Breast size and shape is a common concern for breastfeeding mothers since there are many fallacies surrounding drooping breasts linked to breastfeeding myths. Unfortunately, many new mothers today opt not to breastfeed out of fear that weaning their child will ultimately lead to drooping breasts, and that firming after breastfeeding cannot be corrected without surgery. This reduction in breastfeeding globally has significantly contributed to infant mortality. The World Health Organization estimates that globally, some 1.4 million children would not die in the first year of life if their mothers chose to breastfeed.
Cause of Breast Drooping and Firming
In breastfeeding women, the breast is primarily composed of ‘milk glands’ that empty into lactiferous ducts, which secrete milk through the nipple. Connective tissue, adipose (fat tissue) and ligaments known as Cooper’s ligaments play an important part in the size, shape and firmness of the breast.
Fat plays an important part in providing an energy supply for milk production and contrary to popular belief, it is not the sole reason for larger breasts in breastfeeding women. The enlargement of the milk glands and lactiferous ducts is what contributes to the larger breast size, which is also the reason why the breasts slightly decrease in size once the milk content empties. However there is an increased fat concentration within the breasts of lactating women.
The connective tissue, composed of elastin and collagen, coupled with the Cooper’s ligaments maintain the firmness of the breast. However, the action of gravity and stretching by enlarged breasts in lactating women, will stretch the ligaments and connective tissue and hamper firmness. This ‘hanging’ breast image associated with long term breastfeeding is known as Cooper’s droop, named after the Cooper’s ligaments.
Breast Support for Breastfeeding
Nursing bras should be selected carefully as they have multiple functions for both breast health and convenience for the mother. A good nursing bra will :
- Allow for the convenience of easy exposure of the nipple for baby to drink.
- Ensure comfort of the breast by allowing for varying size and weight of the breast.
- Provides support to maintain breast firmness and prevent or limit drooping.
Milk contained within the breast of lactating women stretches the connective tissue of the breast. The action of gravity on the engorged and heavy breast will add further strain on the Cooper’s ligaments. Over time, both the connective tissue and Cooper’s ligaments cannot continue to maintain breast firmness due to prolonged stretching. This leaves the breast flabby and drooping, with layers of loose skin.
Breast Size, Shape and Firmness after Breastfeeding
To a certain degree, the breasts will restore its shape and size after breastfeeding. However in women over 35 years, this is less likely to occur due to age-related changes coupled with the effects of breastfeeding. Within days of discontinuing breastfeeding, the size will significantly diminish. After a few weeks, and with a good support bra, some of the drooping will reduce. Two to three months after breastfeeding, any extra or sagging skin will noticeably diminish to the point that there is some firmness of the breast. A complete resolution of drooping breasts is not possible, just as the areola and nipple size will never return to the state that it was prior to the first pregnancy.
Surgery may also be considered to help correct the drooping and size of the breast after discontinuing breastfeeding. This breast augmentation surgery will drastically reform the breast but should not be considered for the first 6 months after discontinuing breastfeeding as natural processes may correct much of the drooping.