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Breast changes (leaky, cracked & inverted nipples)

Pregnancy is responsible for many changes to the breasts including changes in size and feel and inverted and cracked nipples. Many women also experience leaky breasts as the milk ducts prepare for breastfeeding.

From about week six in your pregnancy you will start to notice changes in your breasts. The pregnancy hormonesA complex chemical substance created in a part or organ of the body. When released it initiates or regulates activity in an organ or group of cells in another part of the body.
Hormones secreted by endocrine glands are transported through the bloodstream to their target organ. The amount of hormone secreted is regulated either by other hormones, by neurotransmitters, or simply when an excess of the organ's activity indicates a need to reduce the amount of the hormone produced.
Other hormones are produced locally by the organs themselves and are common in the digestive tract.
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responsible for so many changes to your body are stimulating the breasts: progesteroneOne of the two naturally occuring female hormones (the other is estrogen) used to regulate and maintain the pregnancy. Produced first by the corpus luteum in the ovary, production is subsequently taken over by the placenta as it develops. During pregnancy a mother's production of progesterone ten times the level it was prior to conception. Progesterone and estrogen are responsible for giving many mothers a sense of tranquility, shiny hair and glowing skin.
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is responsible for most changes to the breasts while estrogenOne of a group of female hormonal steroids that promote secondary sex characteristics.
Created in the ovaries, adrenal cortices, and fetoplacental unit, estrogen is used to prepare the genital tract for fertilization, implantation and nutrition of the embryo.
Estrogen is a key ingredient in oral contraceptives. Estrogens include conjugated estrogen, esterified estrogen, estradiol, estriol and estrone.
Visit our comprehensive glossary for more pregnancy terms and definitions.
develops the milk glandsGlands in the female breast that begin produce milk during the last stages of pregnancy and postnatally.
Visit our comprehensive glossary for more pregnancy terms and definitions.
and ducts. You may notice a tingling sensation as more blood circulates through the breasts and you bluish veins will appear on your skin.

Changes to the breasts during pregnancy

As the breasts develop during pregnancy you will notice that the area around the nipples will darken from pink to brown or red brown. Your nipples will grow larger and become more erect so that your baby will be able to feed. The bumps on the areolaThe common term for areola mammae or the pigmented circular area surrounding the nipple of the breasts. It is also sometimes known as areola papillaris.
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, called Montgomery's tuberclesThe small bumps on the areola surrounding the nipple, they are sebaceous glands which normally enlarge during pregnancy.
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, also get bigger, secreting a fluid that lubricates the nipples.

Tender and sore breasts during pregnancy

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Estrogen causes the milk glands and ducts in your breasts to grow. These changes are most noticeable as tenderness and soreness in the breasts between week six and week twelve, and in many women are among the first signs of pregnancy. Some women find the changes to their breasts acutely painful, and try hard to prevent anything from touching or brushing against them.

While the breasts continue to develop throughout your pregnancy, the tenderness you noticed early on may not continue throughout the full nine months. You should wash your breasts at least once a day, using a facial soap that will not dry your skin, and gently pat them dry.

Increase in breast size during pregnancy

By week six you may notice your breasts getting bigger because of the water retained in the body during pregnancy. By week eight the milk glands and ducts start to enlarge and there is increased growth of fatty tissue.

Most women's breasts grow at least two cup sizes during pregnancy and each breast increases in weight by about half a pound. If your breasts grow particularly large you may develop stretch marks. It is important to wear a supportive bra throughout your pregnancy, and if you are particularly sensitive, the weight of the breasts themselves may become unbearable. If your breasts grow particularly large you should consider wearing a bra at night as well.

You may notice that your breasts also become lumpy or nodular during pregnancy. This is normal, but if you are worried about the risk of breast cancer you should consult your doctor.

Leaky breasts and caked nipples during the second and third trimester

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During the second trimester the milk glandsGlands in the female breast that begin produce milk during the last stages of pregnancy and postnatally.
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begin to develop a thin yellow colored fluid called colostrumA protein rich form of milk, containing immunologically active substances, white blood cells, water, fat and carbohydrates, secreted by the breasts late in pregnancy until a few days after delivery, after which the body produces mature milk.
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. Increasing in quantity through the remainder of your pregnancy, colostrum contains antibodiesA protein immunoglobulin which is produced naturally by the body and is essential to the immune system by working to combat foreign bodies, germs or bacteria. They are produced by thelymphoid tissue and consist of different classes each of which is designed to fight specific antigens. They include agglutinins, bacteriolysins, opsonins and preciptin.
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and will provide nourishment and immunity for your baby until the breast milk comes in.

It is normal for the breasts to leak colostrumA protein rich form of milk, containing immunologically active substances, white blood cells, water, fat and carbohydrates, secreted by the breasts late in pregnancy until a few days after delivery, after which the body produces mature milk.
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during pregnancy and can often be expressed by squeezing the nipples. You may want to place a cotton or gauze pads in your bra to absorb the extra fluid.

It is very common for the leaking colostrumA protein rich form of milk, containing immunologically active substances, white blood cells, water, fat and carbohydrates, secreted by the breasts late in pregnancy until a few days after delivery, after which the body produces mature milk.
Visit our comprehensive glossary for more pregnancy terms and definitions.
to dry on the surface of the nipples. Caked nipples should be cleaned two or three times a day. Use only warm water, because soap can dry the skin and cause it to crack.

Caring for inverted nipples

The nipples of some women are flat or retract (invert) into the breast. Inverted nipples may make it more difficult for you to breastfeed, but it shouldn't prevent you from breast feeding. If you are concerned that you may have inverted nipples you can easily determine whether your baby will be easily able to suckle.

Place your thumb and index finger on the areolaThe common term for areola mammae or the pigmented circular area surrounding the nipple of the breasts. It is also sometimes known as areola papillaris.
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, the dark area that surrounds the nipple, and squeeze gently. Inverted nipples will retract into the breast. If your nipples project when you become sexually excited your baby will have no problem drawing the nipple out, and breastfeeding.

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If you are concerned about inverted nipples ask your doctor about breast shells. These plastic shells are worn under the bra, and put slight pressure on the base of the nipple to help draw it out.

You can also try the Hoffman technique to evert your nipples. Starting by week thirty four, place one of your index fingers on each side of the areolaThe common term for areola mammae or the pigmented circular area surrounding the nipple of the breasts. It is also sometimes known as areola papillaris.
Visit our comprehensive glossary for more pregnancy terms and definitions.
and gently squeeze it inward and away from the nipple. Then place your fingers above and below the nipple and repeat. Repeat this technique twice a day.

Cracked nipples during breastfeeding

During breastfeeding you may notice your nipples become cracked. If a nipple cracks, avoid feeding your baby from that breast for up to 72 hours. Instead, express the milk from the breast to prevent it becoming engorged.

Cracked nipples can become very painful, and in rare cases may lead to infection, or postpartum mastitis. To reduce the risk of cracked nipples wash your breasts with water only. Avoid using soap since it may dry out the skin. Some women choose to express breast milk onto the nipples and letting it dry. Since breast milk is high in fat it will keep the nipples soft.

If you prefer to use a lotion, apply lanolin or another commercial breast cream that is safe for use during breastfeeding and does not have to be washed off first. You should be aware that lanolin is made from wool, and should not be used if you are allergic.