A number of women decide against breastfeeding partly to protect the appearance of their breasts. The premise deserves a second look, because the research doesn’t support it.
Breastfeeding doesn’t, on its own, cause breasts to sag.
When researchers have looked at what predicts breast ptosis in women who have had children, breastfeeding hasn’t emerged as an independent factor. What does: the number of pregnancies, age, smoking, larger pre-pregnancy breast size, and significant weight gain or loss.
The changes attributed to breastfeeding are mostly caused by the pregnancy that preceded it, and those happen whether you breastfeed or not.
What happens
- During pregnancy, the milk-producing tissue expands and the skin and supporting ligaments stretch to accommodate it. This is the part that changes the shape.
- After weaning, that glandular tissue shrinks back, a process called involution, but the stretched skin doesn’t shrink at the same rate. Breasts often look emptier or less full than before, and the upper part in particular can lose volume.
- It takes time to settle. Give it six to twelve months after weaning before judging the final result; many women find things improve much over that period.
- Areolae darken in pregnancy and often stay somewhat darker afterwards.
- Asymmetry is normal and frequently more noticeable while feeding, since one side often produces more.
- Stretch marks are largely down to genetics, and no cream reliably prevents them.
What you can influence
- Don’t smoke. Smoking degrades elastin in skin, and it’s one of the few modifiable factors that shows up in the research.
- Avoid large weight swings where you can. Repeated substantial gain and loss stretches and empties the tissue repeatedly.
- Wear a well-fitted, supportive bra, especially during engorgement and for exercise. Whether this prevents ptosis isn’t established; that it’s much more comfortable is.
- Get properly fitted at least twice: in late pregnancy and again a few weeks after milk supply settles. Most women wear the wrong size throughout, which is uncomfortable and can contribute to blocked ducts.
- Wean gradually if you can. A slow reduction is easier on the breast tissue and much more comfortable than stopping abruptly.
If you’re considering surgery
- Wait until you’ve finished having children, and at least six months after weaning, ideally longer. The tissue is still changing before then.
- Existing implants usually don’t prevent breastfeeding, though it depends on the incision and technique. Tell your obstetrician and a lactation consultant.
- Breast reduction can affect milk supply, sometimes significantly, depending on how it was done.
- Discuss future breastfeeding with the surgeon beforehand if children are a possibility, since it may change the approach.
Changes that need checking
Breast changes during pregnancy and breastfeeding are easily dismissed as normal, so pregnancy-associated breast cancer, while uncommon, is often diagnosed later than it should be.
See a doctor about:
- A lump that doesn’t change after a feed or resolve within a few days
- Skin dimpling, puckering, or an orange-peel texture
- A nipple that has turned inward, having previously been out
- Bloody discharge from the nipple
- Redness that doesn’t settle with mastitis treatment within 48 hours
- Persistent one-sided pain unrelated to feeding
Most of these are benign. Have them looked at instead of filing them under “that’s just breastfeeding”.
Frequently asked questions
Does breastfeeding make your breasts sag?
Not on its own. Research into what predicts breast ptosis in women who have had children doesn’t identify breastfeeding as an independent factor. The predictors are the number of pregnancies, age, smoking, larger pre-pregnancy breast size, and significant weight change. The changes usually blamed on breastfeeding are caused by the pregnancy itself.
Why do my breasts look different after weaning?
The milk-producing tissue expands in pregnancy and shrinks back after weaning, but the stretched skin doesn’t shrink at the same rate, so breasts often look emptier, especially in the upper part. Allow six to twelve months after weaning before judging the result: many women find it improves a great deal.
Can I do anything to prevent the changes?
Not smoking is the clearest one, since smoking degrades skin elastin. Avoiding large weight swings helps, as does a well-fitted supportive bra: comfort is certain even if prevention of sagging isn’t established. Get properly fitted in late pregnancy and again once supply settles, since most women wear the wrong size throughout.
Should I wait to have breast surgery?
Yes, until you’ve finished having children and at least six months after weaning, since the tissue is still changing. If children are a possibility, discuss future breastfeeding with the surgeon beforehand, as it can influence the technique.
What breast changes should I get checked?
A lump that doesn’t change after a feed or resolve within days, skin dimpling or an orange-peel texture, a nipple that has newly turned inward, bloody discharge, redness that doesn’t settle with mastitis treatment within 48 hours, or persistent one-sided pain unrelated to feeding. Most are benign, but don’t file them under “just breastfeeding”.
What to remember
It’s the pregnancy, not the breastfeeding. Deciding against feeding to protect your breasts is based on a premise the evidence doesn’t support.
What helps: not smoking, avoiding big weight swings, a properly fitted bra, and weaning gradually.
And wait six to twelve months after weaning before assessing anything, including whether you want surgery.
Read next
- How to tell when your baby is hungry
- Breastfeeding in public in Singapore
- Does breastfeeding make children smarter?
This article is general information and not a substitute for medical advice. See a doctor about any breast lump or change, including during pregnancy and breastfeeding.