Quirky Questions: Nipple Changes in Pregnancy?

Updated January 5, 2021.

With all the bliss that comes with becoming a new mom, come some pitfalls. You’re ready for the weight gain, stretch marks, nausea, and soreness that come with carrying your future bundle of joy to go away. And still, there’s a lesser known — and less talked about — side effect of pregnancy you might not anticipate: nipple changes.

Fear not. We’re here to help you navigate this curious aspect of pregnancy — what to expect, why it’s happening, and how to deal.

For most women, the breasts as a whole will grow larger (increasing in weight by 1-1.5 pounds over the course of your pregnancy), while the nipples will experience changes in size, shape, and sensitivity. Typically, they will get progressively larger and darker and women often notice little bumps on the surface of their nipple area. You should expect your nipples to get progressively darker throughout your pregnancy and be the darkest when your baby is born. Your nipples will also begin to produce and may leak colostrum, a precursor to milk, towards the end of your pregnancy.

Hormonal changes, increased breast tissue production, and fat storage play a part in both breast and nipple changes. Much of this occurs as your body prepares to provide nourishment (milk) to your baby. To accomplish this, milk ducts multiply, milk sacs (alveoli) grow, and blood supply increases in your breasts throughout pregnancy.

And oh, remember those little bumps we mentioned above? Those are enlarging glands, known as Montgomery glands. These glands provide a soothing and antibacterial lubricant to protect the nipples. They also give off a scent that helps the newborn baby find the nipple at birth and initiate breastfeeding.

Usually, most of the discomfort is tenderness from the swollen breast tissue and tends to occur during the first trimester of pregnancy. Wearing a well-fitted bra (without an underwire) can help to support your growing breasts. A soft, sports cotton bra can provide some comfort at night, as well as prevent rubbing of sensitive nipples, in general.

If your nipples feel dry and sensitive, there are over-the-counter nipple creams that lubricate and help your nipples heal.

Everything from genetics, pre-pregnancy breast size and BMI, weight gain during pregnancy, age, and smoking status can affect how quickly you bounce back. For women who don’t choose to breastfeed, the color and size usually go back to normal fairly quickly because your body stops producing hormones. Breastfeeding moms will find that their nipples stay darker, longer, but begin to lighten once they stop.

There are creams to help alleviate discomfort, but be sure not to use any anti-pigmentation creams. The darkening is caused by blood flow, not melanin, and anti-pigmentation creams can cause permanent nipple discoloration.

While women don’t usually experience problems during pregnancy, post-partum, a skin infection called mastitis can develop. Mastitis, which is more common in breastfeeding women than non-breastfeeding women, is caused by a clogged duct in the nipple, causing increased inflammation and bacteria to grow. This can result in soreness in an area of the breast, redness, fatigue, and low-grade fever and chills. Warm compresses and continual breastfeeding will usually make it pass on its own, but if your symptoms don’t improve after 24-48 hours, you’ll need to see a provider and get antibiotics.

Additionally, you can treat clogged ducts and therefore, reduce your chances of developing mastitis, by emptying the breasts regularly, staying hydrated, and making sure to rest as best you can. If recurrent clogged ducts are a concern, it can be helpful to discuss this with a lactation specialist or your healthcare provider as well.