Difficulties of Breastfeeding With PCOS

Woman breastfeeding her baby

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If you have PCOS and are trying to nurse your baby but are struggling to produce enough milk, you're not alone. Milk supply issues are commonly reported in women with PCOS. Here are some reasons why and what you can do to improve your milk supply.

Factors Contributing to Low Milk Supply

Early studies show that women with PCOS may have inadequate breast glandular tissue to produce a sufficient amount of milk. Keep in mind that glandular tissue does not correlate with breast size, as insufficient glandular tissue can occur in women with large breasts as well. This is thought to be a result of low progesterone levels during puberty and pregnancy in women with PCOS. Progesterone, which is essential for proper breast growth and development, is produced by the empty egg follicle after ​ovulation occurs. In a woman with PCOS, ovulation may happen infrequently or not at all, leading to low levels.

It’s also known that androgens, which are typically high in PCOS, can also interfere with and bind to prolactin (the primary hormone of lactation or milk production) receptors, reducing the amount of milk produced. Insulin can also disrupt a healthy milk supply.

How to Improve Your Milk Supply

In most instances, milk supply can be improved with a few modifications. Depending on the degree of glandular development, there are a few things a woman can try. Herbal galactagogues like Mother's Milk Tea, ​Fenugreek, or prescription medications (metoclopramide, or domperidone) are an option. Some women have also found success using Metformin in conjunction with these medications.

Taking care to drink adequate fluids and eat sufficient calories are important for adequate milk supply. Extra stimulation by frequent nursing or pumping after feedings is also key to maintaining milk supply. A woman with PCOS should consult with a certified lactation consultant when her baby is born to maximize breastfeeding success.

Sometimes despite all these measures, a woman may still not produce enough milk. Depression, anger, and denial are all common reactions to what can come as a shock to the new mom. A lactation specialist or postpartum counselor may be able to help her work through her disappointment and sadness at not being able to nourish her child.

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