatly during pregnancy,” says Karyn Tapley, an OB-GYN and aesthetic and integrative medicine physician in Bellingham, Washington. “In almost all cases, the breasts will enlarge, get heavier as they prepare for lactation, and often have a darkening of the nipple and areola, which may or may not be permanent. Many express that their breasts ‘looked the best’ while pregnant since the normal architecture was fuller.”
While some women feel unhappy with their breasts after pregnancy, there are plenty of options. With all this in mind, here are some things you can expect during and after pregnancy.
From Tissue to Milk Production, Here's What's Happening Inside Your Breasts
Everything that happens to the breasts during pregnancy starts from the inside, where the body is essentially prepping the breasts to become “natural milk bottles” for baby-to-be. Accordingly, the breast tissue composition starts to shift. “Breast tissue, called parenchyma — the ‘scaffolding’ of the breast — is a combination of fatty tissue, fibrous tissue, and glandular tissue for milk creation and secretion,” says Tapley. “[During pregnancy,] the composition of the breast changes, such that the glandular tissue increases in size and the fibro-fatty areas shrink.”
The expansion of glandular tissue accounts for some of the noticeable increase in breast size, so the breasts will likely feel tighter and firmer. This can also lead to a denser breast appearance on imaging, so most radiologists recommend doing an ultrasound first so that any changes can be tracked if breast imaging needs to be done during pregnancy.
Another change that is surprising for most is the production of a yellowish discharge called colostrum, which usually appears several weeks or more prior to one’s due date. Breast stimulation of any kind can cause the milk glands to contract and express colostrum, which is just the initial fatty milk supply that contains all kinds of concentrated nutrients a newborn needs to quickly gain weight and jumpstart the immune system. Typically, this abates by week two of breastfeeding, but its pre-delivery appearance (and subsequent leakage) is often a surprise to pregnant women.
Why Your Breasts Get Bigger During Pregnancy
The internal changes in the breasts directly affect their appearance. Tracy M. Pfeifer, a New York City double board-certified plastic surgeon who specializes in aesthetic breast surgery says, “I find women are, for the most part, unprepared for these changes and it can take a toll on a woman emotionally." She continues, “As the milk-producing elements of the breast enlarge, the skin of the breast stretches due to increased size, the areola usually gets darker and stretches, the Montgomery glands [small bumps on the areoles that secrete a waxy substance to keep the nipple supple during breastfeeding] become visible, and veins in the skin become more obvious.”
Breasts in pregnancy
Getty ImagesTapley says most pregnant women are shocked by how sensitive their breasts can become (both externally and internally) due to hormonal fluctuations; this can lead to discomfort during sex, an aversion to having the breasts touched because they “feel weird,” and even heightened sensation from clothing rubbing against them. Nipple size also increases to accommodate the baby’s mouth, to enable them to suckle. “Most nulliparous [women who have never given birth] women’s nipples are too small for a baby’s lips to grasp and form suction around,” says Tapley. “They enlarge so this can occur.”
Sagging, Size, and Stretch, and Other Long-Term Changes
No two bodies are the same, so anyone who gives birth should expect some differences in their pre- and post-pregnancy breasts. Tapley says that the individual long-term changes a person will experience post-pregnancy depend on many factors, including whether or not someone breastfeeds and for how long, genetics, pregnancy weight gain, and more.
Pfeifer echoes this, and adds, “After the milk recedes when breastfeeding ends (or if it never started), many women experience breasts that are a bit deflated, especially in the upper half." Presumably, this is because the swollen milk glands during pregnancy squash the fibro-fatty elements, so when milk glands return to normal size, the remaining tissue has been permanently compressed. “Plastic surgeons call this ‘involutional atrophy,’” says Pfeifer. “After pregnancy, many patients come to my office stating that their bra cup is ‘gaping,’ meaning that the breast tissue does not fill out the upper half of the bra cup.”
Sagging breasts may also occur due to overstretched skin. Pfeifer says this is likely for one of two reasons, though both can occur. The Cooper’s Ligaments, which are threads that suspend the breast from the chest wall, are often stretched during pregnancy beyond their ability to snap back. “It's like a slinky that has been pulled too far apart and loses its recoil, so the breast sags,” says Pfeifer. The second thing that can happen is the elasticity of the skin itself is stretched past its tolerance, causing stretch marks. If the elastic elements in the skin's dermis have been damaged and skin is no longer taut, sagging will again be the result.
Finding the Right Bra After Pregnancy
The top tip from experts is to simply wear a bra that's the right size. “Poorly fitting bras can cut into tender breast tissue," Tapley cautions, "support the wrong areas of the breast, and cause more back pain — a common pregnancy complaint.”
