Sore Breasts in Pregnancy
Written by Dr.M.D.Mazumdar, MD
The first sign of pregnancy for many women, are sore and sensitive breasts.
Breast soreness can occur as early as 1-2 weeks after fertilization and conception, or even before the first missed periods. Most however feel their breasts becoming sore at about 4-6 weeks after the first missed periods.
Some women describe the soreness as similar to the changes that occur just before menstruation, only much more intense.
Sometimes the soreness may be so severe that the touch of anything even the fabric of the nightgown may cause discomfort. The nipples may throb or tingle and the breast feel swollen and heavy. You may feel that walking about, mild exercise or even sleeping on your stomach can make you uncomfortable.
As soon as you become pregnant, there is a surge of the female hormones, progesterone and oestrogen in your body. These hormones not only help the uterus to grow and maintain the pregnancy, they also prepare the breasts for feeding the baby when the baby is born.
The glandular tissue in the breasts begins to grow and increase in size as pregnancy progresses. Milk ducts begin to form and increase in number. The alveoli (please see anatomy of the breasts), which are the main milk producing areas, become larger with growth of more cells. This is more so in the first pregnancy. In later pregnancies, the breasts may enlarge very little or sometimes not at all.
The increase in size depends to some extent on heredity, on how much weight you put on and how big the breasts were before you became pregnant.
The blood vessels supplying blood to the breasts increase in both size and number. You may see prominent blue veins running under the skin of your breasts.
A layer of fat is deposited under the skin to support the bulk of the breast tissue and increase milk production. This fat layer together with the increasing mass of breast tissue will make the cup size of your bra go up by about 2 sizes by the time you reach term pregnancy. Some women may go up from a size 34B to a 36C or even more.
The nipples become large and prominent. Pigmentation occurs to make them appear darker than before. This pigmentation may decrease after delivery but never reaches the pre-pregnant state.
The areola, that is the dark area around the nipples appears to spread out more and become darker. An ill-defined secondary areola sometimes appears surrounding the main areola which is called the primary areola. It is less dark in colour and its margin merges gradually with the surrounding skin.
Small oil-producing glands called Montgomery's tubercles become prominent around the edges of the primary areola. They look like small irregular bumps that are firm but painless. These tubercles, meant to keep the areola and nipples moisturized and supple are also present during the non-pregnant stage but can barely be seen.
In some women, thin, fine stria may appear along the sides and bases of the breasts. These stretch marks, similar to those on the abdomen, usually occur if you put on too much weight too fast or if the breast increases in size too fast. They can also appear if the breast skin is dry and flaky. Initially they are pinkish or purplish in colour but later fade to white silvery lines.
Itching can occur while the stria or stretch marks are developing. This is due to the injury to the elastin fibres of the breast skin when it is stretched too much.
Some women may notice that their breasts begin to leak a thin, yellowish white liquid as they near the end of their pregnancies in the third trimester. This liquid, called colostrum, is rich in many essential nutrients and vitamins and is the first food that the baby gets after birth. Leakage of colostrum is just a sign of the body preparing the breasts for breastfeedng the new baby.
Not all women however get all the breast changes. Many do not have any soreness of the breasts, or if present, may be very mild. Breast enlargement may be minimal. Stria may not appear if the breasts are not very enlarged. Colostrum may not leak. These are also quite normal and does affect breastfeeding in any way.
As pregnancy advances, you will find that the breasts become less sore and sensitive, although some women do complain of soreness from time to time.
What you can do for Sore Breasts
- Invest in a good quality maternity bra. The larger the breasts, the more important it is to keep them well supported, to prevent the ligaments being stretched. This will help prevent the breasts from sagging.
If you are on the heavier side, buy a plus-sized bra with wide straps that can take on the added weight easily.
Ask a professional at a department store or maternity store to fit you up. If this is not possible, measure yourself along the widest circumference of your chest, usually over the nipples for your cup size and just under your breasts for your chest size.
You may need to be fitted more than once as the breasts continue to develop throughout pregnancy. Buy a bra that fits when the clasp is on the tightest setting. You will then have room to let them out as your ribs expand in later pregnancy. You can also use bra extenders to adjust for the enlargement of your chest wall in later pregnancy.
If you are planning to breastfeed your baby, buy special maternity bras. These should be bought towards the end of the pregnancy at around the 36th week when the breasts have more or less attained the full pregnancy size. Avoid underwire bras, as under wires can put pressure on milk glands and interfere with milk production.
Pregnancy Sleep Bras: If you feel that the bra chafes your nipples at night, buy a soft pregnancy sleep bra. This is a soft cotton bra with no seams that will prevent sagging of your breasts. Many women also find a camisole and shorty set very comfortable to sleep in at night.
Sports Bras: If you plan to exercise, it is important to invest in a well fitting sports bra designed primarily to support your heavy breasts during exercise. Many women prefer to wear sports bras throughout their pregnancies. Less movement of the breasts cause less soreness.
- If your nipples are retracted, draw them out gently every time you bathe or take a shower. Be careful not to cause damage with your nails. Alternatively, you can buy nipple shields which can be worn inside your bra. They keep the nipples erect and cause them to protrude from the areola.
- Keep a breast pad or a fine cotton handkerchief inside your bra to absorb any colostrum that may leak from your breasts. Select from reusable and disposable varieties available at stores. Change them several times a day and allow your nipples to air dry after each change.
- If a crust forms, wash it off with warm water and a soft cloth. Do not apply soap as it may dry out the nipples and cause irritation. Use soapless washes.
- Application of moisturizers after a bath or shower will keep the nipples soft and supple. This will prevent cracks from forming at the edge of the nipples which can hamper breastfeeding.
- If you find that touching your breasts are uncomfortable, do not hesitate to tell your partner about it.
- If you feel that your breasts are hot and throbbing, apply a cool soft cloth to them. They will feel much better.
- If you sweat too much below your breast, place a fine cotton cloth ( a handkerchief will do) between your breast and your chest wall to soak up the excess sweat. You can also dust the area with non-perfumed talcum powder for more comfort.
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