I expected to watch my stomach expand and contract through two pregnancies, but nobody told me I’d end up with a drawer filled with bras in five different sizes! Pregnancy, breastfeeding and weaning each resulted in another trip to the bra boutique. I brought this up at my 10-month-old daughter’s play group recently, and all of the mothers had stories to tell about dramatic changes in their breasts. Patricia D’Angelo, mother of 18-month-old Chloe, told us that her breasts had increased five cup sizes during pregnancy and the early days of breastfeeding. Within a year after Chloe’s birth however, “my breasts went back down several sizes,” she says thankfully.
1. Breast changes during pregnancy
Maureen Fjeld, a lactation consultant in private practice and director of the Calgary Breastfeeding Centre in Alberta, explains that the hormones of early pregnancy cause changes in the breast tissue. In fact, an increase in breast size is a common symptom of pregnancy. The nipples and breasts may also feel tender, and, says Fjeld, “You might notice that the areolae and nipples are getting darker.” (For many women this darkening fades after pregnancy.)
When I was six months pregnant with my son, I was surprised to notice a yellow sticky substance on my nipples when I got out of the shower. Fjeld explains that this is colostrum, the nutrient-rich milk babies drink in the first 24 to 36 hours after birth. She says that women may notice colostrum at any point during a pregnancy. “Leaking colostrum and not leaking colostrum are both normal,” explains Fjeld. “This has no bearing on milk production after the baby is born.”
2. Breast changes immediately after pregnancy
Colostrum is the perfect first food for a newborn baby, low in volume so as not to stress the baby’s kidneys, yet rich in protein, calories, vitamins and minerals. It provides everything the baby needs until the mother’s milk comes in. But there are other benefits as well. “Colostrum provides high doses of antibodies which protect the baby, who is coming from the sterile environment of the uterus into the world,” explains Fjeld, adding that colostrum’s normal bacteria “help the baby digest the milk as it increases.”
Fjeld explains that “as soon as the placenta is released from the uterus, hormone levels surge so that the body begins to increase the volume of milk.” By the third or fourth day after birth, the colostrum will have changed to more mature milk, which can look bluish white and will be more watery than colostrum.
3. Your breasts after your milk comes in
D’Angelo went to shop for a nursing bra soon after Chloe was born. She remembers saying to the sales clerk, “I didn’t know that bra size existed!” Patricia’s breasts had already increased several sizes during her pregnancy, and within a few days after Chloe’s birth her breasts became larger again. She was experiencing fullness in her breasts that was only relieved by frequent breastfeeding.
Many women find their breasts change dramatically during the first few postpartum days as they begin to produce milk for the baby. Fjeld emphasizes that nursing frequently is important (at least eight to 12 times in a 24-hour period). The baby needs to frequent feeds to get the calories and nutrients he needs, and it will help you stay more comfortable. Besides, plenty of practice will help your baby learn!
“Mother Nature forgot most mothers don’t have twins,” says Fjeld. “The hormone levels are so high in that early postpartum period that most mothers make way more milk than they actually need for their babies.” In addition to breastfeeding often, make sure the baby is well-latched, with the nipple and much of the areola in his mouth, so that the baby is able to get enough of the milk from the breasts to prevent overfullness.
If your breasts become overfull and uncomfortable, try applying heat. Hot baths or showers, or even a heating pad or hot-water bottle applied over a T-shirt, can help the ducts open. If the breasts are so full that the nipples are flattening out, try gently expressing a small amount of milk after applying heat. Expressing before a feeding can relieve the pressure on the nipple and areola so the baby can latch.
Some women’s breasts become engorged – red, painful or hard to the touch – as the volume of milk increases rapidly. True clinical engorgement, says Fjeld, “is an inflammatory response that’s identical to twisting an ankle, where the tissues swell up and are inflamed. Engorgement can make it impossible to feed the baby, because the pressure on the nipples may make them flat and difficult for the baby to grasp.” It’s important to relieve the fullness quickly. If applying heat and trying to express a little milk doesn’t work, Fjeld recommends applying ice to the breasts, ten minutes on, ten minutes off. (Fjeld notes that some women find the cold pack very uncomfortable; if so just keep it on as long as you can tolerate.) Try soft gel freezer packs or bags of frozen peas. Fjeld says, “I recommend that Dad go out and buy a big bag of crushed ice. Put it in eight sandwich bags and arrange in a cloverleaf pattern on both breasts. It may take six to 12 hours for ice to work.” If you experience severe engorgement, a lactation consultant or other breastfeeding professional can help, says Fjeld.
