Not all women wear bras and a special breastfeeding or nursing bra is not essential for a breastfeeding mother. This article answers twelve frequently asked questions about nursing bras.
#1 Do I need to wear a bra for breastfeeding?
Whether or not to wear a bra is personal choice; some women prefer to wear a bra for breast support and/or to keep breast pads in place if they tend to leak milk in the early weeks. Women with larger breasts may feel more comfortable wearing a bra with some support.
Are there any official recommendations?
The Academy of Breastfeeding Medicine (ABM) Protocol #36 1 advocates for wearing a well fitted supportive bra. Their rationale is that during lactation, breasts are fluid filled and will require support to avoid lymphoedema as well as progressive back and neck pain. Lymphoedema is a condition where the body’s tissue fluid drainage system (lymphatic system) is overloaded causing fluid retention and swelling. The ABM recommendation to wear a supportive bra is based on consensus or opinion (level 3 evidence; strength of recommendation C) rather than higher quality research. An alternative opinion is offered by breastfeeding author, lactation consultant and doctor Pamela Douglas who notes that potential negative effects of wearing a bra during lactation include:
- Increased risk of skin damage. Bras and breast pads act like a medical dressing that can prevent exchange of air and fluid. This can increase the risk of moisture associated skin damage (MASD) which could prevent a sore nipple healing quickly. If a mother has nipple pain or persistent pain, Douglas recommends going without a bra as much as possible; nighttime, for example, is a good opportunity to allow air to circulate around the breast.2
- Increased risk of breast inflammation. Any restrictive, poorly fitted bra or item of clothing puts physical pressure on a lactating breast could increase the risk of breast inflammation due to compression of milk ducts.3
- Reduced breast movement. Bras (and less active lifestyles) can reduce normal breast movement so that depending on breast shape and bra fit, some areas of the breast may not experience much, if any, movement. Gentle manual movement of breasts is one of Douglas’s five principles for prevention and management of benign lactation-related breast inflammation (BLBI). According to Douglas, gentle upper limb stretches or lifting and gently moving the breasts in various directions such as via circular movements with the hand or palm laid gently over the breast (sometimes coined “breast gymnastics”) may help to prevent breast inflammation. Note: formal breast massage including therapeutic breast massage of lactation or manual lymphatic drainage is not recommended as this could traumatise breast tissue (Douglas, Vol 18: 1-20 2022).
#2 What is a nursing bra? Can I wear an ordinary bra?
A nursing bra has adaptations to easily access one or both breasts to feed your baby; for example drop down cups released by clips or zips, or soft cups that can be pulled down and tucked under the breast. It is possible to use a regular bra for breastfeeding or even adapt it into a nursing bra with cups that drop down—you can search online for a number of ways to do this. You can also turn a nursing bra back to a regular bra.
Whether you are choosing a nursing bra or considering using a normal support bra for breastfeeding it is important to:
- Make sure the bra is flexible and soft enough so that pulling down or lifting the cup to breastfeed does not put any pressure on your breasts because this could be a risk factor for blocked ducts or mastitis. See #3 below for more fitting tips.
- Avoid underwires (#4) and chose cotton rich material where possible (see #5 below).
- Make sure the bra has enough room for breast pads (see #8) if you wear them
- Check the bra cups will be large enough for when your breasts are at their fullest before a feed.
Zips or clips?
When choosing a nursing bra, it’s a good idea to experiment with opening and closing different styles of bra cup. A drop cup can usually be hooked back in position with one hand which can be important when you are holding your baby at the same time. Zips may require two hands to avoid catching your skin in the zip. Look for a cup that exposes each breast fully so that there is no pressure to the breast from material during a feed. Pumping bras with small front openings meant for pumps (see #10 below) are unlikely to expose enough skin for your baby to get a deep latch (the way a baby attaches to the breast) and can put pressure on the breast which may cause inflammation.
#3 How can I check if a bra is a good fit?
Many bra departments of clothing stores or maternity stores will offer a bra fitting service to help you find the ideal fit. A well fitted bra will:
- Support the breasts without cutting into breast tissue and without breasts “spilling” out of the top of the cup—any pressure on the breasts can increase the risk of mastitis or blocked ducts
- Have side seams that are well behind the breast under the arm pit
- Have bra straps that support the breasts without digging into the shoulders
- Have an adjustable band across your back that sits horizontally and is not riding up your back
- Be sufficiently flexible to allow for breasts changing size as they fill and empty with milk and with room for breast pads.
Finding your bra size and cup size
Bra companies measure bra size (US: band width) and cup size in a variety of different ways. As all bra styles differ, a good fitter may find the right fit for you without a measuring tape, just by trial and error. If buying online, check the measuring or fitting information for the company you are interested in buying from, many have videos to help you.
#4 Can a nursing bra be underwired?
Underwired bras are probably best avoided especially in the early months of breastfeeding as they could press on milk-making tissue, prevent sufficient drainage of milk and increase the risk of blocked ducts and mastitis.4 5 Milk making tissue extends under the arm pit and back to your rib cage 6. The Australian Breastfeeding Association advises that certain makes of underwired nursing bra may cause less problems:
there are now nursing bras available that have a flexible low-gauge wire support, designed to flex and change position with your changing shape. These are less likely to cause problems.
#5 Is cotton best for nursing bras?
