Exploring Breast Changes During Pregnancy: The Third Trimester and After Birth

If you are in the last trimester of pregnancy, your breasts will probably be feeling quite large and heavy now!

You will likely notice that everything has become more prominent; your nipples may have started to protrude more - unless you have inverted nipples, in which case you may not notice any difference - the skin of your areola is really quite dark, the veins just underneath your skin are clearly visible (if you have pale skin) and the stretchmarks may be much more noticeable too.

You may find the skin underneath and on top of your breasts become hot and sweaty and possibly even dry and itchy too, this is due to the skin stretching. Make sure you wear a comfortable, cotton and correct fitting bra...

What to Expect After Birth

Once your baby and the placenta are born it sets off a hormonal reaction to start the milk-making cells producing mature milk in large quantities. In the first hour your baby will normally find and crawl to the breast themselves to breastfeed. If your baby is not yet able to breastfeed the midwives will help you to express your milk.

Small quantities of colostrum are perfect for your new baby right now. Their tummy is only tiny so they only require little amounts of colostrum at the beginning. Their tummies quickly grow over the next few days though, along with your increasing milk supply.

Over the next 2-5 days, you will notice that your breasts begin to feel much fuller and heavier as the milk ‘comes-in’. The milk inside your cells is changing from colostrum into mature milk and the volume available to your baby grows very quickly.

You may find you wake up one morning and your breasts feel like they have doubled in size! They will likely feel full, firm, and warm, and perhaps tender as milk production increases and colostrum begins to change to mature milk. The term for this change in breast fullness is physiological engorgement.

Some women find that their breasts feel uncomfortable. Other women barely notice any change. Mild to moderate discomfort is common and normal. Usually this situation lasts for about 18 to 24 hours. However, each woman is different, so physiological engorgement may last for longer or shorter periods of time.

Your milk will “come in” whether you breastfeed or not, but continued milk production only occurs if you empty your breasts of the milk regularly via breastfeeding or through expressing.

If you feel your breasts are rock hard and extremely full, a warm shower, some gentle breast massage and expressing a little milk to soften your areola before you feed baby can be helpful to ensure baby can attach and drink from the breast well. If baby is unable to attach on to the breast and feed well then it is a good idea to contact your midwife for support.

The Three Stages of milk: Colostrum, Transitional Milk and Mature Milk

Colostrum: Colostrum looks thick and sticky and varies in colour. It is highly concentrated, easily digested and contains everything your newborn needs to build a strong immune system. It is available only in very small amounts, which is just right for your baby's tiny stomach.

Colostrum has a laxative effect, which helps the baby to pass the meconium (the first poo) and helps prevent jaundice by clearing the bilirubin from the gut.

Transitional milk: During the next two weeks, the milk increases in quantity and changes in appearance as well as in composition. The immunoglobulin and protein content decreases, while the fat and sugar content increases.

Mature milk: Mature milk does not look as creamy as cow's milk, your breast milk is meant to look different- often thinner and watery looking, possibly with a cream layer on top. This does not mean it is poor quality milk at all. We are just different from cows! Mature milk contains all the nutrients needed for your baby’s healthy development. Breast milk is never “too thin.”

Mature milk changes over the length of a single feed, as well as over weeks and months, in order to meet your baby’s specific needs. The milk that flows at the beginning of a feed is low in fat and high in lactose, sugar, protein, vitamins, minerals and water. As the feed progresses, the milk changes and contains more fat and less sugar.