How do you know you have the right bra? Well, according to Ali Cudby, best-selling author of *Fit My Bras: How to Find Your Perfect Bra and Why It Matters*, many women get confused about maternity bras versus nursing bras. “Maternity bras are designed to support a woman’s body during pregnancy, while nursing bras have special features to make it easier for moms to breastfeed,” she explains. “Maternity bras are a lot like regular bras, so there’s no real need to buy new bras for pregnancy, until your body says it’s time, meaning your breasts have increased and your ribcage has expanded to make room for baby, so your old bras do not feel comfortable or supportive anymore.”
At this point, getting properly fitted for a bra is a good idea. Most women tend to wear a band that is too big and a cup that is too small, which can't properly support breast weight effectively; a snug band enables the cups to do their job. “A firm fit also prevents you from carrying the weight of your breasts in the straps, because that’s a pain in the neck — literally,” advises Cudby.
To get the most life out of your maternity bras, Cudby suggests that you shop for a band size that fits on the tightest hook row when you buy it. Then, as your ribcage expands, give yourself more breathing room by using the looser rows of hooks. “When you hit the stores for maternity bras, you’re looking for a bra that will grow with you,” says Cudby.
Some women find that buying a comfortable but supportive sports bra to wear, even at night, also helps alleviate breast discomfort. In addition, the compression helps support the breast tissue and keeps gravity from stretching swollen, milk-heavy breasts. Further, Pfeiffer advises pregnant women to wear comfortable, fitted bras around the clock to minimize further stretch.
The same rules apply for a nursing bra: Look for snug fit in the band, appropriate support and cup size, and bounce minimization. You’ll also want to check the hardware: “Practice with the clips before you buy to get a sense of how easy it will be when the time comes [to breastfeed]," Cudby suggests, "because when you’re holding a squirming baby and trying to unclasp a nursing bra one-handed, a quality bra that opens easily will be your best friend.”
Other Tips for Keeping Your Breasts Healthy Post-Pregnancy
In addition to proper support, you want to focus on keeping your skin as healthy as possible. “Pregnant women can promote healthy skin by doing things they are probably already doing for their own health and the baby," Pfeifer says. "Staying well hydrated, avoiding excessive weight gain, avoiding inflammatory foods, eating a diet high in antioxidants to help minimize oxidative damage to the skin, and including a high intake of vitamin C, which is key in collagen production.”
She also says that keeping the skin supple can help reduce stretch marks and recommends pregnant women massage extra virgin olive oil, coconut oil, Bio-Oil, or aloe vera into the breast skin at least twice a day.
What to Do If You're Unhappy With Your Breasts Post-Pregnancy
Some folks are unhappy with their bodies post-pregnancy, and though body-positive messages seem to be everywhere, sometimes aiming for body neutrality is just as good. While there are options (like surgery) for those who want to make some changes after something as major as giving birth, others can't take advantage of those options for things like medical reasons or because of the cost, and that's perfectly okay. But for those who want to undergo procedures, here are some that exist.
When there are structural changes to the breasts, many women turn to surgery. For involutional atrophy, or loss of volume, breast augmentation is a reliable method for restoring breast fullness.
If you're unhappy with sagging and wish to correct it, a mastopexy (or breast lift) may be the best option. “When a surgical breast lift is performed, there are several goals: to lift the nipple and position it correctly on the breast mound, to reposition sagging breast tissue, and to remove excess skin that is stretched, to tailor the skin,” says Pfeifer. “The stretched areola can also be reduced in size.”
For women who feel their breasts are too large after pregnancy, they may consider a breast reduction, a procedure that is sometimes covered by insurance if back pain occurs because of the additional weight. “Reductions are a bit more involved," says Tapley, "have a longer recovery, and cost more due to the reconstructive nature of the surgery. But very few women regret undergoing the procedure.”
Enlarged visible veins can be treated with sclerotherapy (or medical injections to shrink veins) by a vein treatment therapist, and usually get good results. Stretch marks can be addressed with laser therapy. Microneedling and PRP (plasma rich platelet) injections, both of which are therapies aimed at increasing collagen production, can also improve the appearance of post-pregnancy breasts.
For a “free” option, Tapley says weight lifting, especially push-ups, can help. “Weight lifting with a concentration on the pectoral muscles can help strengthen and enlarge the chest muscles, leading to a subtle ‘lift’ of the breast. Building a solid core can also improve posture, giving the appearance of more uplifted breasts.”
It is completely normal to be concerned about bodily changes during and after pregnancy — it's also fine if you're happy with your body or feel totally neutral about it, too. “Understanding what can happen will empower women to take action so they can minimize the changes,” says Pfeifer. It is also important, she adds, to understand that many women are reluctant to speak truthfully about how they feel about these bodily changes for fear people will think they are selfish if they express dismay. It's not selfish to seek a place of acceptance with your own body — even Beyoncé agrees.
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