I am 26 years old. I gave birth to a baby girl five months  ago. Prior to giving birth, my boobs started really getting big. They had already started during the first month but nothing too serious. Towards labour, they got bigger and bigger.

My cousin told me they would go back to normal maybe two months after birth but it looks to me like they are just getting bigger. I am normally a c -cup (which isn’t that big) but now, getting a bra that fits me is a hustle. It’s beginning to depress me as I now struggle to find what to wear to work and I can’t keep on wearing my maternity clothes. What is going on? Will I go back to normal? I’m really worried.

Sandra, Kacyiru

Dear Sandra, 

Enlargement of the breasts naturally occurs during pregnancy. It is part of the changes which occur in the body to receive and sustain a new life. There are no hard and fast figures for how much the breast shall or has to enlarge.  Previous weight, dietary fat intake, level of physical exercise and hormonal levels determine the overall increase in breast size.

Once a baby is delivered and starts suckling, the trigger is set to increase the number of milk cells and milk ducts in the breast for continuous supply of milk to the new born. This occurs due to hormonal changes occurring during pregnancy and after delivery causing all other physiological changes happening at this stage of life. 

If a woman puts on a lot of weight after child birth, this also contributes to the increase in the size of breasts. Hormonal disorders like hypothyroidism can cause weight gain and increased swelling of the breasts.  There would be excess dryness of the skin, poor appetite, feeling cold, e.t.c. and problems associated and it can be confirmed by a simple blood test to assess the level of thyroid hormones.

At times somebody prone to heart failure like one suffering from high blood pressure or diabetes can develop heart failure or existing problems can be aggravated. In this situation, apart from breast enlargement, there would be swelling over the feet, face and even abdomen.

Other systemic diseases like liver and kidney failure (where the body fails to eliminate excess salt and water from the body) cause generalised swelling over the body and also swelling of the breasts. 

However there would be other features of the systemic disease like excess fatigue, anorexia, nausea, e.t.c. heart failure and any of these conditions if the existing can be diagnosed easily with the clinical features and suitable tests.

Occasionally the breast tissue or one or more of the milk ducts may get infected with accumulation of pus while feeding the baby. This results in the breast getting swollen, inflamed and painful. Even if one touches them slightly, there is a lot of pain. This condition is absolutely treatable with suitable antibiotics and anti inflammatory drugs. In severe cases, a surgical incision to drain the pus helps. 

Apart from these, genetic factors also help in determining the size of the breasts both with and without pregnancy. If apart from increase in size of breasts, there is no other problem like excess weight gain, swelling over feet, reduced urination, nausea, vomiting, red and painful breasts, e.t.c, there is absolutely nothing to worry about. Once the baby stops feeding, the size will also reduce. However you should be cautious to avoid extra weight gain by going on a suitable diet and doing regular physical exercise

Dr. Rachna Pande is a Specialist in Internal Medicine at Ruhengeri Hospital