Breast pads: which ones do you actually need, and do you need them at all?

They're on every hospital bag list, somewhere between the maternity pads and the nipple cream. Breast pads. Nobody tells you which ones, how many, how often to change them or what to do when they don't work. So you buy a box, because the list says so.

Two weeks later you're lying there at three in the morning in a soaked top, with a pad rolled up halfway across your cup and the nagging question of whether you bought the wrong ones or whether you simply leak too much.

Neither, most likely. Before you buy a second box, this is the more useful thing to know: what a pad is actually supposed to do, how to work out whether you need them at all, and where disposables and washables each fall apart.

A pad has three jobs, and everyone only talks about the first

Look at a packet or a review and it's always the same thing. How much the thing soaks up. Super absorbent. Up to 20 times its own weight.

Except a pad almost never fails on absorbency. It fails on the two jobs nobody mentions.

1. Catching it. Holding the milk that comes out. Most pads are perfectly good at this.
2. Staying where the milk actually arrives. Absorbency in the wrong place absorbs nothing. The pad is still dry. Your top isn't.
3. Keeping the wet off your skin once it's caught it. A saturated pad sitting against your nipple gives some of it back: to your skin, and to your top.

You can hear those second and third jobs on the forums, without anyone naming them as such. About one brand that didn't hold up: "they leaked through faster and wouldn't stay put". About the clammy feeling after a couple of hours: "I always seem to be cold with those things in".

That changes what you look for on the shelf. When you pick up a pack, ask whether this one will stay where you put it and whether it will leave your skin dry once it's full. The millilitres on the box tell you nothing about either.

Do you even need them?

This is where the wasted money starts. The list says you need them, so you buy a box of 60. What the list doesn't say: how much mothers leak varies enormously.

In one forum thread on exactly this question, these three answers sit one under the other. "Never needed them." Below that: "I only needed breast pads for the first two or three weeks." And below that: "All three times I needed them until about nine months."

All three are normal. How much you leak comes down to how strong your let-down reflex is and how full your breasts get between feeds. What it isn't: a reliable measure of your milk supply. Leaking a lot doesn't mean you're making a lot, and barely leaking doesn't mean you're short. It also changes week by week: La Leche League describes leaking easing off sharply or stopping altogether for many mothers after a few weeks to a few months. For some it lasts longer. Why that happens and what's going on underneath is in why do my breasts leak, and what's normal.

What this buys you: leaking a lot doesn't mean there's anything wrong with you. One mother wrote that she nearly lost her temper when someone told her they'd never needed a single pad, while she was wearing them day and night. That comparison is useless, because you aren't leaking the same amounts.

Watch your own pattern for three days before you buy a big box. Note down each day:

• How often your top or your bra is damp, and when. Only when you feed on the other side? When you hear your baby? Hours after a feed?
• How much: a few drops, a wet ring the size of a coin, or a soaked cup.
• Whether it happens during the day or mainly at night.

With those three answers you can buy properly. A few drops in the daytime call for something completely different from a cup that fills up twice a night.

And if you're leaking already while you're still pregnant: that's colostrum, and it says nothing about your later supply. One pad a day is usually plenty at that stage. One exception: fluid that is bloody, smells odd or comes from one breast only isn't a question about which pad to buy, it's a question for your GP or midwife. See the section further down on when to get in touch. What else to do, and not do, in that phase is in leaking colostrum during pregnancy.

Disposable or washable: where each type breaks

The advice you find online contradicts itself outright. In one thread you read that disposables shift less and are thinner. In the next, that disposables curl up and washables stay put better. Both mothers are right, because they leak differently and they're wearing different bras.

The two break in opposite directions. That's what you need in order to choose.

Disposable. Thin, discreet and at full strength straight away. They often have an adhesive strip to fix them into your bra, which helps right up until the strip lets go or the whole pad rolls itself up during a feed. The outer side is usually a thin plastic layer. That keeps the milk off your top. It also keeps heat and moisture against your skin. Which is exactly where the complaints you read on the forums come from: hot, clammy, itchy or irritated skin. With sore or cracked nipples there's a further problem: a dry fibre layer can stick to a broken bit of skin and hurt when you peel it off.

Washable. Softer, more breathable, cotton or bamboo, and cheaper in the long run. They're thicker, so more visible under a fitted top. One mother said precisely that about the washables she'd tried: "I didn't like them because you could see them much more than the disposables (tight summer tops) and they leaked through on me just as badly." Also important and almost never mentioned: many washable pads only absorb properly after a few washes, because that's when the fibres fully open up. So they're at their weakest in exactly the weeks when you leak the most.

