Hi Laurie!
 
We see a lot of moms who fall into this category as well. Our perinatologists have been very willing to put moms back on their metformin and we have found it to be very helpful in many cases. I routinely ask moms about a hx of metformin use if I am following a mom with an  older baby for low milk production/ low weight gain. I have had several moms with extremely low milk production many weeks out tell me that they have taken metformin in the distant past. Their doc has represcribed and they have all had significant increases in their milk production.  They usually start with whatever dose the mom was on in the past. Refer to page 172 of "Making More Milk" where it discusses dosages. Metformin is also discussed elsewhere in the book. 
 
Warmly,
 
Holly McSpadden, IBCLC

 
Holly McSpadden IBCLC
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>>> laurie wheeler <[log in to unmask]> 7/31/2013 11:58 PM >>>
One of our docs sees a large number of infertility patients, many with
polycystic ovaries,with insulin resistance, and uses metformin for a time
to help the patient get pregnant and I believe continues it for a time
during the pregnancy. Virtually all of them, though, have the med
discontinued after the birth. We were talking today about possibly
continuing that med during lactation. I have Making More Milk by West and
Marasco, and it's on my desk to re-read. We did a quick pub med search but
we didn't get much.
What we are wondering: are there any practices that see benefit of keeping
mother on metformin during lactation? Any thing you can tell me about this
would be appreciated. For example, what pts would be candidates, dose and
frequency, length of time pt is on this, are you seeing results, anecdotal
or have any studies been done?
We see a fair number of these moms with very poor milk production, despite
our best efforts to help them.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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