Breast changes can be expected during and after pregnancy, whether or not a woman breastfeeds. Common symptoms after giving birth include engorged breasts, which refers to a feeling of fullness, and sore or leaking nipples.
While many breast changes naturally occur after delivery, it is important to discuss any unusual or worrisome symptoms with a doctor.
Below, we list some of the most common breast changes that occur after pregnancy and while breastfeeding, and we explain when someone should see their doctor.
Changes to the breasts and nipples can begin in very early pregnancy and continue throughout it. Hormones and increases in blood flow account for these changes.
Early symptoms can include:
- breast tenderness
- rapid growth of breast tissue
- sore or heavy breasts
- prominent blue veins under the skin
In the second trimester, common breast changes include:
- darker areolas, which are the round areas that encircle the nipples
- nipple discharge
- lumps, from clogged milk ducts or noncancerous tumors
Breast changes during the final trimester include continued enlargement of the breasts and leaking nipples, along with the development of stretch marks on the skin.
After giving birth, breast changes continue to occur. The most common are:
At around 3–5 days after delivery, the milk comes in. A good indicator of this is that the colostrum — the thick, yellow fluid that may be the baby's first food — becomes lighter in color and thinner in consistency.
Some women experience leaking from their nipples within the first few days of their milk appearing. It can happen:
- when the baby cries
- when their breasts are very full
- when they experience strong emotions
- for no obvious reason
Leaking often tapers off after the first few weeks, although some people experience it for longer.
Disposable or reusable breast pads can soak up this milk and prevent it from showing through clothing. Reusable breast pads are available online.
Full breasts are a regular part of the postdelivery experience. The medical name for breast fullness is engorgement, and it happens when the milk comes in. A woman may also experience:
- heavy, hard breasts
- skin that is warm to the touch
- lumps in the breast tissue
Leaking nipples often accompany full breasts.
Women who are breastfeeding should try to feed frequently, as releasing milk more often reduces the fullness. Within a few days, symptoms of engorgement should decrease as milk production begins to fall in line with the baby's needs.
Those who are bottle-feeding should avoid releasing milk from the breasts during this time because doing so will cause the body to produce more milk.
During nursing, other related changes can occur in the breasts. These include:
Breastfeeding women may notice a tingling sensation in their breasts when the babies begin to nurse. This can indicate the "let-down" of milk — the milk releasing into the ducts so that the baby can drink it. Over time, these sensations may become less noticeable.
It may not be possible to feel the milk letting down, and the presence of tingling does not reflect the amount of milk that the baby is getting.
Increased cup size
Typically, the breasts remain enlarged for at least the first few months of nursing. They tend to feel softer and emptier immediately after feedings and may shrink slightly after the baby starts eating solids.
In general, the breasts remain enlarged until breastfeeding is over. They may then return to their original size, become smaller than before, or remain slightly larger — every body responds differently.
Sore or cracked nipples
In the initial stages of breastfeeding, some women experience nipple pain. This occurs while the woman and baby adjust to the process of nursing.
When babies do not latch on to the nipple correctly or suck very strongly, it can cause the nipples to crack, bleed, or blister.
Nipple cream or breast milk can soothe painful nipples. However, if the pain continues, it can help to get advice from a doctor or lactation consultant.
Nipple cream is available for purchase online.
Many women find that their breasts never look exactly the same as they did before pregnancy.
They may be smaller or larger, sag or droop more and develop stretch marks. The nipples may also look different. It is also possible for one breast to change more than the other.
When the breasts return to their prepregnancy size varies from person to person. In general, the breasts tend to revert to their original size when the body resumes its prepregnancy weight.
However, the shape of the breasts may change permanently. This is because the engorgement that occurs when breast milk comes in can loosen the ligaments in the chest, making the breasts droop or sag.
Some women believe that if they bottle-feed, they will not experience breast changes after pregnancy. This is not true because pregnancy, rather than breastfeeding, causes most of the changes to the breasts.
Factors that have a more significant effect on the breasts than breastfeeding include:
- weight gain during pregnancy
- the number of pregnancies that a woman has had
- being a smoker
- breast size before pregnancy
Several complications involving the breasts and nipples can occur following pregnancy and breastfeeding. These include:
This is an infection that arises from a clogged milk duct. It typically only develops in one breast at a time. Signs and symptoms of mastitis include:
- an area of hard swelling
- red streaks on the skin of the breast
- hot skin around the clogged duct
- intense pain in the breast
- pus or blood in the breast milk
Mastitis is most common in the first 3 weeks after childbirth, although it can occur at any time during breastfeeding. Women who are bottle-feeding may also develop mastitis shortly after their milk comes in, as they are not releasing milk from their breasts.
Moderate or severe mastitis usually requires antibiotic treatment. Untreated mastitis may develop into a breast abscess.
Women who nurse can develop a yeast infection in one or both nipples. It typically occurs when the nipple cracks.
- itchiness of the nipple
- pain and sensitivity
- white discharge from the nipple
- shooting pains in the breast after feeding
The yeast infection can pass to the baby. If this happens, they may have:
- patches of white on their tongue or in their mouth
- feeding difficulties, such as pulling off the breast and crying
- diaper rash
Research from 2019 suggests that younger women who have recently given birth have a slightly increased risk of breast cancer, though pregnancy may actually lower breast cancer risk over time.
It is important to seek medical attention if unusual breast changes appear, such as:
- lumps that are painful, persistent, or increasing in size
- unusual nipple discharge
- dimpling or puckering of the skin on the breasts
Anyone who has concerns about breast changes that occur after pregnancy or during or after breastfeeding should talk to their doctor.
Seek prompt medical attention if any symptoms of mastitis develop, especially if the symptoms are severe or do not improve within 24 hours.
A doctor should investigate any breast lumps or unusual skin or nipple changes, as these may suggest cancer.
Most women experience breast changes after pregnancy, regardless of whether they breastfeed.
Even if the breasts never return to their prepregnancy state, most of the changes are cosmetic, meaning that they are not a medical concern.
Occasionally, however, breast changes can indicate an infection or cancer. Both require further investigation and prompt treatment.
Regular breast self-exams can help people become more familiar with their breasts, which may help them catch unusual changes at an early stage.