Prenatal Breastfeeding Information 

Breast changes during pregnancy
Understand how your breasts make milk
What I should know before my baby is born

 Breast Changes to Expect During Pregnancy

The skin on the breast becomes more elastic and the nipple and areola may become darker in color. Tiny raised bumps known as Montgomery glands on the areola secrete oil that cleanses and lubricates the nipple, keeping it soft and pliable. It also has a scent that the baby uses to locate the breast. You cannot smell it but your baby will be able to, especially right after the birth. Do NOT remove this oil with soaps or other drying agents such as alcohol or witch hazel. If your nipple tissue becomes dry or crusty from leaking colostrum, cleanse gently with clear warm water and apply a small dab of Lansinoh ointment after showering. “Toughening” of the nipples before birth is no longer recommended as it will further damage your tissue toward breakdown.

You should notice an increase in your breast size during your pregnancy. Swelling and tenderness are indications that the breast is changing appropriately. The amount of breast change will vary between women.  Breast size does not indicate success or failure in breastfeeding. It is the development of the glandular tissue (shown below) throughout pregnancy that leads to milk production. If there is very little or no breast change, it is important to discuss it with your lactation consultant or health care provider knowledgeable about breastfeeding.

Your breasts already are producing colostrum during the 2nd trimester of pregnancy. Some women may even experience slight leaking from the nipples toward the end of their pregnancy. Colostrum is the first type of milk that your baby will receive after birth until it changes into mature milk by the 3rd to the 5th day after birth. The illustration below shows the alveoli, the grape-like cells that make, store and secret milk. Each one connects to small ducts which branch out from the nipple. Your nipple has many openings that release milk as the baby suckles the areola (the darkened target around the nipple) after latch-on. The baby’s jaws compress the areola, the tongue moves in a wave-like motion front to back, creating a vacuum to release the milk. The NEW* finding noted below is there are no lactiferous sinus structures as once believed. * Medela@ copyright illustration and research.

Understand How Your Breasts Make Milk 

1. Areola
2. Milk Ducts and Branches
3. Alveoli
4. Nipple Openings
5. Glandular Tissue
6. Subcutaneous Fat

What Should I Know before My Baby is Born? 

• Talk to women who have breastfed for 6 months or longer. Be careful about taking advice from women who tried to breastfeed but didn’t make it beyond the first few weeks.
• Sign up for a breastfeeding class before your 34th week of pregnancy. That way, if your baby is born early, you will have had an opportunity to learn about breastfeeding in a class setting. Mercy-Memorial Hospital in Monroe offers a monthly evening class for a fee of $5.00  to Monroe County residents.
• Ask your doctor or midwife to check your breasts around the 32nd to 34th week of pregnancy. A simple nipple pinch test will determine if your nipples are flat or inverted. This condition can be corrected with help of a lactation consultant.
• Go to a Moms Club or LaLeche League meeting where you will see lots of mothers nursing their infants. You will have a chance to ask questions and share the experiences of others. You will have access there to books, pamphlets, phone help and new friends who will continue to support your plans to breastfeed. To find groups closest to you, call 1-800-LA LECHE or for Monroe Moms Club; 734-384-0250 or click on to www.moms club.org.
• Purchase a cotton nursing bra, with easy to detach cup fasteners. Avoid underwire if you can or look for one with a partial wire, to help prevent milk gland constriction which sometimes leads to plugged ducts. Other helpful items are washable nursing pads and Lansinoh nipple ointment.Large cup size bras can be purchased from Penney's catalogue and online at Bravado.com, Medela.com or Mother wear.com.
• Wait till after the baby is born to purchase a breast pump. If you receive one as a shower gift, do not open it until after your milk is in and breastfeeding is well established. Breast pumps cannot be returned once opened, and can be a costly loss if it is not the right one for your needs. Your lactation consultant or peer counselor can help you choose which pump is best for your needs. Employed mothers will need advanced features for breast pumping frequently at work.
• Access the internet for more information; (See our website link page.) Be cautious about information posted from others without medical or professional lactation education. A board certified Lactation Consultant should have the credentials of IBCLC, (International Board Certifies Lactation Consultant) Often other health professionals have gone on to become certified in the lactation field such as MD’s, DO’s, CNM’s, Dieticians( RD’s), Pharmacists, and Registered Nurses, and Nursing Professors. Read as much information as you can about breastfeeding. Ask your health care provider for a referral to a local Lactation Consultant for a prenatal visit. Also ask for pamphlets or books on breastfeeding. Public libraries have many books about breastfeeding and may have videos available. Your childbirth educator or Lamaze Instructor may also have a lending library.
• Read books by lactation professionals. Some excellent sources to choose from at your local library or bookstore are:
  • The Womanly Art of Breastfeedingby La Leche League International
  • The Nursing Mothers Companionby Kathleen Huggins RN, MS
  • The Latch and Other Keys to Breastfeeding Success by Dr. Jack Newman and Teresa Pitman
  • Breastfeeding: Getting Breastfeeding Right for You by Renfrew, Arms & Fisher
  • Dr. Mom’s Guide for Breastfeeding by Maryann Neifert, MD
  • Breastfeeding: Keep It Simple by Amy Spangler MN, RN, IBCLC
  • Nursing Mother, Working Mother by Gale Pryor