Large breasts

How do big breasts affect breastfeeding?

If their breasts are large or long, mothers may find positioning the baby and finding the right breastfeeding hold can be a challenge. Mothers may have a hard time seeing their nipples, which makes it difficult to latch the baby. Or the breasts may be too long and the nipples too low for the baby to breastfeed using certain breastfeeding holds. These problems can be solved by choosing the right hold, supporting the breast and the baby, and using proper techniques. Mothers may need to be creative! If the mother and baby are comfortable and the baby is growing well, there is no need for concern.

A) Breastfeeding with larger breasts

While the amount of milk tissue plays a role in the size of the breasts, breast size is mostly determined by the amount of fat in the breast (Ramsay 2005). As such, having large breasts is not a guarantee of a large milk supply.
 
Mothers with larger breasts may not feel as much breast filling on Day 2 to 4 when the milk comes in after delivery as mothers with smaller breasts. This is normal and happens because there is more room in the breast to accommodate milk than in a smaller breast.

B) Swelling of the nipple root

If mothers have excess fluid in their bodies, the fluid will pool in the lowest area, namely the feet and lower legs, and cause swelling. If the breast is larger and the nipple is under the breast, the fluid can also cause swelling of the nipple root.

C) Positioning adjustments

Mothers with larger breasts may need to adjust their breastfeeding techniques. The size of the breast makes certain holds hard to use and seeing the nipple can be more difficult.

1) Seeing the nipple

If you have larger breasts, your nipples can be harder to see as your view of the nipple may be blocked by the top half of the breast. This can make latching your baby difficult.

You may try the following:

  • Hold your breast and turn it up so you can see the nipple. This is easier for short feeds.
  • Put a rolled face cloth or small towel under the breast to prop it up. This generally lifts the nipple to where you can see it.

2) Choosing a breastfeeding hold

You may have positioning challenges and will need to make certain that the breastfeeding hold you choose works for you and your baby.

Once your baby is positioned at the breast in the hold of your choice, see where your nipple is in relation to the baby’s mouth. The baby’s mouth should be right in front of the nipple and the nipple should point towards the back of the baby’s mouth. If the nipple is below the baby’s mouth, it will be pulled up after latching the baby and may get tender and even damaged on the underside.

This may also make it difficult for a sleepy newborn or premature baby to stay latched as they may not have the suction strength to hold on to a nipple that is pulling away.

To raise your nipple, you can try the same options as those for seeing your nipple listed above.

The cradle and cross-cradle holds can be difficult for mothers with larger breasts. Mothers with larger breasts often use the following holds:

You may have to be a little creative. Breastfeeding holds and positions may change over time. If you and your baby are comfortable and your baby is growing well, you are probably doing fine.

3) Bringing the baby to the breast and not the breast to the baby

Larger breasts can be more easily moved than smaller ones. It is best practice to bring the baby to the breast. However, some mothers with larger breasts will bring the breast to the baby’s mouth. If the breast is then let go, it will fall and move away from the baby after latching and can cause nipple pain and damage. This generally affects the under and outer sides of the nipple.

4) Choosing the right pillow

Mothers who put their baby on a breastfeeding pillow need to make sure the baby’s mouth is right in front of the nipple both before latching the baby and once the baby lets go of the breast after feeding. The former prevents problems and the latter confirms that the baby is at the correct height.

If the breasts are larger, the pillow may bring the baby’s mouth too high in relation to the nipple. If the baby’s head is too high, the nipple will be pulled upward and may become tender and damaged on the underside. You may consider a thinner pillow or not using one at all.

References

Ramsay DT, Kent JC, Hartmann RA, et al. Anatomy of the lactating human breast redefined with ultrasound imaging. J Anat. 2005 June; 206(6): 525–534