Breastfeeding A to ZNutrition During Pregnancy

Prenatal Breast Changes

During pregnancy your breasts will be undergoing changes to breastfeed your baby.  This happens regardless of how you choose to feed your baby.

Often breast changes are your first sign that you are pregnant.  It is common for your breasts to be tender or sore in early pregnancy.  Growth in the milk producing part of each breast is taking place, causing the breast to become larger. (1)(2)  You may also notice little bumps on the areola or dark area around the nipple.  These are called Montgomery glands and become raised in pregnancy and resemble pimples.  These glands provide lubrication and protection for the nipple. (1)

You may also notice leaking from the nipple.  The liquid may appear to be golden or orangish in color.  This is colostrum, the type of milk that your baby will receive first.  It is yellow or orange in color because of its high beta-carotene content, a form of Vitamin A.  Sometimes it is in such small amounts, it appears crusted on the nipple.  There is no need to express this or worry about it.  You may have this happen or you may not, either is normal. (1)

There is nothing you have to do to physically prepare for breastfeeding.  If you notice during the end of your pregnancy that the nipple itself, is flat or dimpled in, have your healthcare provider evaluate it.  If the nipple stands out it makes it more helpful to the baby to latch on to the breast, but not every baby will have difficulty if it doesn’t.  In the past you may have been encouraged to do some exercises or wear shells (cups) if your nipples were flat or inverted. (1)(2)  This is now usually discouraged because stimulation to the nipples can cause you to start contractions and start your labor and there hasn’t been consistent evidence that they work. (2)  Baby’s breastfeed by latching on to the areola or the dark area around the nipple not just the nipple itself. (2)

If you have ever had surgery on the breast, please make sure your healthcare provider knows this.  Surgery on the breast such as breast reduction, breast implants or reconstructive breast surgery can alter your breasts ability to make milk.  It may help you to see an International Board Certified Lactation Consultant (IBCLC) before your baby is born.  This health professional has special breastfeeding training and thousands of hours of practice before they can become certified.  An IBCLC can provide education resources and follow-up with breastfeeding your baby.  Check with your healthcare provider to locate someone with this special breastfeeding training in your area or online check www.ilca.org or call 888-452-2478.

Consider taking a breastfeeding class during your pregnancy for further information and resources in your community to assist you with breastfeeding your baby.

A breastfeeding class will also provide a place to find out about breast pumps if you are thinking about buying one.  You want to have done your homework and understand how you will be using a breast pump before you buy one.  Check out whether or not your insurance or healthcare reimbursement account will cover the purchase cost or rental of a breast pump.  Also, check to see if your employer provides any on-site pumps or kits to be used with a pump.  (Sometimes a spouses’ employer may provide this benefit.)  This will help you determine the best breast pump choice for you.

References:

  1. Mannel, R, Marten, PJ, Walker, M, Core Curriculum for Lactation Consultant Practice, 3rd edition, Burlington, MA, Jones & Bartlett Learning, 2013, pp 262, 264, 357, 647-49.
  2. Lawrence, RA, Lawrence, RM, Breastfeeding: A Guide for the Medical Professional, 7th edition, Maryland Heights, MO, Elsevier Mosby, 2011, pp 66, 242-43.