Crusty Nipples During Pregnancy (What To Do With Leaking Colostrum)

Have you noticed crusty nipples during your pregnancy? You may be wondering if that could be your breast milk coming in already. Do you know what to do?

Crusty nipples during pregnancy are common and caused by leaking colostrum in the second or third trimester. Colostrum is the first milk that a mother produces and it can dry into a white or yellow crust on the nipple as it slowly leaks from the breast. Nursing pads can be used to help absorb the colostrum and avoid drying on the skin.

Read on to find out why you have crusty nipples, and what to do with them. Learn what’s normal during pregnancy, how you can deal with it, and why leaking colostrum before birth can give your baby a head start.

What is the yellow or white crusty dried stuff on your nipples during pregnancy?

If you’ve been pregnant for several weeks, you may start noticing yellow or white crusty dried stuff on your nipples. Even though you’re only in your second or third trimester, could that be breastmilk leaking already?

Yes, the crusty dried stuff on your nipples is antenatal colostrum or early breast milk. It can be orange, yellow, or white and it’s sticky. In some pregnancies, breast milk begins to come in early. Others may not experience this. The alveolar cells in the breast begin secreting colostrum as early as the 16th week of pregnancy. 

Colostrum is a thick, yellow liquid that is high in immunoglobulin (IgA), protein, hormones, and antioxidants. It is rich in nutrients your baby needs immediately after birth to protect them from infection. Colostrum is especially important for pre-term babies who are at greater risk of infection. Colostrum continues to be produced for the first 2 to 5 days before your mature breast milk comes in.

Is dried colostrum on your nipples during pregnancy okay?

Dried colostrum on your nipples during pregnancy is completely normal. It’s just your body’s way of preparing for breastfeeding. If it’s leaking now, you don’t have to worry. It won’t all leak out. Your body will continue to produce colostrum through the pregnancy and for several days after the baby’s birth. 

If you have concerns or notice blood mixed with the colostrum, it’s best to have a conversation with your healthcare provider.

What to do for crusty nipples during pregnancy

Crusty nipples can be a surprise for some. It’s best to keep your nipples clean and dry as much as possible to prevent irritation or infection. 

Wash nipples only with warm water and don’t use a harsh cloth or sponge. Using soap or alcohol-based cleaners can dry out the nipples causing them to become sore and irritated. Air drying your nipples is recommended to prevent irritation. If leakage is a problem, you can insert nursing pads into your bra to prevent stains or wet spots on clothing.

It can also help to begin wearing a soft cotton bra without an underwire. Not only will it be more comfortable, but underwires can also sometimes cause issues when your breast size is fluctuating during pregnancy. Just make sure your bra is comfortable and doesn’t dig in or pinch the breasts.

Is it safe to press on your breast during pregnancy?

A study published in 2017 included over 600 low-risk pregnant women with diabetes. Participants were urged to hand express colostrum (antenatal expression) in the final weeks of their pregnancy and store it until delivery. 

It is safe, with your healthcare provider’s guidance, to hand express colostrum by pressing on the breasts in the latter weeks of pregnancy. You should not use a pump. Direct nipple stimulation should be avoided when expressing as it has been shown to induce labor in some individuals by releasing oxytocin, which also causes uterine contractions.

Pregnant women with diabetes are sometimes encouraged by their healthcare providers to begin expressing and storing colostrum at 36 weeks. Their babies can be fed immediately after birth and avoid a drop in blood sugar (hypoglycemia), which is common in newborns of diabetic mothers and can lead to diabetes later in life.

It’s important to check with your healthcare provider for instruction on the correct technique, timing, and duration for expressing colostrum during pregnancy. Pumping breastmilk to continue feeding an older child while pregnant will not cause contractions or preterm labor.

How the breasts, nipples, and areolas change during pregnancy

Leaking colostrum is just one of the many changes your breasts may experience during pregnancy. As the body prepares for birth, here are some of the changes you’ll notice in your breasts, nipples, and areolas as your pregnancy progresses.

  • Enlargement
  • Darkening of nipples and areolas
  • Darkened veins 
  • Feeling tender and swollen 
  • Nipples stick out more and areolas grow larger
  • Montgomery tubercles around the areola
  • Itching, dryness 

Englargement

During the first trimester, an increase in estrogen levels causes ductal systems in the breast to enlarge and expand. Most women can expect to go up one to two cup sizes. Your band size will also increase as the rib cage expands to make room for the baby.

Darkening of nipples and areolas

Estrogen, progesterone, and prolactin are also responsible for the darkening of the areolas and nipples. It is thought this happens to help babies identify their food source easier. The pigment changes can start in the first few weeks of pregnancy and be present through birth and breastfeeding. After breastfeeding is complete, these areas will lighten again.

Darkening of veins on the breasts

During pregnancy, your blood volume increases to deliver oxygen, blood, and nutrients to your baby. This increase of 20 – 40% can mean your veins are closer to the skin and therefore more visible. Not to worry, like many of the changes during pregnancy, darker veins will lighten a short time after breastfeeding stops.

Feeling tender and swollen

It’s those pesky pregnancy hormones again. In the first trimester of pregnancy, your body is flooded with estrogen, progesterone, and prolactin. These hormones are preparing your body to breastfeed. 

As the blood flow and milk duct production increase and your breasts expand in size, they become achy and painful. This can begin just a couple of weeks after conception. Sometimes, it can be the first sign of pregnancy.

This discomfort will peak in the first trimester as the hormones complete the jobs they are there to do. Until then, the best things to do are:

  • Wear a soft, supportive bra (no pinchy underwires).
  • Wear loose clothing to minimize constriction of the breasts.
  • Wear a sports bra to restrict bouncing and movement.
  • Wear a sleep bra to bed to minimize nipple contact with bedsheets.
  • Wear breast pads if the lining of your bra bothers you.

More prominent nipples and areolas

As your breasts grow and stretch in preparation for breastfeeding your baby, your nipples and areolas also go through changes. Not only do they get larger and darker, but they also begin to protrude more. These changes to your nipples and areolas not only make it easier for the baby to identify their food source once they’re born, but they also make it easier for the baby to latch on and feed.

Montgomery tubercles

You may notice there are bumps around your nipples very early in your pregnancy. These bumps are Montgomery tubercles. Their purpose is to lubricate the breasts for breastfeeding. They are sebaceous oil glands that secrete an antibacterial oil that protects the nipple from drying out during breastfeeding. 

It’s important not to use soap when washing your nipples. It removes the oil from these glands and can cause your nipples to become dry and cracked. Montgomery tubercles shrink and disappear on their own after breastfeeding is complete. 

Dryness and itching

With all the stretching of your skin and tissue during your pregnancy, the skin on your breasts can become dry and itchy. There are several things you can do to minimize the discomfort. 

  • Limit the heat and duration of your showers to lessen the chance of dryness.
  • Wear a larger bra made of a softer material to reduce friction.
  • Apply moisturizers with jojoba oil, shea butter, or cocoa butter immediately after a shower.
  • Switch to a detergent with no perfumes. Perfumes can irritate dry skin and make it worse.

Many changes are happening to your body during pregnancy. Some can be unpleasant for a while. Remember that all these changes are preparing the best possible environment for your baby to grow and flourish. Go with the flow, embrace the changes and do what you can to make yourself comfortable while you wait for your bundle of joy to arrive.