PCOS and Breastfeeding

Someone close to me has PCOS or Polycystic Ovarian Syndrome and was dealing with breastfeeding issues of low milk supply which lead to a failure to thrive (FTT) in her infant son. In a desperate attempt to help her in anyway I could I came across a lot of information that maybe isn't readily known or available to the public. It took a good part of the day and constant Google searches and cross referencing to find what I found.
There IS a correlation between the two. PCOS is known to cause low milk supply in about 1/3 of women who are diagnosed with it. PCOS effect about 15% of women, so only about 5% of women have this problem with PCOS effecting their milk supply and therefor not a lot of research has been done on it. It is heartbreaking to think that these women have so much trouble just getting pregnant and carrying a baby to full term and now they have a 1 in 3 chance of struggling with milk production too, which can halt BF.
So what did I find. I found that PCOS is caused by hormone imbalances which can cause the following symptoms: an irregular or late onset of the menstrual cycle, fertility problems, recurrent miscarriages, excessive body or facial hair, head-hair loss, acne and weight problems, insulin resistance and blood lipid abnormalities. Gestational and adult-onset diabetes can also occur. PCOS is now seen as a potential marker for heart disease in women due to insulin issues. While PCOS symptoms usually start in adolescence, in some women they do not develop until their early to mid-twenties. While PCOS is treatable, and long term improvement is obtainable, there is no cure. (Information from mobimotherhood.org)
The reason why this causes low milk production is according to Lisa Marasco, (leading researcher on the correlation between PCOS and low milk supply) there are several different ways that PCOS could potentially interfere with breastfeeding. (the following information is from mobimotherhood.org)

1. Due to the hormonal imbalances which occur, there is the potential for poor breast tissue development during puberty and pregnancy. Fewer menstrual cycles in early puberty can translate into less estrogen to develop mammary tissue.
2. Prolactin and oxytocin are two of the main hormones involved in the onset of lactation. Women with PCOS have higher levels of androgen hormones that can interfere with prolactin reaching its receptors.
3. In addition, if too few prolactin receptors were formed during pregnancy, milk production will be limited.
4. Estrogen is known to inhibit lactation, particularly in the early days after delivery. Women with PCOS typically have an imbalance called “estrogen dominance.” If estrogen levels are not down-regulated after birth, circulating estrogen may interfere with lactation. This is why the contraceptive pill is not recommended for breastfeeding mothers.
5. Insulin resistance may affect breast growth and milk synthesis. Insulin is known to be an important factor in lactation in conjunction with prolactin and cortisol.

So what can be done? Firstly, if you are a mother who has PCOS you already did a great job even achieving motherhood, and now attempting BF is another amazing feat. Take a breath and pat yourself on the back. You are doing great!

Now if you would like to increase milk supply hear are some things you can try. (from mobimotherhood.org)

     1. PCOS can lead to sugar cravings. The minerals chromium and vanadium can help with this. Insulin resistance, a key symptom of PCOS, plays a role in sugar cravings. It is worthwhile to follow dietary principles to improve insulin sensitivity: Avoid foods that lead to a sharp spike in blood sugar, and prefer foods with a so-called low glycemic index. Breastfeeding is a time when all mothers naturally tend to crave sugar. Remember that breastfeeding removes sugar from the blood, making a breastfeeding a different situation from other times. For instance, diabetics frequently see improvement while breastfeeding because breastfeeding naturally lowers their blood sugar. This removal of sugar requires a regular tanking of new sugar from food that contains more natural sugar, higher on the GI list, such as fruit, starchy grains, and sweet vegetables.While breastfeeding, a mother can beat her sugar cravings and maintain steady blood sugar levels by eating and snacking every two to three hours on healthy, whole foods. Getting healthy fats and a source of protein with each meal or snack will also help keep blood sugar levels steady. 

     2. As for dieting to lose weight, a common concern of mothers with PCOS, remember that actively trying to lose weight while breastfeeding can damage a shaky milk supply. For low-supply mothers, even a small but sudden weight loss can translate into significantly less milk. Slow and steady does it. There is time ahead to lose weight. 

     3. Stress management: Stress levels can have a real impact on your milk production – from difficulty in achieving a let-down to more chronic low supply effects. 

     4. Herbal remedies for lactation. A selection of herbs which help the body prepare for lactation can be started during pregnancy and continued when the baby arrives. Examples of these are alfalfa leaf, red raspberry leaf, nettle, oat straw, dandelion leaf and red clover.

The information I found also spoke of two drugs which may help Metformin and Domperidone. The first is used to control the glucose intolerance and the second is known to increase milk production. As with all drugs please talk to a doctor before taking anything like this. They have been known to help but a doctor is always best when dealing with anything not herbal.

So this is my blog post for a Green Mommy close to my heart. I hope the information I shared with her, as well as this blog post helps. From what I learned today there is no cure for PCOS and no real cure for the havoc it can wreak on your milk supply. There is however the knowledge that though you may struggle you are doing the best thing you can for your baby. You are providing the most nutritious and immune boosting food that your can give an infant. Hugs and Love to all BFing Moms but especially to ones struggling with PCOS.