The most common reason for recommending breast self-examination is to detect monthly changes in your breast tissue. However, it is also important to self-evaluate your breasts in the latter stages of your pregnancy in order to get your breastfeeding plan off to a good start. Use these guidelines to do a self-assessment, and if you have any concerns, speak with a lactation consultant prior to giving birth. She will be a wonderful resource and support for you and having her in your life will be better than any breastfeeding book you can find on the shelf!
Think About Your Medical History First!
- Did your breasts change during your pregnancy? You should have noticed a difference in size, pigmentation of the areola, and tenderness.
- Have you ever had any breast surgery? If yes, what type? Augmentation? Reduction? Biopsy? Don't assume that you cannot breastfeed if you've had any of these surgeries! Once you've delivered your baby, a lactation consultant can assess your situation and will formulate a plan to increase your milk supply, if need be.
- Have you ever had any injury to the breast or medical problems with your breasts? You may be surprised about what is considered to be trauma. This includes burns and piercings.
- Do you do regular breast self-exams?
Inspect Your Breasts
Check for:
- Breast tissue density and elasticity. There should be a natural fullness and stretchiness to your breasts.
- Symmetry. Are your breasts proportional? Every woman has one breast that is slightly larger than the other, but they should be generally similar.
- Scarring. If you've had breast surgery, procedures, or trauma, where is the scarring?
- Venous pattern. It is normal (and expected!) to see a blue vein structure in your breasts.
- Montgomery glands. These are glands on the areola that appear as tiny bumps. They secrete natural oils to lubricate the nipple and areola and help to prevent bacteria from breeding.
- Supernumerary nipples.
- Nipple and areola. You should have noticed this getting darker during your pregnancy.
There are other important factors to note. If you notice any of the following when inspecting your breasts, speak with your doctor:
- Thickening of the skin
- Prominent pores
- Dimpling
- Flattening
- Distortion of nipple direction
- Color
- New retraction
Touch Them!
You should:
- Do a pinch test. Compress the areola between your forefinger and your thumb just behind the base of your nipple. You will notice one of three responses: The nipple comes out (protraction), the nipple pulls back slightly (retraction), or the nipple pulls in completely (inversion).
- Feel tenderness
- Notice nodularity. You will feel lumpy and bumpy during lactation. This is normal and it occurs because of the increased density of your breast tissue.
- Check for nipple elasticity
- Observe the density of your areola
