Dear Doctor,

I am three and a half months pregnant with my second child and the pregnancy has been normal without any complications. However in the past month, I have been experiencing pain in my breasts around my nipple area. The pain is however not constant, it comes and goes without any particular triggers. Though I have noticed it is more recurrent when I do not have a bra on.

The pain goes away without any remedy. Some of my friends have been telling me that the pain might go away if I wear a more comfortable bra, but I am yet to figure out what they mean by a comfortable bra as I have tried a couple of them but nothing changes. What would be the cause of this pain and how can I see to it that I experience it less often? What is the recommended remedy when it occurs?

Natasha, Kimironko

Dear Natasha,

As such, during pregnancy the body prepares to keep the fetus comfortable and safe. Breasts grow in size during pregnancy and may even become sore, for preparation regarding the arrival of the new baby. Soreness can come and go throughout pregnancy. In fact soreness over breasts can be the first sign of pregnancy. This occurs due to change in the level of hormones estrogen and progesterone.

In some, it may feel like just heaviness or sense of tingling in the breasts or there may be severe pain. However if there is associated redness and pain on touch present continuously, there is possibility of infection which needs treatment in form of suitable antibiotic and anti-inflammatory drugs.

A tight bra can also cause pain over breasts when one is pregnant. A normal bra may feel tight as breasts increase in size and swell. The bra size may keep on changing during pregnancy and subsequent breast feeding. The size may increase from two to three times since before getting pregnant. Therefore it is vital to pick the right size bra during pregnancy and nursing.

A tight bra can occlude milk ducts and hamper with output of milk. As such, also wearing tight bras regularly is a risk factor for breast cancer later in life. Large sized bras may make breasts look ungainly and also cause discomfort.

To buy a bra of correct size during pregnancy, one should put a tape over both breasts. The measuring tape should be put loosely over the fullest part of the breasts. This will help in deciding the cup size. To find the band size, tape should be put over the bust just below ribs.

This should also be held loosely not tight. The straps and hooks should be comfortable and not hurt one in any way.

A bra, thus, may not last throughout pregnancy. If it starts to feel tight after some days, it needs to be changed and another bigger one should be purchased. A good bra not only keeps a woman feeling comfortable during the nine months but also helps in preventing backache.

Material of a bra during pregnancy should ideally be cotton. Even plastic straps should be avoided. This helps to prevent any kind of allergy or eczema due to nylon. Another thing is throughout pregnancy there is some lactation intermittently due to the hormonal changes.

Cotton helps to soak the milk secreted and keep a woman comfortable.

Dr. Rachna is a specialist in internal medicine at Ruhengeri Hospital.