Breast Changes After Pregnancy: Will They Ever Be the Same?

Soon after getting a positive pregnancy test, you may notice subtle differences in your breasts. "Breast tenderness is one of the earliest signs of pregnancy," says Staci Biegner, M.D., an OB-GYN with Clinic Sofia. And that's only the beginning of the breast changes you'll experience during pregnancy and the postpartum period, whether you decide to breastfeed or not.

Naturally, this brings up plenty of questions for expectant parents: How exactly will your breasts change while carrying the baby and after birth? Does nursing affect their appearance and sensation? Will your nipples go back to normal after pregnancy? Here, we spoke with experts to answer your top breast-related questions.

Why Do Your Breasts Change During Pregnancy?

So what's up with all the breast changes you're experiencing during pregnancy? "They're gearing up to produce enough milk for a newborn baby," says Tanmoy Mukherjee, M.D., a reproductive endocrinologist at Mount Sinai School of Medicine in New York City. As soon as those pregnancy hormones start circulating through your body, your breasts start preparing to feed your baby.

Hormones like estrogen and progesterone rise sharply in early pregnancy; these hormones stimulate your breasts' milk glands and milk ducts, respectively. The result can be an increased bra size as your pregnancy progresses.

My Breasts Are Big Already. Can I Slow the Growth?

No matter the size of your breasts before conception, they'll probably get bigger during pregnancy, and they'll stay that way for some time after your baby is born. The size depends partly on factors like genetics and heredity, and partly on whether you decide to breastfeed. It's all driven by hormones, and there isn't much you can do to alter or slow the growth.

"Keeping your weight gain in check might ensure that your breasts won't get even bigger, but there's nothing you can do about the hormones," says Shari Brasner, M.D., an OB-GYN and author of Advice from a Pregnant Obstetrician. "No special foods, massages, exercises, or creams affect breast growth during pregnancy, so spend your money on a good supportive bra instead."

Why Are My Nipples Bumpy and Dark?

One of the first breast changes you'll notice is more prominent nipples and small bumps that surround the areola. Those are called Montgomery's tubercles, and they lubricate your breasts and keep germs away during breastfeeding.

Also, hormones can stimulate pigment-producing cells, so expect the nipple and areola to get darker, particularly if you already have a deep skin tone. Fortunately, within a few months postpartum, most nipples return to their original appearance.

Can I Avoid Getting Stretch Marks on My Breasts?

Whether or not you get stretch marks depends on heredity, says dermatologist Barbara R. Reed, M.D., founder of the Denver Skin Clinic. Stretch marks appear when the collagen and elastin in your skin stretch beyond the point of snapping back; if you inherited skin that has a tendency to lose its elasticity when stretched, you're more likely to develop those angry-looking red or purple lines.

Though there are creams that promise to prevent stretch marks, don't expect miracles. They'll keep your skin soft, and that's about it. Doctors give mixed reviews to laser treatments that target the redness in stretch marks. Some say they make a difference; others aren't so sure about the pricey procedure. "In my experience, laser treatments involve three to five sessions, and they're not that effective," says Rod Rohrich, M.D., president of the American College of Plastic and Reconstructive Surgeons.

While there's no surefire treatment for stretch marks, watching your weight gain will help prevent them from looking their worst. And here's one bit of good news: Several months after the baby is born, the marks will fade to a pale silvery color.

Why Are My Breasts Asymmetrical?

According to Dr. Brasner, "Breasts are incredibly sensitive to hormones." If you're lopsided to begin with, the smaller side will be less receptive to hormones because there's less breast tissue, so both breasts won't grow at the same rate during pregnancy. In addition, if a person with equal-sized breasts has had surgery on one, the scarred breast may also be less receptive to pregnancy hormones.

Can I Prevent Breast Sagging?

There's not a lot you can do to control sagging (besides keeping your weight stable and wearing a supportive bra). Whether your breasts end up the same or plagued with ptosis—a fancy medical word for saggy breasts—how you wind up is really the luck of the draw, determined by factors such as heredity, weight gain, and how much your breasts grow while pregnant. As breast specialist Susan Love, M.D., summarizes, "Lots of women end up with smaller breasts, some end up with bigger breasts, and a lucky few stay the same."

While there are many creams and tonics that promise to perk up your bust, doctors say save your cash. You may feel some surface tightening from ingredients such as seaweed, but within minutes or hours, the effect is gone. "Putting a cream or lotion on the outside of your breast won't perk up what's underneath," says Dr. Reed. And because breasts contain no muscle tissue, exercises won't help to perk them up much either.

Why Do My Breasts Ache During Breastfeeding?

Your breasts are likely engorged, which is a fancy term that simply means they're full of milk. The simplest solution is pumping your milk or nursing more often. Unfortunately, that's not always possible. Cupping an ice pack around the sore breast can help relieve the pain. And while the exact reason isn't quite understood, studies indicate that using chilled cabbage leaves can provide relief from engorgement. For breast-shaped ice packs, put a head of cabbage into the fridge or freezer. After it's sufficiently cooled, peel off a leaf and put it in your bra for relief from engorgement.

Can an Underwire Bra Interfere With Breastfeeding?

Yes. Your milk ducts extend down to your rib cage. An underwire bra can obstruct them and interfere with milk production. Plus, the wires may dig into your chest as your breasts change for nursing. Fortunately, there are wireless supportive bras for nursing parents, which can easily be found online or in retail maternity clothing stores.

Why Are My Nipples Sore, Cracked, and Bleeding From Nursing?

Some soreness is normal when you begin nursing, but if it continues for more than a week or two, it may be an indication that your baby hasn't latched on correctly. A poor latch means that your baby may not be getting as much milk as they need, which could compromise your milk production and keep your nipples in rough shape.

A consultation with a lactation specialist can be helpful in determining whether your baby needs to latch onto your breast differently, or if there's a separate issue at hand. You can also try Lansinoh, a soothing lanolin ointment that's applied directly to your nipples and doesn't need to be washed off before nursing.

I Have a Hard, Painful Red Spot on My Breast from Nursing. What Is It?

Your milk is an ideal medium for growing bacteria—and your baby's mouth is full of germs. Add tiny breaks in your skin caused by sucking, and you can end up with lactational mastitis, an extremely painful bacterial breast infection. You'll know if you have it: The infected area gets red, hot, and swollen, and is accompanied by a fever and flu-like symptoms.

To treat mastitis, your doctor will likely prescribe an oral antibiotic that's safe for nursing parents, tell you to frequently apply warm compresses, and encourage you to continue breastfeeding. Sometimes, mastitis can pave the way for a breast abscess—a sore, pus-filled lump in the breast that sometimes requires a needle aspiration or surgery to remove infected pus.

To avoid these problems, nurse and pump constantly to keep your milk flowing freely; a blocked duct is usually where mastitis starts. In between nursing sessions, wash and rinse your nipples to safeguard against bacteria.

The Bottom Line

It's normal to experience lots of breast changes during and after pregnancy, especially if you decide to breastfeed. But if there's anything that seems abnormal, or you have concerns about any of the breast changes you're experiencing, your best bet is to contact your doctor.