Dawn,
I wanted to give a little additional info on the medication issue for your
mom, since I've researched it from the PCOS angle.  Glucophage (metformin)
is a small molecule and ~50% protein bound, passing into the milk. It works
by reducing insulin resistance, not directly on glucose, and given to a
"normal" adult it does nothing, including it does not induce hypoglycemia.

There are also some other anti-diabetic oral meds, troglitizone, and the
second generation rosiglitizone. Troglitizone is a large molecule, 90%+
protein bound, unlikely to pass into the milk in significant amounts,
therefore a potentially good choice for breastfeeding mothers. I suspect
that rosiglitizone will be similar, without some of the side-effect concerns
of the first generation parent drug.

With the PCOS angle, glucophage may help obese PCOS women lose weight, but
troglitizone doesn't. Thus, obesity may be a factor in the choice of drug
here.

I had a diabetic mom who had been on glucophage before pregnancy. She and I
did this research, she took it to her doctor, and after birth they put her
back on the drug. Her pediatrician did periodic blood checks, and her son
grew appropriately with no effects of concern. This is only a test case of
one, but was encouraging for her and I. The books officially warn of the
concern of hypoglycemia in the infant, but I am wondering how valid that
really is; only time will tell.

Lisa Marasco, BA, IBCLC

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