4. When your cup runneth over…
For about six weeks after each of my children were born I slept on layers of towels to absorb the milk leaking from my breasts. Annette Magled, however, only leaked milk with the first of her two daughters. “For the first seven months, whenever Alexandra nursed, my other breast leaked,” she says. She wore cloth nursing pads in her bra to absorb the milk. Fjeld explains that “some women never leak, whereas others are soaked all the time.” Both extremes, and everything in between, are normal. Even mothers who leak profusely usually find that it tapers off by about six weeks postpartum. For a few women though, it can continue, and may last as long as they are breastfeeding.
Leaking can actually have a purpose other than creating extra laundry. It can help balance a mother’s milk supply, says Fjeld. Women who have an abundance of milk often experience strong let-downs that can overwhelm the baby. If you experience too much milk coming too fast, try expressing a little milk before feeds to make breastfeeding more manageable for both you and your baby. (For some women, a hot shower or leaning over a hot steamy sink will often stimulate leaking before nursing.) It’s important to know, says Fjeld, that not leaking doesn’t mean your milk supply is inadequate.
Another concern some mothers have is that they don’t feel their milk let down. A “letdown” occurs when milk made in the breasts is released into the milk ducts, making it available for the baby. Some women experience let-down when their baby starts to nurse. Others find that just hearing their baby cry or thinking about the baby is enough to stimulate this reflex. Fjeld says that a let-down can be “a tingly or warm feeling’ in the breasts, but she finds that ‘the majority of women don’t feel it at all.” Mothers should not worry if they do or do not feel their milk letting down. Either way, it’s no indication of how much milk the baby is getting.
Leaking, and other breastfeeding concerns, usually settle down by the time baby is six weeks old. By then most mothers feel comfortable breastfeeding and their milk supply is well-regulated, says Fjeld. “After six weeks the breasts are soft and may be smaller,” she explains. “That’s normal. Mothers may lose the sensation of fullness and heaviness, unless they miss a feeding or two,” says Fjeld. At this point some mothers may worry that their milk supply is decreasing, but as long as the baby “is nursing on a regular basis and is gaining weight,” says Fjeld, there is nothing to worry about.
My friends and I often discuss what has happened to our bodies because of pregnancy and breastfeeding. Patricia says, “Watching my body change throughout pregnancy and breastfeeding has given me a new sense of purpose. These changes are part of the best thing I have ever done – having my daughter.”
5. Sex and the breastfeeding woman
Breastfeeding is a powerful hormonal process that affects more than just your breasts. Although most parents find that their sex lives change after the birth of a baby, breastfeeding mothers may notice some specific changes. Heather Kritzinger, a La Leche League Leader in Etobicoke, Ontario, says that breastfeeding women may experience some or all of the following:
• No periods. You may not have a period for several months after the birth if you’re breastfeeding exclusively and frequently.
• Breastfeeding offers some protection against pregnancy but it’s not foolproof. You may ovulate before your first period after the birth. If you don’t want to get pregnant again, talk to your doctor about birth control.
• Go Gently. Reduced libido, vaginal dryness, and a longer arousal time are common among breastfeeding women, especially at first. Sound exciting? A lubricating gel – and a little patience – can help.
• Ouch. Breastfeeding nipples can be tender and sore at first, or they may be less sensitive than usual.
• Flood Warning. Let-downs and/or milk ejection can occur during sex and at orgasm, especially in the early weeks. Feeding the baby or expressing some milk before making love may prevent this.
• Keep talking. Remember that although any changes to how you respond sexually will be obvious to you, they won’t be to your partner. Let him know what feels good—and what doesn’t—and be prepared to experiment. It may be a truism, but good communication really is the key to rediscovering a satisfying sex life.
This article was originally published online in September 2015.