Two other things get muddled up with these, and they do something completely different. Silicone pads absorb nothing: they stick over your nipple and hold the flow back with pressure. Handy for two hours at a party, not for a whole day or a whole night. And there's a warning that comes with them which isn't on the packet: a milk duct doesn't get plugged up by milk itself. What sustained pressure on your breast does do is cause inflammation and swelling in the tissue, and that swelling narrows the ducts. Engorgement sits at the very start of that spectrum, and mastitis at the other end of it. So wear them briefly, and not if you can already feel a tender or hard patch in your breast. Hydrogel pads are a treatment for sore or cracked nipples, cool and moist by design. They won't keep your top dry, and you don't wear them as a replacement. They're personal, too: don't share them with anyone, and throw them away if your nipples are infected. And if cracked nipples aren't healing, that isn't a pad question at all, it's one for a lactation consultant (see the section further down).

What stands out when you set the two columns side by side: they don't solve each other's weak point. Moving from disposables to washables takes away the plastic layer and gives you a thicker item that's still attached to nothing. The mother quoted above went from disposables to washables and leaked straight through both.

If you do buy both, this is the split that works for most mothers: washables at home, where being visible doesn't matter and your skin needs a break. Disposables when you're out and under fitted clothes. For the night there's no good option. That's the next section.

How often should you change them, and why that rule breaks at night

The advice is shorter than you'd expect. The NHS, in its advice on sore and cracked nipples, says to change your breast pads "after every feed if you're using them". And while you're being treated for thrush, its advice is to change breast pads frequently. The thinking behind it: moisture left sitting against your skin can irritate it. With cracked or sore nipples that weighs heavier, because a broken bit of skin needs to lie dry to heal.

Real life looks different. One mother on a forum described her usage: "I usually only get through two or three in 24 hours." Two or three a day, while the advice says: after every feed. Nobody has ever explained that gap to her. That gap is the heart of this whole piece.

How often you really need to change comes down to your volume, not to a number on the box:

• Light dripping: two to four a day is usually enough. Have a feel: dry can stay, damp comes out.
• Moderate leaking: at every feed, and every time you feel one turn damp. Reckon on six to eight a day.
• Heavy leaking or oversupply: more often. And that's when you run into the ceiling of this system fairly quickly. What does work then is in managing heavy leaking.

And then there's the night, where the advice collides with your life. You sleep for four to six hours in one go. Or you try to. Your breasts get fuller because there's more time between feeds, so that's exactly when you leak most. A pad that saturates at half one is still lying against your skin at six. Changing it as soon as it feels damp isn't sustainable, unless you set an alarm to change your breast pads. Nobody does that.

That same long gap does something else too: your breasts can turn hard and engorged. Usually that settles as soon as your baby drinks. If a hard, painful patch stays put, or you start to feel fluey, it isn't about wet pads any more. That belongs in the section below.

One mother put it so compactly it can't be improved on: by early morning she could wring her washable pads out, and they'd stayed so clammy against her skin that she started worrying about thrush. That isn't user error. That's the system hitting its limit at night. What you actually can wear in bed we've worked through separately in night-time leaking: what to wear in bed.

What goes wrong when it shifts or stays wet

Four things. And they all come back to the same thing: it's a loose object in a bra.

It moves at precisely the wrong moment. Usually during the feed itself. You unclip, your baby drinks, you click the cup shut again and the pad has rolled itself into a damp little sausage somewhere halfway across. English-speaking mums describe it exactly like that: a soggy sausage in their bra. You straighten it out, and at the next feed it starts again.

Your skin stays wet. Hot and clammy with a disposable and its plastic backing, cold and clammy with a soaked washable. Which is what stops a saturated pad from being neutral: it holds moisture against the very skin that needs to stay dry.

It shows. A pad that's moved, or a thick one, puts a circle in the wrong place under a fitted top. One mother called the pads she'd tried "so stiff that I kept worrying they were visible through my clothes".

You start stacking. This is where nearly every forum thread ends up. Two pads on top of each other. A muslin tucked in as well, as one mother wrote word for word: "And when I leaked a lot (during a feed or at night) I'd shove a muslin in there too." A towel on the mattress. And then the line that says everything about how badly this system fails at night: "Nights were the real disaster, and out of sheer desperation I ended up using my baby's nappies instead of breast pads." Which isn't something to copy, however well you understand why she got there: a nappy isn't made to sit against broken or sore skin.

The only advice that ever comes up on the forums is more pad. Never: a different system.

There is, mind you, one thing you can fix without buying anything new. A cup that sits too loose holds every pad off your skin, and the milk simply runs past it. A cup that digs in presses it flat and skew. Your size changes faster in this phase than you'd think: how to measure your nursing bra size again.

How many do you need?

If you're going with pads, buy to your own pattern and not to the size of the box.

• Disposables: take your daily usage and multiply by 30. With moderate leaking you're on six to eight a day, so 180 to 240 a month. Buy one small pack of a single type first and test it for a week. The shape matters too: contoured pads (with a seam, so they curve) stay put better for a lot of mothers than flat round ones.
• Washables: eight to twelve pairs is a workable stock if you wash every other day. Wash them a few times before the birth, so they already absorb properly by the time you need them.
• Washing washables: hot wash, no fabric softener. Softener leaves a coating on the fibres that repels moisture, which lowers the absorbency.
• For out and about: two clean ones in a little bag in your changing bag, plus a bag for the wet ones.

