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A woman's breasts and areolas go through multiple changes during pregnancy. She needs to invest more time nurturing and caring for her breasts, even though she never did the same during puberty. The breasts play an important role to support a human life to develop and grow.
Breasts start changing in their size and composition in order to supply milk for the baby. Breast tissues are dynamic in nature; they always keep adjusting to hormonal changes. Hormones are responsible for necessary functioning within our organs.
The chemicals like progesterone and oestrogen levels rise inside the body, which in turn cause physiological changes in breasts. The lactiferous ducts widen in order to produce and store milk  .
Changes In Breasts During Pregnancy
- Women can feel their breasts becoming tender; they experience a tingling sensation in them. This can sometimes amplify to a burning sensation. The size of breasts increase and they start feeling heavier.
- It is common for the skin in breasts to stretch during pregnancy, which can cause itching in that area. Stretch marks can become prominent.
- Blue- or green-coloured veins become visible due to mass and stretching.
- Some women who always complained about small breasts start noticing cleavage.
- Women who had babies previously can also secrete colostrum from their breasts.
- Breast lumps can be found in certain places, even though they were non-existent before. However, it is advisable to get them checked by a doctor.
- The lumps can appear red and soft due to blockage of milk duct  . Gentle rubbing and warm massage would help to circulate the blood again. The maternity centre must be consulted in case of emergency.
Changes In Nipples During Pregnancy
- The nipples become highly sensitive. They develop hypersensitivity to hot or cold conditions.
- The nipple and areola become darker; even their size becomes wider. There might be more hair growth around the nipple area during pregnancy.
- Pimple like structures called Montgomery's tubercles start developing around nipples. They might appear painful; however, their job is to provide the softness and suppleness to nipples so that they can conveniently feed the babies.
How To Care For Breasts And Nipples During Pregnancy
1. Wearing the right bra
As the breast size keeps increasing during the first few months, you might need to change your bras often. It is essential to wear the right size and material to provide maximum comfort. Any bra that looks good but suffocates you underneath should be discarded. Bras with underwire linings or push up bras must be avoided. Instead, cotton bras with soft padding should be opted.
Underwire bras can disrupt the production of milk and cause blockage in nipple ducts. Big breasts need better support, so it is essential to choose the right bra.
2. Warm massage
Nipples can crack and dry out during pregnancy during stretching. It can be a hard task to keep the nipple area moist and pain-free. The nipples can be massaged lightly with coconut or olive oil multiple times a day, to retain moisture  .
Excessive pressure should not be used while massaging. Only the fingertips can be lightly circled around the area, and this could make a difference in pain and discomfort.
3. Maintenance of proper hygiene
It is important to clean the nipples, as a viscous liquid called colostrum passes through them in the last trimester  . A wet tissue paper can be used to clean up the area whenever it is released. Breast pads can also be used to keep the area dry.
It is better to avoid soap to wash the nipples as it can result in dryness and cracks in the skin. Petroleum jelly, coconut or sesame oil are really effective in giving softness. It is advisable to pull the nipples gently with thumb and forefinger while taking bath. This can activate lactation and promote milk extraction post pregnancy.
4. Avoiding usage of soap over nipples
Soaps cause dryness and itching in the nipple area. This can even lead to cracking of skin, which can turn out to be painful for expecting mothers. A moisturizing lotion can be used for cleaning and it is a better substitute for fragrant soaps. This is one of the major breast care routines that women must adopt during pregnancy.
5. Moisturizing the nipple area
Breasts can become very itchy during pregnancy. The stretch marks make the skin cracked and painful. Apart from massaging the breasts and application of oil over them, moisturizing creams can be a remedy too. Post bath, when the skin feels rough and patchy, moisturizer can be immediately rubbed over the breasts to retain their softness. The nipples will feel hydrated if the cream is also applied before sleeping.
Petroleum jelly is also a wonderful moisturizer as it does not let the water beneath the skin escape. Women should avoid scrubbing around their breasts for too long. Scratching near the dry skin or rubbing it over and over with towel can increase the itchiness. The secretion of oils through glands can be hampered thus dissolving sebum, the naturally produced oil by the epidermis. The breasts should always be lightly patted with a cloth to soak water.
Aloe vera gel can also be really great for applying over cracked or sore nipples. If the gel is refrigerated for some time, it can provide a cooling sensation and easily heal the pain.
6. Oatmeal bath
When we take a hot water bath, our skin feels more itchy and sore because hot water tends to dissolve the natural oil secreted by the skin. A better option to soothe the dry skin is to add oatmeal to lukewarm water and take bath with it. Or rub the paste on skin post bath and gently wash it away with water. This can make a huge difference in skin care of breasts and nipples.
7. Nipple protectors
When the nipples are sore and dry, their friction against the clothes can cause discomfort and pain. Markets are flooded with nipple protectors that act as protective barriers between the clothes and nipples  . This can definitely help to retain the sweat and moisture that appear on skin. The pain would also be alleviated due to no contact between the skin and clothes.
8. Use of breast pads and ice pads
Let us be honest about it. Breasts and nipples need extra care during pregnancy to prevent leakage from them. Breast pads really serve as a blessing to give the required dryness around the area. They soak any leakage from nipples and avoid infections from growing. They can be placed between bra and nipple and their material is either disposable or reusable.
Besides, the nipples can feel stressed out and become erect majority of the time during pregnancy. Ice pads help them to relax. They reduce pain and provide the much-needed relief.
The changes in breasts cannot be avoided even though women do not desire it. However, some changes solely depend on the care and maintenance we provide to them.
- Lukewarm water must be used to wash the skin. Anything too hot can harm the baby and cause skin burns.
- Bra should be changed every day. The irritation resulting from sweat and leakage can then be prevented.
- The breasts should be observed every day to notice specific changes. If something feels off and different, a doctor must be consulted immediately.
- Simple stretching exercises like arm rotations can be added to the routine to prevent breasts from sagging. Allotting a little time every day to take care of breasts can be helpful in the long run to have better body shape post labour  .
-  Nascimento, S. L. D., Godoy, A. C., Surita, F. G., & Pinto e Silva, J. L. (2014). Recommendations for physical exercise practice during pregnancy: a critical review.Revista Brasileira de Ginecologia e Obstetrícia,36(9), 423-431.
-  World Health Organization, & Unicef. (2009). Baby-friendly hospital initiative: revised, updated and expanded for integrated care.
-  Bryant, J., & Thistle, J. (2018). Anatomy, Colostrum. In StatPearls [Internet]. StatPearls Publishing.
-  Flacking, R., & Dykes, F. (2017). Perceptions and experiences of using a nipple shield among parents and staff - an ethnographic study in neonatal units.BMC pregnancy and childbirth,17(1), 1.