Breast changes by trimester: what to expect - Ruth Health

Breast changes by trimester: what to expect

Fast facts:

  • Hormone changes throughout pregnancy may affect just about every part of your breasts, from breast size and shape to nipple sensitivity and the color of your areolas.
  • Sore, tender, or swollen breasts during the first trimester are sometimes the earliest sign of pregnancy.
  • Make sure you have a comfortable, well-fitting bra at every stage of your pregnancy.
  • Stretch marks and changes in the size or shape of your breasts are often a natural part of the prenatal to postpartum journey — not something to be ashamed of.
  • If you’ve chosen to breastfeed, engorgement may be uncomfortable as your milk first comes in. A lactation consultant can offer individualized support and tips.

Breast changes are among the more frequently discussed physical effects of pregnancy, and for good reason. From the size and sensitivity of your nipples to the color of your areolas, you might be surprised by how much the breasts can transform. (Thank you, hormones!)

Here’s what to expect during each trimester. You may not experience all of the changes mentioned below, and that’s okay. Each pregnancy journey is unique.

Some birthing people have only mild breast changes, or none at all. This isn’t always an indication of an unhealthy pregnancy or issues with breast milk production.

If you have concerns about how your breasts are or aren’t changing during pregnancy, speak with a trusted healthcare professional.

First trimester

For some individuals, sore, tender, or swollen breasts are the earliest sign of pregnancy, even before a positive test. This is the result of the rapid hormonal changes that start upon conception.

Your levels of estrogen and progesterone will steadily increase, preparing your body for milk production and causing your breasts to grow

Breast soreness and tenderness often decrease in the coming weeks as your body adjusts to hormone changes. In the meantime, hot or cold compresses, lotions, and creams are your friend.

Your nipples and areolas may change during the first trimester. The size and sensitivity of your nipples may increase, and your areolas may darken. You might also notice small, painless bumps on your breasts. These are oil glands called Montgomery tubercles, which support breastfeeding.

How to ease discomfort

  • Experiment with hot or cold compresses, lotions, or creams to reduce soreness or tenderness.
  • A comfortable bra makes all the difference. Look for one that offers good support, with adjustable closure and straps and no underwire.
  • Breast changes can affect your sex life. Each person’s needs are different. It’s 100% okay if you’d prefer to not have your nipples touched, or to refrain from having sex altogether. Open communication with your partner is key.

Second trimester

As estrogen continues to increase, your milk ducts will develop and your breasts may feel heavy or full.

If your nipples and areolas haven’t yet darkened, they may now, as hormone changes affect pigmentation. You may also notice dark spots on your breasts or nipples.

Many women develop reddish, brown, or purple stretch marks as the breasts grow. Don’t feel pressure to hide or change them. When stretch marks form, they are a natural result of the pregnancy journey — not something to be ashamed of.

That said, there are some ways to potentially reduce the visibility of stretch marks, including exfoliation, cocoa or shea butter, stretch mark creams, and massaging your skin. However, some may never disappear completely. Many factors are at play, including genetics.

As your body prepares for milk production, your breasts may begin to produce colostrum — the first type of breast milk — early in your second trimester. Some women experience leakage of colostrum.

How to ease discomfort

  • Make sure that comfortable bra you have still fits! Many birthing people go up one or several cup sizes during this stage.
  • Avoid over stimulating your nipples to prevent cramps or contractions.
  • If colostrum leakage causes discomfort (or frustration), breast pads can protect your clothing and prevent stains. Breast pads are absorbent liners placed between your nipple and bra. Make sure they are breathable, as moisture can lead to a yeast infection.

Third trimester

As you approach labor and delivery, your breasts will likely become even fuller and heavier. Your nipples may become larger and more pronounced. These changes can cause itching, dryness, or stretch marks.

How to ease discomfort

  • Continue to use your preferred form of relief for breast soreness, tenderness, or itchiness.
  • If you are planning to breastfeed, invest in a nursing bra, which has cups that drop down so you can easily offer your breast to your baby.
  • If breast changes are impacting your sleep, consider buying a sleep bra.

Fourth trimester and beyond

You may be surprised by just how quickly breasts can change after delivery. About 3-4 days after birth, breast milk production will ramp up as your levels of prolactin, a breastfeeding-related hormone, increase.

Your breasts may feel sore or tender as milk comes in, transitioning from colostrum to transitional milk and then mature milk.

Breast engorgement in breastfeeding individuals typically decreases throughout the first six weeks, as you settle into the rhythm of breastfeeding and have a steady milk supply.

Lactation consultants can offer individualized support as you navigate breastfeeding discomforts.

Book a session with a Certified Lactation Counselor (CLC).

Changes in your breast size and density during pregnancy may affect your breasts’ appearance during postpartum and beyond. Some women’s breasts eventually return to their pre-pregnancy size and shape.

Others find that their breasts remain larger, or become looser. It depends on various factors including your genetics, age, and previous pregnancies.

Sometimes these changes can be difficult to accept. Like stretch marks, changes in the size or shape of your breasts are often a natural part of the prenatal to postpartum journey.

Be gentle with yourself as you process how pregnancy can affect the breasts and body. Though social media and society more broadly can make it seem like it’s easy to bounce back after pregnancy, that isn’t the case for everyone.

How to ease discomfort

  • Use cold compresses, cabbage leaves, or hand expression to reduce swelling and pain. If breastfeeding, try to fully empty your milk supply by alternating feeding positions, alternating breasts, and using a pump if you are unable to nurse.
  • Don’t be afraid to seek support from a mental health professional such as a therapist or psychiatrist as you process how your body or breasts have changed. Many birthing people experience these feelings, and your emotional and mental well-being is paramount.
  • Breast or nipple soreness can impact your sexual needs and desires during postpartum. Prioritize your physical and emotional comfort during this time, and communicate openly with your partner.

Supporting your pregnancy and postpartum journey

Ruth Health is here to help you prioritize your comfort throughout pregnancy and postpartum. We provide expert, evidence-based maternal advice so that you can make the best decision for yourself.

Learn more about pregnancy, postpartum, and everything in between at And be sure to join our community by signing up below!

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