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Women may notice the darker skin around the nipple, the areola, increasing in diameter and getting deeper in color. It is believed that the darker color of the areola serves a purpose by helping the newborn to spot the nipple. The Montgomery glands, the small pimple-like glands on the areola, also enlarge during pregnancy. The role of the Montgomery glands is to secrete a substance that lubricates and helps to protect the areolae from infection. Women should avoid using soap, or doing any preparation or "toughening" of the nipples, since this may interfere with the effectiveness of the Montgomery glands and does not reduce the occurrence of nipple soreness as was once thought.
During the third month of pregnancy the beginnings of colostrum appears. Colostrum is the thick yellow nutrient and immune component-rich first milk that the breast will produce for the baby's first few days. By the second trimester true colostrum is produced as early as 16 weeks. Some women may notice slight drainage of colostrum from their nipples and occasionally a small amount of blood. This is not a cause for concern. The blood comes from within the breast and is due to the increased number and rapid growth of blood vessels in the growing ductal system. Drops of blood may also be seen on the bra because the sticky colostrum may temporarily "glue" the nipple to the inside of the bra and a tiny bit of nipple skin is remove with the bra. Understandably, this could cause alarm in the pregnant mother.
In the last trimester the breast continues to expand from the enlargement of milk making cells and distention with colostrum. If a baby is born prematurely, it is interesting to note that the mother of a preterm baby has milk that is somewhat different from a mother of a full term infant. The mother of the preemie will have a milk composition more appropriate to the differing needs of the preemie's more immature body systems.
The most important thing a mother can do to prepare for breastfeeding is to become informed. Attend a breastfeeding class, mother's breastfeeding support group or locate a board certified lactation consultant in your area. Become familiar with the local breastfeeding related services. There are also many excellent breastfeeding books available today. You may want to get a recommendation from your local lactation consultant or breastfeeding support group. Be cautious of "free" brochures and information as they are frequently published by commercial interests who may not be the best source of information for breastfeeding women.
The breasts know how to do the job of breastfeeding. It is really rare for a problem to occur that is related to the intrinsic nature of the breasts and how they function.
Most breastfeeding problems are related to the management of breastfeeding and techniques that are involved. Knowledge and appropriate support can be key to a successful breastfeeding experience.
- Riordan, J. and K. Auerbach. Breastfeeding and Human Lactation Jones and Bartlett, Boston, 1999. p 98.
- Lawrence, Ruth, Breastfeeding: A guide for the medical professional..Mosby, New York, 1994, p 61
- Mohrbacher, N. & J. Stock, The Breastfeeding Answer Book, La Leche League International, Schaumburg, Illinois, 1997. pp 16-17.