Hello Medora,
I can share with you one case of a woman with PCOS who had (is having)
a greatly enhanced lactation experience with her 2nd baby over what
happened with her first, and one changed variable in her situation was
the continuous use of metformin from pregnancy through the postpartum
period and lactation.
During her first pregnancy (which was a shock to her), she resisted
taking any kind of medication, including metformin. She has breast
hypoplasia -- one very well-developed breast and one much smaller,
both somewhat tubular in shape and widely spaced. She did notice
breast changes during this first pregnancy. Her baby was born and
transferred to the NICU, there were several barriers to breastfeeding
in the early days but these were barriers that most mother-baby dyads
can overcome with support and assistance (such as baby being bottle-
fed, etc.).
After the baby was about a week old, they started attempting to
breastfeed but the mother was making no milk. Not even drops. Major
attempts to relactate were begun (and this was still within the first
month postpartum) but even with medications, pumping, and
galactagogues, she could make only drops of milk. She was devastated.
During her 2nd pregnancy, she took metformin. She also took
progesterone at the end of her pregnancy (with the hope that extra
progesterone might create a more precipitous drop in progesterone
levels after the delivery, one hormonal factor in successful
lactogenesis). This 2nd birth was with a midwife, at home, and mother
and baby were not separated. There was extensive (sometimes twice
daily) lactation support and baby was feeding well.
As it turns out, this mother is making just over half of what her baby
needs and is supplementing at the breast with donated human milk from
other mothers in our community. She is also using a combined herbal
tincture of fenugreek and goats' rue (with some other lactogenic
herbs, I believe) and taking Domperidone.
The metformin may or may not have been a significant factor in this
mother's increased lactation success with her 2nd baby. Many studies
show that mothers tend to make more milk after subsequent pregnancies
anyway; her efforts to relactate after the first pregnancy likely
influenced the readiness of her breast tissue, and the birth scnario
and immediate postpartum circumstances worked to stack the deck in her
favor. The fact that there has been such a significant improvement in
the lactation experience for this mother tells me that there were
several factors at work for her, metformin being one of them.
I hope this helps you in your studies,
Diana in NY
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