Breast Changes During Pregnancy: What to Expect

By OBGYN Dr. Kenosha Gleaton

Breast changes are often one of the first signs of pregnancy and frequently continue into the postpartum period. Hormonal changes, breastfeeding, and everything in between can lead to a wide range of symptoms. Let’s talk a bit more about what to expect. 

Early Signs of Breast Changes

There are a few symptoms of pregnancy that can appear as early as a week or two gestation, including morning sickness, a missed period, spotting, and fatigue. Many people also experience breast changes during early pregnancy, such as [1]:

• Darkened areolas 
• Enlarged areolas 
• Swollen or engorged breasts
• Sore or tender breasts
• Breast growth

Detailed Breakdown of Breast Changes During Pregnancy

There is a long list of breast changes that can occur during pregnancy, from week 1 to week 40. 

Enlarged Breasts

Pregnancy can lead to larger breasts. Not only can the breasts become engorged with milk during the postpartum period, but elevated hormones in pregnancy can also cause enlarged breasts. High levels of estrogen and progesterone promote the growth of mammary tissue, which may lead to you feeling as though your bra is tighter or your chest is heavier. [2] This may steadily increase throughout pregnancy as estrogen levels continue to rise and peak in the third trimester. [3] 

Breast Tenderness

Breast tenderness is another common symptom of pregnancy. Sore breasts during pregnancy may feel similar to the way breasts feel before a period and are caused by, you guessed it, hormones. Estrogen and progesterone cause the breasts to swell, which can also lead to them feeling sore. [1-2] There are a few ways to manage this- including hot and cold compresses, well-fitting bras, and using over-the-counter medications with your provider’s approval.  Learn if you can take ibuprofen while breastfeeding → 

Changes in Nipples

Aside from changes in breast tissue, many also experience nipple changes. It’s common for heightened hormones to cause nipple sensitivity and nipple growth while the body prepares for breastfeeding. [4] If you’re looking for relief, try wearing a bra that is not too tight or loose, has a properly fitting band, and has a comfortable amount of padding. Using nipple balms and over-the-counter pain medications can also be useful if you’re looking for additional support. Just remember to speak to your provider about the use of any new products or medications, especially when pregnant or breastfeeding. 

Skin Changes

Skin changes can also arise during pregnancy. I’m not just referring to melasma or pregnancy acne, but the skin on the breasts, stomach, and thighs can also change and stretch to support your growing body. You may notice itchiness, dry skin, or stretch marks from these changes. Look for pregnancy-safe creams, balms, and oils for relief! 

Darkened Areolas

The areola is the small pigmented circle of skin that surrounds the nipple. Areolas can vary from person to person in size, color, and texture, and it’s especially common to see changes in the areolas during pregnancy. The surge of hormones during pregnancy often causes the areolas to become a darker color. [1,4] This may also persist during breastfeeding or for a prolonged period of time after giving birth. 

Montgomery’s Tubercles

Another breast change that isn’t talked about as frequently is the presence of Montgomery's tubercles. Montgomery’s tubercles are the small bumps seen on the areola that can range from flesh-colored to white or red. [4-5] Some people have obvious tubercles outside of pregnancy, while others may only notice these bumps for the first time after conceiving. Montgomery’s tubercles are actually the openings of oil glands that play an important role in breastfeeding. [5] Not only do these glands lubricate and protect the nipple, but research shows that the sebum that is released actually has a scent that helps infants locate the breast and initiate breastfeeding. [6] You may notice an increase in the number of bumps, or the bumps may change in color or size. Read more about Montgomery’s tubercles here. 

Leaking Colostrum

Colostrum is the first milk that comes in when preparing to breastfeed and is often thick, yellowish-white, and nutrient-dense. [7] Colostrum contains more proteins than mature breast milk and is rich in immunoglobulin, which is important for supporting an infant's immune system soon after birth. [7] It’s normal for the breasts to begin making colostrum as early as 12 weeks gestation, and some people may experience leaking colostrum during the second trimester. 8 This doesn’t happen to everyone, but it is considered normal. Leaking may be more obvious to some, or could even appear as dried colostrum on the nipple. 

Post-Pregnancy Breast Changes

It’s normal and expected that your body will look and feel a bit different after pregnancy. Your skin has stretched to make room for a growing fetus, your breasts have filled with milk, and you’ve likely gained weight and will lose a few pounds after giving birth. Regardless of whether someone breastfeeds or not, it’s normal for the breasts to change in appearance after pregnancy. [1,4] Some pregnancy changes may be more lasting than others- such as the presence of Montgomery’s tubercles, darkened areolas, and stretch marks. You may also notice your breasts seem to hang lower, be larger or smaller than pre-pregnancy, and feel less firm. The nipples may also be sore or cracked from breastfeeding. There continues to be a lot of hormonal change occurring during postpartum which can lead to sensitivity, soreness, enlargement, and more. [1-4] 

Choosing the Right Bra During Pregnancy

Having a comfortable bra during and after pregnancy is one of the best ways to manage discomfort. Make sure you’re shopping for a bra that fits snugly but isn’t too tight. Your bra shouldn’t dig into your shoulders or back and there shouldn’t be any spillage in the cups. You always want to make sure you are comfortable, so look for options that are adjustable and made with breathable fabric. If you are breastfeeding, nursing bras can be a great option. It’s best to keep your breasts dry and clean, so look into nursing pads if you’re experiencing leakage. Speak to your provider if you have any concerns or questions about breast changes during or after pregnancy. 

Embracing the Changes with Natalist

It can be difficult to manage all the physical and physiological changes you experience during your fertility, pregnancy, and postpartum journeys. Even though many of these changes are out of our control, we can still appreciate our bodies for getting us through the many beautiful, difficult, and tender moments of life. Shop self-care products including Natalist Belly Oil or Cooling Cream to pamper yourself. 

References:

1. Am I Pregnant? Cleveland Clinic. July 2022. https://my.clevelandclinic.org/health/articles/9709-pregnancy-am-i-pregnant
2. Al-Chalabi M, Bass AN, Alsalman I. Physiology, Prolactin. [Updated 2023 July 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507829/
3. Robinson DP, Klein SL. Pregnancy and pregnancy-associated hormones alter immune responses and disease pathogenesis. Horm Behav. 2012;62(3):263-271. doi:10.1016/j.yhbeh.2012.02.023
4. Breast Changes During Pregnancy. American Pregnancy Association. Accessed October 2023. https://americanpregnancy.org/healthy-pregnancy/changes-in-your-body/breast-changes-during-pregnancy/
5. Khan YS, Sajjad H. Anatomy, Thorax, Mammary Gland. [Updated 2023 July 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547666
6. Doucet S, Soussignan R, Sagot P, Schaal B. The secretion of areolar (Montgomery's) glands from lactating women elicits selective, unconditional responses in neonates. PLoS One. 2009;4(10):e7579. Published 2009 Oct 23. doi:10.1371/journal.pone.0007579
7. Jozsa F, Thistle J. Anatomy, Colostrum. [Updated 2023 Feb 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513256/
8. Colostrum. Cleveland Clinic. February 2022. https://my.clevelandclinic.org/health/body/22434-colostrum