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Breast discharge during pregnancy
Last reviewed: 23.04.2024
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Most women feel tingling and soreness in the chest; many say that breast discharge occurs during pregnancy.
With the onset of pregnancy in the woman's body, a radical restructuring of the hormonal system, which is aimed at performing the fertility function, occurs. The most important part of this function is lactogenesis, that is, preparation for feeding the baby with breast milk. The size of the mammary glands during pregnancy increases, expands and becomes more intensely colored pigmentation areas around the nipples (areola), their sensitivity increases.
Causes of discharge from the breast during pregnancy
The preparation of the mammary glands for lactation is known hormones: prolactin, estrogen and progesterone. Progesterone (which is first produced by the corpus luteum, and then by the placenta) and the estrogen hormone estriol provides an increase in the number of alveoli, milk lobules and excretory ducts of the secretory sections in the breast of the future mother. And prolactin produced by the anterior pituitary gland is responsible for the maturation and release of colostrum, its conversion into milk and the maintenance of milk production after the birth of a child. A constant increase in the production of this hormone occurs at the end of the second month of pregnancy (from the 8th week of gestation). By about the 24th week, the content of prolactin in the blood plasma reaches a maximum level, and then the volume of discharge from the breast during pregnancy may increase.
So the reasons for discharge from the breast during pregnancy - in the form of a special secret of colostrum (colostrum) - is pregnancy itself. By the way, the mammary glands are ready for lactation at the beginning of the second trimester. But the action of the hormone prolactin before birth is restrained by the same estrogen and progesterone. After childbirth, the content of progesterone in the blood of a woman falls, and then prolactin starts its “work”, which stimulates milk production. It turns out that - in principle - there should be no discharge from the mammary glands during pregnancy...
However, everything is much more complicated. In addition to prolactin, a special peptide hormone, chorionic somatomammotropin, which is synthesized only during pregnancy by the placenta, plays an important role in the preparation of the mammary glands for the lactation process. In its structure and function, it is similar to growth hormone. Moreover, as the researchers found, the lactogenic activity of somatomammotropin is much higher than that of prolactin. And the effect of this hormone progesterone can not be restrained. Therefore, discharge from the breast during pregnancy is physiological, that is, normal. Moreover, these secretions are an obvious sign of the preparatory stage of production of breast milk.
According to most obstetrician-gynecologists, the presence or absence of physiological discharge from the breast during pregnancy is not an indicator of the intensity of milk production after the birth of a child. So their absence should not cause concern.
But with an uneven or non-uniform increase in the mammary gland, with aching chest pain, swollen lymph nodes, pain and swelling in the area of the areola of the nipple, as well as with pathological (non-colostral) discharge from the breast during pregnancy, you should immediately contact a mammologist. These signs may indicate pathological processes. Possible causes include trauma, ectasia (inflammation) of the breast ducts, duct papilloma, breast abscess, or fibrocystic mastopathy.
Diagnosis of breast discharge during pregnancy
The state of the mammary glands during pregnancy is monitored by the female consultation doctor in charge of the pregnant woman. And with all questions regarding discharge from the breast during pregnancy, it is necessary to contact him.
In case of any pathology, it is necessary to consult a mammologist, who diagnoses the discharge from the breast during pregnancy. To do this, after examining the mammary glands, blood tests and fluid secreted from the breast are made, and an ultrasound examination is prescribed.
The characteristic discharge in inflammation of the ducts (ectasia) is thick, sticky to the touch, greenish or brown. With papillary polyp (papilloma) in the duct of the mammary gland, discharge is thick with blood, and when there is accumulation of pus in the tissues of the mammary gland (that is, with an abscess) - purulent. In addition to pain and swelling, there may be a clear, slightly yellowish discharge from the nipple of the injured gland with a bruised breast.
In case of fibrocystic mastopathy, soreness and thickening of a separate part of the glandular tissue may be accompanied by transparent yellowish nipple discharge. It is believed that this disease occurs due to the violation of the level of hormones, especially sex. During pregnancy and lactation - under the influence of changes in the general hormonal background - fibrous seals can significantly decrease or completely dissolve.
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Treatment of breast discharge during pregnancy
Physiologically caused increase in the content of prolactin in the body (hyperprolactinemia) is a natural condition for pregnancy. And discharge from the breast during pregnancy does not require any treatment.
The colostrum released during the gestation period cannot be decanted, let alone squeezed out by any means. It should be borne in mind that any irritation or physical impact on the mammary glands (especially on the nipple area) can cause the muscles of the uterus to tone and provoke the threat of termination of pregnancy...
When allocating colostrum, one should wear a comfortable, well-supporting and non-squeezing breast bra, and also use special sanitary napkins in the bra. Mammary hygiene must be observed to prevent any infection from entering.
During the period of carrying a child, the discharge from the breast is not a disease; therefore, the prevention of discharge from the breast during pregnancy is not carried out.
Forecast
The prognosis is positive: after cessation of breastfeeding, a clear discharge from the nipples can be observed for 2-6 months, which is not considered pathological in obstetrics.
If in the process of excretion from the breast during pregnancy a woman is worried about some questions, it is best to ask them to your gynecologist. Professional advice will help dispel future mother's doubts, increase her mood and improve well-being.
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