Thank you all for your interest in this young family. To answer some of the
questions I have received...The mom has all the s/s of PCOS except what she
referred to as "the ring of pearls." She reported that her infertility was
related to Syndrome X, insulin resistance. She built up her dose of glucophage to
2000 mg daily for 3 months before she "was allowed to get pregnant" (conception
IVF). She continued on that dose for approximately the first half of
pregnancy. The dose was then lowered to 1000 mg daily for the remainder of the
pregnancy. She is no longer taking the medication. I believe that her milk supply
issue is significantly affected by the fact that she has only been BF from one
side each feeding. She has only been pumping one time daily. So, as you may well
guess, we have had to address numerous potential barriers to exclusive
breastfeeding.

One of my initial concerns was if it is possible that the baby's kidneys
could be affected, in utero, by the glucophage. I agree that there was probably
elevated sodium in mom's milk prior to our interventions. That certainly could
have affected the results of the lab work. You will be happy to hear that the
baby's labs were rechecked at the children's hospital and came back within
normal limits. In fact, the nephrologist didn't even want to see them. They had
been told that the initial results indicated kidney failure. They called my
office requesting prayer just before rushing the baby to the emergency room some
70 miles away.

They called back, elated at the good news. Dad was giving mom a much
appreciated foot massage while she breastfed baby. They plan to have a follow up with
us on Wednesday (5/5) to see if any of the suggestions have made a difference.
I will keep you posted. As already noted, we can expect other moms with
similar problems related to PCOS. This is a wonderful forum through which to keep
informed about what works and what doesn't. Thank you again for your input.
Kathy Bowers, RN, IBCLC

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