Your breasts begin preparing for breastfeeding on their own during pregnancy, but there are practical steps you can take to set yourself up for a smoother start. Most preparation is about learning what to expect, getting comfortable with your changing body, and having the right support lined up before your baby arrives.
Your Body Is Already Doing Most of the Work
From early pregnancy, rising estrogen and progesterone levels trigger significant changes inside your breasts. During the first trimester, the milk ducts grow and branch out, while glandular tissue gradually replaces fat tissue. Blood flow to the breasts increases noticeably. By the second and third trimesters, progesterone drives the expansion of the milk-producing lobules, the small clusters of cells that will eventually make milk. This is why your breasts feel heavier, more tender, and visibly larger as pregnancy progresses.
Your body starts producing colostrum, the thick first milk your baby will drink, between 12 and 18 weeks of pregnancy. Some women notice small amounts leaking from their nipples in the third trimester; others don’t leak at all. Both are completely normal and say nothing about your future milk supply.
The small bumps on your areola, called Montgomery glands, also become more prominent during pregnancy and after birth. These glands produce a fluid that naturally moisturizes the nipple and areola skin. Research has shown this secretion carries scent cues that are highly attractive to newborns, helping them locate the breast and begin feeding. That built-in system means you don’t need to apply special creams or ointments to “prepare” your nipples before birth.
What You Don’t Need to Do
One of the most persistent pieces of advice passed between generations is that you should “toughen up” your nipples before birth by rubbing them with a rough towel, pulling on them, or exposing them to air. While one older study from the late 1970s found that a specific conditioning routine (nipple rolling, gentle towel friction, and airing) reduced early breastfeeding pain, this approach has largely fallen out of mainstream recommendations. The soreness most new parents experience comes from the baby’s latch, not from the nipple tissue being too soft. Focusing on learning proper positioning and latch technique is far more effective than trying to condition skin that your body is already preparing hormonally.
You also don’t need to wash your nipples with soap or antiseptics. The natural oils from the Montgomery glands protect the skin and provide the scent signals your baby relies on. Plain water during your normal shower is enough.
Flat or Inverted Nipples
If your nipples don’t protrude or seem to pull inward when you gently compress the areola, you may have flat or inverted nipples. This is common and doesn’t mean you can’t breastfeed, but it can make it harder for your baby to latch in the early days.
Hard plastic breast shells, worn inside your bra during the last weeks of pregnancy, exert gentle traction that can help draw the nipple outward over time. They’re inexpensive and noninvasive. For severely inverted nipples, a lactation consultant can assess the situation and recommend specific strategies, including the use of a nipple shield after birth if needed. Identifying this early gives you time to gather the right tools and support before delivery.
Antenatal Colostrum Expression
Hand-expressing small amounts of colostrum during late pregnancy is a practice that has gained attention, particularly for people with gestational or pre-existing diabetes. The idea is to collect and freeze colostrum before birth so it’s available if your newborn needs supplemental feeding right away, especially to prevent low blood sugar. This is typically started around 36 weeks of gestation.
Current evidence supports antenatal colostrum expression for specific high-risk situations but does not recommend it as routine practice for all pregnancies. Nipple stimulation can trigger uterine contractions. Research on at-risk patients found that nipple stimulation in the early third trimester produced contractions in 50% of those tested. For this reason, hand expression before 36 weeks, or in pregnancies with a history of preterm labor, should only be done with guidance from your care provider.
Take a Breastfeeding Class
Prenatal education is one of the most impactful things you can do before birth. A systematic review of 21 studies found that breastfeeding education programs with both prenatal and postpartum components had significant positive effects on breastfeeding duration in 64% of the studies examined. Interestingly, prenatal classes alone only improved duration in about 29% of studies, and those that succeeded were the ones that incorporated psychological skills like mindfulness training and simulation exercises, not just information delivery.
The takeaway: a class that teaches you latch mechanics and pumping basics is helpful, but one that also builds your confidence, teaches coping strategies for common challenges, and involves your partner tends to have longer-lasting effects. Couples-based breastfeeding education with mindfulness and hands-on practice showed benefits in breastfeeding duration up to three months postpartum, with effects approaching significance at six months. Look for classes offered by hospitals, birthing centers, or certified lactation consultants that go beyond lectures.
Practical Items to Have Ready
About a month before your due date, gather a few supplies so you’re not scrambling in the first week postpartum:
- Nursing bras: Buy these in late pregnancy when your breast size has mostly stabilized. Look for bras without underwire that allow easy one-handed access. You’ll likely need a size larger than your current pregnancy bra to accommodate engorgement in the first week.
- Breast pads: Disposable or washable pads absorb leaking milk and keep your clothes dry. Pack a few in your hospital bag.
- Nipple cream: A lanolin-based or plant-based nipple balm can soothe soreness in the early days of breastfeeding. You won’t necessarily need it, but having it on hand saves a postpartum errand.
- A nursing pillow: Not essential, but many people find a firm, curved pillow makes positioning easier and reduces strain on your arms and back during long feeds.
Line Up Support Before Birth
The most common time to stop breastfeeding earlier than planned is the first two weeks, when latch issues, engorgement, and nipple pain peak. Having a lactation consultant identified before you deliver means you can get help quickly if problems come up. Many hospitals have lactation consultants on staff, but availability varies, and you may want someone you can call after discharge. Ask your provider or birth facility for recommendations during the third trimester.
If you have a partner or someone who will be with you postpartum, include them in your preparation. Partners who understand basic breastfeeding mechanics, like how to recognize a good latch or how to help with positioning, can troubleshoot alongside you during those exhausting early feeds. The couples-based education programs that showed the strongest results in research worked precisely because the support person was actively involved, not just watching from the sideline.