Pregnancy is all about change. Your mind, your heart, your belly … and your breasts! Breast changes usually starts right around the time your test reads positive — they may start to feel more tender or sensitive, and they’re already starting to build additional duct tissue in preparation for lactation.
So what can you expect to happen to your breasts during pregnancy? We talked to Lisa Paladino, a certified nurse midwife and lactation consultant and the author of It Shouldn’t Hurt To Nurse Your Baby to get an idea of what’s normal, what’s not, and how to set yourself up for a successful breastfeeding relationship.
Most people will notice some colostrum (the first milk, which is usually thick and yellowish) at around 20 weeks gestation, explains Paladino. Some women will see it dried on their nipples or experience leakage, and others will notice that they can squeeze some out of their nipples, right up until the end of pregnancy.
However, if you don’t see any colostrum production during pregnancy, it doesn’t mean you can’t breastfeed. “There are so many variations,” says Paladino. “Some women never see colostrum before birth and others have copious leaking all throughout pregnancy. For most, it’s somewhere in-between.” Paladino adds that this can even vary from pregnancy to pregnancy.
Colostrum production is only one breast change you’ll notice during pregnancy. Others include a general increase in size and heaviness, as well as darkening of the areola (fun fact: the darkening of the areola is supposedly an evolutionary adaptation that helps the blurry-visioned newborn find the nipple). But again, not everyone experiences these changes, and some won’t to a very noticeable degree, so don’t worry if you find that your breasts are staying more or less the same over the course of your pregnancy.
Of course, if you’re worried, you can make an appointment with a international board-certified lactation consultant, or IBCLC, to go over your questions. Talking to your doctor or midwife is an option as well, but keep in mind that IBCLCs have the most education, experience, and expertise in infant feeding — they’re your best bet for breastfeeding concerns.
Talking with an IBCLC also can reveal if you have any indications during pregnancy that might mean you need some extra lactation help before or after birth. Paladino says these include “if a mom has very small, widely spaced, or conically shaped breasts; a history of breast trauma or surgery, including reduction or implants; inverted nipples; or a history of hormonal imbalances including PCOS or infertility, thyroid disease, or other endocrine disorders or autoimmune disease.”
If any of these apply to you, an IBCLC can “take a history and perform an exam and give guidance on how to prepare, how to optimize the first few days, and what warning signs to look for that would be concerning or reassuring,” explains Paladino. But again, don’t get anxious about your future breastfeeding capabilities. Paladino adds, “I’d like to emphasize that many women who have these concerns can nurse their babies without any problem at all.”
Other useful things you can do to prepare for breastfeeding include taking classes, reading books, and visiting a breastfeeding support group. If you’re not planning to breastfeed, you don’t have to do much of anything, other than observe your breast changes and enjoy the ride that is pregnancy!