Some mothers can be sensitive to synthetic fibres in pregnancy or while breastfeeding which could cause skin irritation or promote sweating. Authors Lauwers and Swisher recommend cotton rich bras (cotton or a cotton-polyester blend)7 and Ask Dr Sears explains the importance of fabrics being “breathable” i.e. allowing air flow so that any moisture is released quickly.
Cups should be made of a breathable fabric. This is usually 100 percent cotton, although some of the newer synthetics also allow the skin to breathe. Other synthetics trap moisture next to the nipples and encourage bacterial growth and soreness. Don’t buy a bra with a plastic lining.
#6 When should I buy a breastfeeding bra?
During pregnancy breasts generally get bigger as they prepare for breastfeeding and some women may need one or more new bras during this time. Nursing bras that are bought during the early months of pregnancy may not still fit when you are first breastfeeding, however they will probably fit at some point in your breastfeeding relationship and will often be more comfortable than a regular bra.
Fit from 28 weeks
Most nursing bras fitted in the last trimester of pregnancy (from 28 weeks gestation) will also fit during breastfeeding but some mothers may find they need a bigger cup size for the first few months after birth. Lauwers and Swisher explain:
The last trimester of pregnancy is generally the earliest time for selecting a nursing bra. Some women wait until after delivery, when full milk production occurs.
How many nursing bras do I need?
Two or three nursing bras allow for washing and wearing. Start with the minimum number you can manage incase your size changes after your baby is born when your milk comes in. You can add more bras as needed when your milk supply settles down and when you’re happy your chosen bra is a good style and fit. Alternatively you may decide you prefer not to wear a bra at all.
#7 Will a nursing bra stop my breasts changing shape or sagging?
A nursing bra won’t stop your breasts changing shape as it is thought that pregnancy hormones are the main factor affecting breast shape regardless of the intention to breastfeed or the bra you wear.8 9 Wearing a supportive bra may reduce stretching of tissues that could contribute to sagging but even if you always wear a supportive bra—pregnancy, skin ageing, smoking, being over weight or losing weight quickly and even genetics are also likely to affect breast shape.
Will breastfeeding make my breasts sag?
As above, the hormones of pregnancy can cause permanent changes to breast shape irrespective of breastfeeding. However, if breasts increase several sizes during pregnancy or lactation, this may cause cause stretch marks and a new breast shape after breastfeeding ends, just as some mothers’ tummies change shape after being stretched during pregnancy.
#8 What are breast pads and do I need them?
A breast pad is a circular pad of absorbent material that is worn inside the bra over the nipples to absorb any leaked breast milk. Some mothers leak breast milk between breastfeeds for example if their breasts are full, or if they hear their baby cry and have a let-down (milk ejection reflex). Some mothers may leak a little milk from the opposite breast while they are breastfeeding, especially in the early weeks. If you need them, breast pads can be washable (better for the environment) or disposable.
It is important to change damp or soggy breast pads frequently to avoid sore nipples. Authors Wambach and Spencer recommend choosing a breast pad that is comfortable and non irritating, be replaced whenever wet and does not leave a residue that could be swallowed by your baby. They also offer tips to prevent leaking such as feeding baby on cue around the clock (not scheduling feeds), or applying direct pressure to the leaking breast across the nipple eg by crossing your arms can help stop leaking temporarily.10
#9 Do I need a sleep bra?
Wearing a breastfeeding or nursing bra at night is down to individual choice. If a sleep bra is used for light support at night and to keep breast pads in place, it should fit very loosely so as not to cut into any breast tissue and ideally be made of cotton.1112 Pamela Douglas points out that nighttime can be a good time to allow breasts full access to circulating air which can help with nipple healing and prevention of soreness (Douglas. Vol 18. 1–29 2022).
#10 Do I need a special “pumping bra”?
Most breastfeeding mothers won’t need to pump regularly or at all, let alone need a special bra to use a breast pump successfully. What exactly is a pumping bra and if a mother finds she is pumping frequently or exclusively is a pumping bra desirable or unnecessary?
- What is a pumping bra? A pumping bra is one with openings that will hold the breast pump flanges in place over your nipples so that both your hands are free. This could be helpful for pumping both breasts at the same time, for massaging the breasts during pumping (hands-on-pumping), to take the strain from your hands or release your hands to multitask. You can buy pumping bras or simply adapt a cheap sports bra by making holes in the cups that are just big enough to bring the pump flanges through.
- Is a pumping bra desirable or unnecessary? It is not necessary to use a special bra in order to use a breast pump. Although it may be useful for some mothers, Pamela Douglas IBCLC cautions against hands-free pumping since it is more likely to lead to a phenomenon she calls “breast tissue drag” where there are uneven forces on the breast. Uneven pressure around the nipple and areola can cause persistent nipple pain and damage and is more likely when mothers are not using their hands to support the pump flange (Douglas, 2022, 1-29). Some mothers have supported pump flanges with elastic bands or ponytail elastics clipped to their existing bra13 however Douglas advises against this.
#11 Where can I get a good nursing bra?
Many good baby stores, bra departments in larger stores and online boutiques sell breastfeeding bras.
#12 I need a large cup, where can I find a larger bra?
Retailers for larger sized bras in UK include: Bravado Designs, Bravissimo, Ample Bosom, and Bras4mums. For breastfeeding tips with larger breasts see Breastfeeding with Large Breasts.
Summary
Nursing bras are not an essential purchase but if you do want one it is important to find one which fits well. A badly fitted bra could contribute to plugged ducts and mastitis.
