>My face is dragging on the floor tonight, after having to gently inform
>another mom with PCOS that her incredibly voloptuous breasts may not be
>enough to nourish her tiny new baby.

The good news is that she can nurse this baby... and who knows what will happen next?  An awful lot of us wear glasses, or take thyroid pills, or have some other "shortage" that we have to compensate for.  But we still see, we still get around, we still enjoy, we still think of ourselves as complete.  She can too.  In fact, I think the *real* tragedy is the woman who can't put her baby to breast, not the one who has very little milk when she does so.  For me, it was the breastfeeding that was the joy, not the milk itself.

I'm always excited when a mom can almost cover the bottom of the bottle when she pumps.  That's a *lot* in baby terms, when you figure that a couple ounces a day can alter the course of illness in an adult.  And if she has enough milk that she can supplement with bottles instead of a feeding tube device, well that's absolutely fabulous.  That means she gets to *choose* how she supplements, whether she feeds entirely at breast, as an adoptive mother friend of mine does (for years with each child, no bottle in the house, never a full milk supply), or supplements entirely away from breast, as many others do.

Breastfeeding builds milk for just about anyone.  One of my recent clients with PCOS had neither much milk nor a latching baby at first.  Once the baby was breastfeeding, she supplemented as needed by bottle, took galactogogues, nursed, nursed, nursed... and by golly, against the odds, she was exclusively breastfeeding by the time her daughter started solids.   They're well past a year now and going strong.  Adoptive moms have what I think of as a "standing start" - no milk, no hormones working for them.  But any newly delivered mom, PCOS or not, has a start that an adopting mom would love to have - at least some tissue build-up and usually at least some milk.    

The low-milk moms I've worked with have an agonized first month or so, wishing for milk that just isn't there.  But by the time they've been nursing for several months, they're in a routine.  The supplements might be mik from friends or from a can, but those extra ounces have fallen into a pattern that's secondary to their breastfeeding relationship.  Mom and baby have worked out their routines, the baby has figured out that nursing feeds his soul even if it doesn't bulge his tummy (or mom has figured out how to fill his tummy at breast), and life is truly sweet for them both.  I don't know a way to make that first month easier, but I really really feel that the biggest gift is the breastfeeding, not the milk.  And your mom with PCOS has that greatest gift on-board and ready to go.  

Diane Wiessinger, MS, IBCLC  Ithaca, NY  USA
www.wiessinger.baka.com

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