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Breast Tenderness

Davi Peters had a feeling she was pregnant. Her breasts were tender, and felt different than when she had her period. The Hollis, New Hampshire, resident took a pregnancy test, but it was negative. She figured her period was on its way and forgot about it. About five days later, she realized she hadn’t gotten her period and took another pregnancy test. This time it was positive. Peters describes her breasts as having an aching tenderness. “They also started to feel fuller right away, and my bras stopped fitting just after I found out I was pregnant,” she says.

What Causes the Tenderness?

Simply put, breast tenderness happens due to increased hormone levels of estrogen and progesterone, says Dr. Shelley Binkley, an OB-GYN and author of DIY Baby! Your Essential Pregnancy Handbook.

The estrogen production causes a response of the mammary tissue within the breast that results in tenderness, says Michelle Collins, assistant professor of nursing, nurse-midwifery specialty at Vanderbilt University School of Nursing in Nashville. There is also a great deal more fluid and blood circulating within the pregnant woman’s body. “This increase in circulation volume can result in engorgement of the breast tissue (fullness) as well as prominence of the blood vessels of the breast tissue, which is also why the pregnant breasts can look like they have a blue ‘highway’ map on them,” Collins says.

A First Sign of Pregnancy

Sore breasts are typically the first sign of pregnancy because as progesterone shoots up in the first trimester, it stimulates breast glands to enlarge, Dr. Binkley says. “This rapid first trimester enlargement in breast glands stretches the support ligaments of the breasts (Cooper’s ligaments),” she says. “Stretching of the ligaments causes breast pain.” Also, breast tissue is a type of tissue that is very responsive to estrogen increases, Collins says.

The Duration

Breast tenderness “usually occurs early in the pregnancy—in the first few weeks—then subsides somewhat, then can resume late in pregnancy,” Collins says. “It is very individual. Some women have great difficulty with breast tenderness, and other women, not so much. It cannot be avoided.”

Collins points out that women who have had a pregnancy loss are often reassured when they have a subsequent pregnancy and have breast tenderness. “That is not to say that if a woman feels no breast tenderness that she should be worried,” she says.

After Davi Peters found out she was pregnant, her breasts continued to be sore during her first trimester, and then the soreness went away. With her second pregnancy, she only had a little bit of soreness. “Again, it was the first symptom I had, and again, I took a pregnancy test too early and got a negative result,” Peters says. “This time, I took another one two days later and got a positive result. [The soreness] only lasted probably the first month and then my breasts felt fine for the rest of the pregnancy.”

Coping Tips

Because breast tenderness is hormonally caused, there are no medications that will make it better, Collins says. Dr. Binkley says you can take vitamin E (800 IU a day) and vitamin D (2,000 IU a day) for some relief, but again, it really can’t be avoided.

Dr. Binkley says that cold works better than heat for breast tenderness. Cool cabbage leaves work well because they conform to breast shape. Ice packs, like a bag of frozen peas, can be placed across the chest while you lie down on the couch or bed, Collins says. There are also some breast soothing products that are little silicone-filled reusable packs that you can place in the refrigerator and then inside the bra for long-lasting coolness/soothing without the bulkiness of an ice pack. If you’re leaking colostrum and need a breast pad, cotton pads allow more airflow, whereas the plastic backed pads hold moisture in next to the nipple, which isn’t ideal, Collins says.

A Good Bra

“A good-fitting bra worn 24 hours a day can be very helpful,” Collins says. “Underwire bras may actually cause more discomfort as the underwire may lie across some tissue at the bottom of the breast. Maternity sports bras are a nice choice. Cotton bras are good because they allow for air flow and evaporation of sweat better than some synthetic blends.”

Just make sure you get a supportive bra in the right size. “Many people wear bras that become too tight in pregnancy,” says Dr. Binkley, who recommends getting a bra sizing done, and purchasing at least one or two bras in a more comfortable size. “Also, it’s important not to purchase nursing bras until the milk comes in after delivering the baby,” she says. “Breast size can double or triple when the milk comes in.”

Consider sleeping in the bra, even at night. For some women, feeling the sheets next to bare nipples is very uncomfortable, and fuller breasts without adequate support are also uncomfortable. Nighttime may also mean getting used to a new sleeping position. Felts normally sleeps on her stomach, but had to stop because it hurt too much to lie on her sore breasts.

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