Your body goes through innumerable and amazing changes during pregnancy with even an area as small as your nipples experiencing a whole host of new symptoms.
One not-so-fun change comes in the form of dried white bits on the nipple skin — so what’s behind this?
Dry white flakes or patches of skin on the nipples are often a result of hormonal changes which can trigger eczema, yeast infections, and colostrum to leak and dry in crusty white patches. The growing breast tissue can also cause nipple skin to stretch and peel, resulting in white flakes.
Powerful pregnancy hormones are mostly to blame here, but being kind and gentle to your breasts can help to ensure your nipples won’t cause you any more irritation than necessary!
We’ll look at the 5 main causes of dry, crusty nipples and how to deal with them and take a look at some other nipple changes and conditions you can expect in pregnancy.
Crusty Nipples in Pregnancy – 5 Causes
There are a few reasons why you might find white flaky patches of skin on your nipples during pregnancy from a bout of eczema to natural leakage. Let’s take a look at the most common causes of this condition.
1. Fluid Leakage
In the third trimester of your pregnancy (or midway into the second trimester for some women), a form of early breast milk known as antenatal colostrum can begin leaking from your nipples.
As colostrum leaks slowly from the breast, it commonly dries into a white or sometimes yellow crust on the nipple.
Nursing pads (these were my favorites) can help absorb much of this colostrum before it dries and irritates your nipple skin.
If you notice dry and scaly patches on your nipple skin accompanied by cracking and itchiness, it’s likely that you have pregnancy-related eczema.
This is caused by powerful new hormones in the body and typically appears in the first or second trimester.
This can occur even if you have never had eczema before, though women who have had atopic dermatitis in the past are more likely to see this condition in pregnancy.
It’s wise to speak to your doctor about this condition before taking over-the-counter medication.
3. Nipple Thrush
As pregnancy suppresses your immune system, it’s common for women to develop a yeast infection known as nipple thrush somewhere around the third trimester.
This is caused by the fungus Candida albicans and usually occurs when the nipple skin has cracked or been cut, causing the yeast to thrive in the dark and moist environment.
In addition to dried, flaky skin, nipple thrush often comes with a burning or shooting sensation in your nipple. Always consult your doctor about appropriate nipple thrush treatment.
4. Extreme Dryness
As early as the first trimester, it’s common for your breasts and nipples to become very dry as the skin begins to grow and stretch.
How you care for your breasts during this time could even be exacerbating this dryness.
It’s wise to clean your breasts with gentle, fragrance-free soap in the shower, though plain warm water is even better.
Gently pat your breasts dry instead of rubbing to prevent further irritation, and keep your nipples well moisturized.
5. Enlarged Montgomery Glands
As your breasts grow, the sebaceous oil glands known as Montgomery glands (the little bumps around your nipples) also become enlarged, which can cause your nipple skin to stretch to the point of peeling.
Applying lanolin cream can help keep the area moisturized.
Again, avoiding soaping your breasts can help combat the peeling and dryness caused by stretching Montgomery glands as many soaps strip the glands of the natural oils that help to protect your nipple skin.
Additional Nipple Changes & Conditions During Pregnancy
Your nipples can go through other changes besides flaky skin during pregnancy. It’s perfectly normal to see things like a change in pigment or experience very tender and sore nipples.
Here are some common and not-so-common nipple changes and conditions during this time.
Itching and Dryness
In the same way period hormones made your nipples feel dry and sensitive, pregnancy hormones significantly crank up this feeling of dry itchiness, which can be made worse by tight bras, perfumed detergents, or overly hot showers.
It’s common for the skin on and around your nipples to feel super tender and swollen due to the increase in blood flow and expanding breast and nipple tissue.
Expect to see the color of your nipples darkening midway through your pregnancy.
Ob/Gyn and women’s health author Dr. Sheryl A. Ross explains that “An increase in estrogen and progesterone causes pigmentation changes in the nipples and areolae.”
They can remain dark even after pregnancy.
Around the third trimester, the nipples will change size and shape, growing larger and more pronounced than before.
This happens due to the surge in estrogen levels, which also causes your breast ducts and tissue to expand.
While seen most commonly in breastfeeding mothers, mastitis can — in rare cases — occur during pregnancy.
This type of infection known as puerperal mastitis is caused by the Staphylococcus aureus bacteria and can present in breast inflammation and pus leaking from the nipple.
Doctors will typically prescribe antibiotics and drainage treatment for this.
Is It Normal for Nipples To Crack During Pregnancy?
Yes. Cracked nipples or nipple fissures in pregnancy happen when the breasts become engorged with milk.
This excess fluid causes your nipple tissue to stretch, which can result in cracked skin on or around the nipples. Applying fresh breast milk or a warm compress can help to soothe the area.
Should I Moisturize My Nipples During Pregnancy?
Moisturizing your nipples is encouraged during pregnancy to help keep the skin supple for breastfeeding. It can also help soothe dry, itchy, or irritated nipples.
Nipple creams containing pure lanolin (fat from sheep wool) are recommended in addition to all-natural moisturizers such as coconut oil.
The appearance of dry, white patches on your nipples is fairly common during pregnancy and can be caused by a few things such as the leakage of early breast milk (colostrum), an eczema flare-up, and peeling that comes with stretched, growing skin.
Most of the above reasons are not a cause for concern. However, if you suspect you may have nipple thrush or eczema, it’s vital to speak with your doctor before you try any over-the-counter medications.
You can’t always be sure that home remedies or seemingly safe drugs have been regulated for pregnant women, so trust your professional healthcare provider with the right course of treatment.
Rebecca is a seasoned copywriter and researcher with over a decade of experience, specializing in parenting topics. With a passion for all aspects of raising children, from breastfeeding to potty training.