Breast Changes in Pregnancy

First Trimester

If you are in your first trimester and you are not feeling breast tenderness or increase in size, ask you doctor to evaluate your progesterone levels.

Second and Third Trimester

You may start to leak small amounts of colostrum. Many women may not experience this.

After delivery, in the hospital

• Try to get the baby to nurse within the first half hour to hour after birth.
• Continue to nurse on que (at least every 2-3 hours), including the middle of the night.
• If the baby falls asleep easily on the breast, stays on the breast for hours, cries a lot, is less than 7 pounds or is a premie, he/she may not be removing milk effectively.

Make sure to get the evaluated by the hospital staff and get the baby weighed daily

If baby has lost more than 10% of birthweight: You should offer expressed breastmilk or formula to the baby after each nursing. See Low Production: First Weeks and Bottle Feeding articles.

1. continue to nurse on que
2. pump as directed below
3. make sure to get the baby evaluated by the pediatrician on the day after hospital discharge and then every 2-3 days until you and the pediatrician are sure that he is getting enough milk

If baby is not gaining weight, see Low Production: First Weeks.In the hospital, pump after feeds, every 2 to 3 hours. Ask the nurses and lactation consultants in the hospital to help you learn to use the hospital grade pump. Massage the breasts gently while pumping.Pump for 5-15 minutes. Stop sooner than 15 minutes if no milk is coming out.

Remember:

1. Feed the baby. Breastmilk is preferred but if you don't have enough, use banked donor milk or formula. Don't worry.
2. Increase or maintain your milk production:
• Pump after feeding
• Eat well, try herbs and herbal teas if appropriate and contact your doctor about medications.