Your "Expectant" Breasts: What to Expect When You Are Pregnant

May 28, 2010 - PRLog -- So many obvious changes are occurring when you are pregnant, and although so much attention is directed at your ever-expanding baby bump, your “expectant” breasts have been quite busy too!
   Shortly after conception, the placenta begins to release estrogen and progesterone which causes breast changes that can be felt as early as 4-6 weeks.  Estrogen increases growth of the milk ductal system, while progesterone will cause the expansion of glandular tissue throughout the breast.  These hormonal changes cause an increase in breast tissue, expansion of blood vessels as well as a significant increase of blood flow to the area.  Women often site breast tenderness, tingling, soreness, swelling and increased sensitivity of the nipples and breasts.
   At about 8 weeks of pregnancy, many women notice that their breast feel itchy and some may see stretch marks appear at this time.  This is due to the rapid expansion of breast tissues: so rapid in fact some women may increase 2 bra cup sizes within these weeks!  Stretching of the skin due to the increase in blood supply causes veins under the skin to appear more visible.  The extra blood supply is needed in the breasts because the nutrients in the breastmilk are derived directly from the blood stream.
   By 12 weeks, changes to the outside of the breasts are becoming evident.  Small bumps on the areola (the dark area surrounding the nipple) are becoming more pronounced.  These Montgomery tubercles are actually oil-producing glands that become active at this time to clean and lubricate the nipple and areola in preparation for breastfeeding.  Amazingly, this fluid has the same familiar scent as amniotic fluid which serves to attract the baby to the breast following birth.  In addition, nature helps the baby find it’s “target” for nursing by enlarging and darkening the areola.  Research has shown that babies prefer to look at dark circles more than any other shape!
   By the end of the 1st trimester, the breasts will already begin to produce colostrum. This “pre-milk” is truly a super-food with a concentration of antibodies immunities that is unmatched in nature. While some women leak colostrum and others do not, this is not a reflection of the ability to produce enough breastmilk for their baby.  If you are leaking and develop a discharge that has hardened, just wash the nipples with warm water, avoid drying soaps and wear cotton breast pads if necessary.
   Late in the 1st trimester, there is an increase in 2 other hormones responsible for breastmilk production (prolactin) and let-down (oxytocin).  Prolactin is sometimes called the “mothering” hormone since some feel it has a maternal or even relaxing effect.  Prolactin increases throughout pregnancy and eventually peaks at delivery and stays elevated during lactation.
   With all of these changes, many women’s breasts will begin to feel uncomfortable at this time.  A good supportive maternity or nursing bra will help alleviate some of the back pain that is caused by the heavier breasts. Choose a well-fitting bra as underwire bras may not be comfortable due to compression and bra seams that run near the nipple may cause some irritation. Cotton fabrics breathe easier and allow more air circulation than synthetic, often keeping women much more comfortable.  It’s great to keep exercising and make sure your sports bra is extra supportive without causing compression of the breasts.
   As soon as the baby is born, there is a dramatic hormonal shift which jump starts the milk production process.  The antibody-rich colostrum is immediately available as soon as the baby is put to the breast and begins to nurse.  The breasts produce this colostrum for 2-3 days whereby the baby’s suckling will trigger an increase in prolactin and oxytocin. These are the hormones that drive the volume and let-down of your breastmilk.  From this point on, breast stimulation and milk removal by the baby (or hospital-grade pump) will maintain these high hormone levels and therefore your sufficient breastmilk supply.
   So keep in mind that your breasts are “expecting” too!! Women are built to breastfeed their children and although breastfeeding may have some initial challenges, early assistance from a certified lactation consultant can prevent problems and insure a positive breastfeeding experience for you and your baby.

Dawn Cedrone, RN, MSN, IBCLC is a certified Lactation Consultant at NewBornMom Breastfeeding Solutions in Livingston, New Jersey.  She is affiliated with Saint Barnabas Medical Center, Livingston, New Jersey.  For more information, she can be reached at 973-740-0400.

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Saint Barnabas Medical Center is a 597-bed, acute care teaching hospital. For more information call 1-888-SBHS-123.