What none of that solves is the shifting and the night. There's a different route for that, and we compare it in full in nursing bra or breast pads: what actually stops you leaking through.

When pads become a question for your GP or a lactation consultant

Leaking in itself isn't an alarm bell, however maddening it is. But a few things don't belong in a conversation about which pad to buy. Contact your GP, your midwife or a lactation consultant if you have:

• a fever, or a fluey, run-down feeling alongside a breast complaint;
• a red, warm, painful patch or a hard area in your breast, particularly if you feel yourself getting more unwell quickly. That can point to mastitis;
• a hard patch or lump that doesn't shift after a feed or after a couple of days;
• persistent burning or stabbing nipple pain, shiny or flaky nipples, possibly with white patches in your baby's mouth. That can point to thrush, and it needs treating for both of you;
• cracked, bleeding or infected nipples that aren't healing. Sore nipples usually come down to positioning and latch, and that's where the fix lies;
• nipple fluid that is bloody, an odd colour or has an odd smell, coming from one breast and unrelated to cracked nipples;
• a breast complaint that isn't improving within 24 hours, even though you're feeding well and often. Don't sit it out longer than that: get in touch with your GP or a lactation consultant.

For support with feeding itself, start with your midwife or your health visitor. They can refer you on to your local NHS infant feeding team or a breastfeeding support group nearby. Not every team has an IBCLC lactation consultant in it; if you'd like to see one, you can also find a private IBCLC through the Lactation Consultants of Great Britain directory. For the everyday questions, the National Breastfeeding Helpline is staffed by trained breastfeeding counsellors. With a fever, a red painful breast or unexplained nipple fluid, your GP comes first, not a helpline; out of hours, use your out-of-hours GP service or NHS 111. A breast pad keeps your clothes dry. Ask nothing more of it than that, because it won't fix a medical complaint and it should never be allowed to mask one.

Why is the absorbency in a loose pad at all?

Line the four failure points up and they all have the same cause. The pad is attached to nothing. Loose means: it rolls up, it slides, it falls out, it shows through your top, you have to think about it all day long, and the moisture stays wherever it happens to be lying.

We built our nursing bra because that weak link can go. The absorbent layer is built into the cup, in four layers that each do one job. An inner layer that wicks moisture away from your skin, a core that holds it and takes up to 30 ml per cup (60 ml per bra, roughly two saturated standard pads), a barrier that protects your top, and a soft outer layer. There's nothing to straighten after a feed, and nothing to put in at bedtime.

It's wireless, opens one-handed with the clip and is knitted from an OEKO-TEX Class I certified fabric (certificate number 11-36224), the strictest category: for textiles that may touch a baby's skin. Designed in Belgium, knitted in Türkiye.

If you lose the odd few drops during the day, a handful of washable pads will see you through nicely and you need nothing else. For the nights, for the feeds you have to reassemble yourself after, and for the days when you'd rather not think about it at all: see the nursing bra. Everything on nursing bras, fit and all-day comfort is gathered in the overview of this guide.

Frequently asked questions

How many breast pads do I need a day?

That depends on how much you leak, not on a number on the packet. With light dripping you'll get through two to four a day, with moderate leaking six to eight. Watch your own pattern for three days before you buy a big box. Change a pad as soon as it feels damp: moisture left sitting against your skin can irritate it.

Are washable breast pads better than disposables?

For your skin, usually yes: softer, more breathable and without a plastic layer trapping heat. They are thicker though, so more visible under fitted clothes. And they only absorb properly after a few washes, so they're at their weakest in exactly the weeks you leak most. Give them a few washes before the birth.

Why does my breast pad keep moving?

Because it's attached to nothing. It's wedged between your skin and your cup, so every movement works against it: the clip opening at a feed, a turn in your sleep, a strap sliding. A contoured shape and a well-fitting cup help, because a cup that's too loose lets go of it straight away. The only real fix is building the absorbent layer into the bra itself.

Can I sleep with a breast pad in overnight?

You can, but it's the weakest point of the whole system. You often leak most at night and at the same time you can't change it the moment it turns damp. So you sleep for hours with a saturated pad against your skin, which can irritate it. For the night, an absorbent bra or an extra towel under your shoulder is the more practical answer.

Does everyone need breast pads?

No. Some mothers barely leak and never use a single one, others wear them well into the first year. Both are normal: how much you leak isn't a reliable measure of your milk supply or of how well feeding is going. So don't stockpile in advance. Start with a small pack and see how your body behaves in the first few weeks.

Read on in this guide

• Which nursing bra is actually leak-proof?
• Signs of a poor fit or too much compression
• When does leaking stop for most mothers?
• Oversupply and a strong let-down reflex