It’s common for women’s nipples to change during pregnancy and breastfeeding. As the breasts grow and prepare for lactation, the areolas (the area around the nipples) often get darker and larger. The nipples themselves also frequently become more pronounced and swollen. These changes are normal and expected as the breasts go through changes to get ready for breastfeeding.
Why do nipples get bigger during pregnancy?
There are a few reasons why nipples typically enlarge during pregnancy:
- Hormonal changes – Rising levels of hormones like estrogen, progesterone, prolactin, and oxytocin cause the breasts to start developing the milk duct system in preparation for breastfeeding.
- Increased blood flow – More blood circulates to the breasts and nipples, causing swelling and enlargement.
- Montgomery glands – These sebaceous glands around the areola and nipples enlarge to help lubricate and protect the nipples during breastfeeding.
- Fatty tissue – The area around the nipples becomes more vascular and develops more fatty tissue to support milk production.
These changes typically start early in pregnancy as the breasts ramp up production of milk ducts, alveoli (milk sacs), and other glandular tissue. The areola diameter increases progressively week by week, with the most rapid growth happening between weeks 16-22 of pregnancy.
How much do nipples grow during pregnancy?
There is a wide range of “normal” when it comes to nipple changes during pregnancy. On average, studies have found:
- The areola diameter increases from about 2.6 cm to 4.5 cm from early pregnancy to late pregnancy.
- The nipple diameter increases from about 1.3 cm to 1.9 cm.
- Total areola area increases from about 5.3 cm2 to 15.5 cm2.
However, every woman is different. Some women may only see a slight increase in nipple size, while others have more dramatic enlarging. Genetics, breast size, and hormone levels all play a role.
Common nipple changes during pregnancy
Here are some of the specific ways nipples often change during pregnancy:
- Darkening areolas – Increased hormones cause the areolas to darken in color, usually in the first trimester. The darker pigment helps the baby locate the nipple for breastfeeding.
- Bumps on areolas – The tiny bumps on the areola (called Montgomery glands) become more pronounced and raised due to swelling.
- Larger areolas – As mentioned above, the diameter of the areola increases significantly to prepare for milk production and breastfeeding.
- Protruding nipples – Some women’s nipples become more pronounced and swollen early in pregnancy as the underlying tissue expands.
- Tenderness – Increased blood flow and swelling can make nipples feel sore and sensitive.
- Discharge – Small amounts of milky or clear discharge can leak from the nipples as early as the second trimester as the milk ducts start developing.
These nipple changes are temporary and will usually return closer to pre-pregnancy appearance after breastfeeding ends. However, there may be some permanent differences in exact size, color, and texture.
Does breast size determine nipple growth?
Breast size can play a role in how much nipple expansion occurs during pregnancy. However, it does not dictate nipple changes. Here’s what we know:
- Women with larger breasts tend to have larger areolas in general compared to women with smaller breasts.
- During pregnancy, nipple growth is generally proportional regardless of original breast size.
- One study found areola diameter increased about 1.5 times from early pregnancy to late pregnancy for all participants.
- The difference in areola size between large-breasted and small-breasted women remained proportional after pregnancy as well.
So larger-breasted women often have bigger nipples than smaller-breasted women to begin with. But nipple changes during pregnancy usually align with the overall breast growth, not the original breast size.
Can uneven nipple growth happen?
Yes, it’s possible for one nipple to become larger than the other during pregnancy. Potential reasons include:
- Natural asymmetry – Most women have slightly unequal breasts already, which can extend to the nipples.
- Hormone sensitivity – One breast may be more sensitive to the hormonal changes of pregnancy.
- Injury or irritation – Past issues like piercings, infections, or trauma could impact nipple growth on one side.
- Breast abnormalities – An underlying condition like capsular contracture from implants could affect nipple size.
Minor asymmetry (less than 1 cm difference in nipple/areola size) is usually nothing to worry about. But significant unevenness or dramatic enlarging on only one side should be evaluated by a doctor.
Do nipples stay bigger after pregnancy?
For most women, the nipples shrink back down somewhat after breastfeeding ends. However, they don’t always return to exactly the same size as pre-pregnancy. Changes that may remain after breastfeeding include:
- Larger areola diameter by 1-2 cm
- Slightly more pronounced nipples
- Darker areola pigmentation
- More bumps on the areolas
- Loose or stretched areola skin
These are permanent effects from the expanded milk duct system that developed during pregnancy and breastfeeding. But for many women the changes are relatively subtle.
Here are some general guidelines about postpartum nipple size:
- Within 6 months postpartum, the areola diameter decreases by about 1 cm on average.
- 50% of nipple diameter growth reverses within 3 months of weaning.
- After 1 year, the areola diameter is still about 1.5 cm larger than pre-pregnancy.
Of course, there is individual variation in how much reversal happens after weaning. Factors like genetics, breast size, and age may play a role.
Tips for easing nipple discomfort
For some women, the nipple changes during pregnancy can cause soreness, sensitivity or irritation. Here are some tips to help relieve nipple discomfort during pregnancy:
- Wear a supportive, well-fitted maternity bra.
- Try breast shells or gel pads inside your bra to prevent friction.
- Use nursing pads if your nipples are leaking colostrum.
- Avoid harsh soaps or chemicals on the nipples.
- Apply lanolin or moisturizer to soften and soothe areolas.
- Wear loose clothing and avoid underwire bras.
- Try cold compresses or cool gel packs for soothing relief.
If discomfort persists, consult your healthcare provider about medication options for relief.
When to see a doctor
Consult a doctor promptly if you experience:
- Extreme nipple pain
- Sudden dramatic changes in one nipple/breast
- Discharge from the nipples other than colostrum
- Open wounds, ulcers, or rashes on the nipples
- Retracted or inverted nipples that don’t protrude
These could potentially indicate an underlying infection, condition or congenital disorder needing medical attention. Most nipple changes in pregnancy are normal, but it’s always a good idea to mention concerns to your doctor.
Frequently asked questions
Why are my nipples so itchy during pregnancy?
Itchy nipples are common due to increased blood flow, swelling, and skin stretching. Using moisturizer and avoiding harsh soaps can help. Check with your doctor if itching is severe.
Will my nipple piercings close up during pregnancy?
Maybe. Pregnancy hormones and nipple expansion can cause pierced holes to tighten or close up. Maintaining jewelry through pregnancy may help, but not always.
Can I breastfeed if I have flat or inverted nipples?
Yes, in most cases. Flat or inverted nipples often protrude more during pregnancy and breastfeeding. If not, a nipple shield can help draw the nipple out for latching.
Do cracked nipples mean I won’t produce enough milk?
No, nipple cracking does not affect milk production. Cracks are due to friction and can be healed with creams and proper latching.
Will nipple stimulation bring on labor?
Mild stimulation may help release oxytocin and promote contractions. But only when the body is ready for labor (not before full term).
Conclusion
Nipple changes like enlargement, protrusion, and darkening are extremely common during pregnancy and breastfeeding. Exact sizes vary, but on average the nipple and areola diameter increases 1-2 cm from the start of pregnancy to the end. Underlying hormonal shifts cause the tissue to swell and expand in preparation for breastfeeding. While the nipples revert somewhat after weaning, mild differences in size and pigment often remain postpartum. This is normal, but any sudden nipple changes or abnormalities should be discussed with your doctor.