Bras and Breastfeeding

This piece was originally posted on October 17, 2011 on Breastfeeding and Parenting Solutions. Thank you to Patricia Berg-Drazin for allowing us to re-post!

Among the many concerns that arise with preparing for breastfeeding is the concern about bras. Let us start by taking a brief walk though the history of the bra in America. The bra replaced the corset during the 19th century. The movement from corset to bra was driven predominantly by fashion although some concern was expressed by health care professionals about the health risks of corset.

Understanding that bra wearing is driven by fashion, not “need,” is important. The mammary gland lays on top of the pectoralis muscles; therefore, there are no muscles that need to be supported to keep them from “stretching” as the breast changes size prior to and during lactation.

By the third or fourth week of pregnancy the breast starts developing in preparation for lactation. There is ductal branching and lobular formation that often lead to breast tenderness, which is often one of the first signs of pregnancy. These changes lead to breast growth that varies from woman to woman – some grow a little and some grow more. Most growth is usually completed by week 22. Some women find that they increase by 1-2 cup sizes and 1-2 band sizes as well.

Delivery sets in motion greater changes with a proliferation of secretory tissue, an increase in milk components, blood flow, oxygen uptake, and the closure of the junctures that allowed interstitial fluid flow to and from the breast. Again, there may be another 1-2 cup size difference.

By 8 weeks postpartum your breast sizes will have decreased, often to pre pregnancy sizes. Band size will have decreased as well. With this as a base, be aware that bras are optional. If you choose to wear one, make sure that you get fitted properly. There has been some theorizing that improper bra wearing can be hazardous to your health.

Underwire or not is a matter of fit and comfort. There has been controversy over breastfeeding women wearing bras with underwires and potential dire consequences. The most important factor is fit and making sure that when you put your bra on you lift the breast so that the wire is on your chest and not pinching breast tissue. Ductal structure is only 2 mm in diameter. This means that is can easily become compressed causing milk flow problems.

In terms of “sleep” bras – I don’t know how or why this “fashion” has developed. Some breastfeeding women find that they leak and choose to wear a bra in order to hold pads to soak up the milk. For these women it is important to wear a bra that is loose enough not to constrict the lymph vessels that carry toxins from our systems and “tight” enough to hold the bra pads. For everyone else, wearing a bra at night is not necessary.

Remember that each woman is an individual and what works or is “right” for one may not be for another.

Patricia Berg-Drazin, RLC, IBCLC, CST
Breastfeeding and Parenting Solutions
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