Angela Cleary, IBCLC
Pregnancy
Pregnancy is often a time focused on your baby’s in utero growth and development and preparing for childbirth, but it is also a critical time to learn about lactation. It is recommend to take a lactation class during the early weeks of your 3rd trimester as a way to prepare for breast/chestfeeding. In addition, working with an International Board Certified Lactation Consultant (IBCLC) during your 3rd trimester can help identify breast changes, answer questions about your unique breast health history, and create an infant feeding plan that you can bring with you to your birthing space.
Breast Anatomy
Pregnancy includes significant changes to prepare the body for milk production. When you are examining your breast development throughout pregnancy, you can gently palpate your breast tissue with your finger tips, and take note of any changes to the sensitivity and density of your breast as you grow glandular tissue (alveolar milk sacs) and milk ducts. These areas of the breasts may become engorged and swollen as your milk supply transitions from colostrum to mature milk in the first 72 hours after birth. Your breasts will grow in size even more after birth as the volume of fluid increases in your alveolar milk sacs. It is advisable to wait until this point before investing in a nursing and pumping bra.
Get Familiar with Your Breasts
Using your preferred oil or lotion to moisturize your breasts and nipples during pregnancy and after birth can maintain adequate hydration and prevent dryness. Take note of your nipples and how they appear as these findings can be helpful to share with the lactation experts that you encounter. Do your nipples evert out and away from your areola? Are they flat against the areola? Is there a line or crease at the tip of your areola, indicating an inverted nipple? It is not recommended to “toughen up” your nipples with a towel or any other rough material prior to breastfeeding or pumping. Do you have questions about your anatomy? Schedule a Prenatal Lactation Consultation for a breast evaluation and tips for preparing for your first feedings!
Breast Massage
Massage is well known to be an act of self care at any point in the lifespan and has physical and emotional benefits. Massage is an easy way to boost oxytocin, an important hormone involved in lactation. Introducing gentle massage to your chest and breasts during pregnancy can bring you closer to the changes your body is making to prepare to be an ongoing source of nutrition, development, and connection for you and your new baby. Breast massage and movement can also improve range of motion in the chest during times of ductal growth and fluid increase during pregnancy and postpartum.
How to start chest and breast massage during pregnancy
Relaxation/Comfort Items to consider:
- A light sweater, blanket, or robe to keep your body warm
- Preferred oil (unrefined coconut oil works well)
- Comfortable place to sit
- Relaxing music
- Candle or essential oil of your choice
- Deep breathing or meditation
Apply a small pea sized amount of oil to your finger tips and slowly massage under your collar bones in a small circular motion. After a few passes along your collar bones, use the flat part of your fingers and palms to move your hands gently down towards the arm pits. As you reach your arm pit, use your finger tips to apply 5 rounds of gentle but firm pressure inward into the center of your arm pit on each side. Reapply small amounts of coconut oil as needed. Repeat the entire sequence as desired. Next, practice range of motion with your breast by gently lifting your breast with each hand and moving it slowly up and down, and side to side. Avoid firm pressure. Alternate between each breast every 30-60 seconds for 3-5 rounds. Aim for 10 minutes of relaxing, gentle massage once a day throughout your 2nd and 3rd trimester.
Hand Expression
As you become comfortable with breast massage and movement, you can easily transition to hand expression. Hand expression is helpful when it’s time for colostrum to begin moving through your breasts after birth. Hand expression stimulates oxytocin, which activates tiny muscle contractions around your newly formed milk alveolar sacs to push milk through your milk ducts to the nipple. This is known as the milk ejection reflex, and can commonly be referred to as your milk “letting down.” You can begin hand expressing at 37 weeks with approval from your OB/GYN or midwife. This allows you to collect colostrum prenatally. Otherwise, begin hand expressing after baby’s feeding, and as needed to manage breast fullness and engorgement in the first 2 weeks after birth.
Maintaining a well balanced diet with meals and snacks through the day and night, drinking water whenever thirsty, and taking prenatal vitamins will help support the rapid growth and development of your breasts before and after birth.
Resources on breast massage and hand expression:
Hand Expression — Maya Bolman IBCLC
Hand Expressing Milk | Newborn Nursery | Stanford Medicine
Breast Gymnastics — Maya Bolman IBCLC
Schedule a prenatal class or consultation with Nurture!
About the Author:
Angela Cleary, IBCLC, has a background working with WIC as a peer counselor and lactation consultant. In addition to providing lactation care, Angela teaches lactation classes and enjoys supporting parents through the 4th trimester.