>>The questions I have on my mind, (1) Could baby experience side
effects from the glucophage that would involve the kidneys? (2) Could
inadequate milk intake affect the results of the "sweat test"? (3) Does
insulin resistance significant enough to affect fertility also cause
difficulties either in milk production or calorie (milk fat) content?<<

Kathy,
It was unclear to me from your post whether the glucophage was actually
continued into lactation or not. Without being sure of that fact, is
there a question of mom having low supply? I would be curious as to
whether her milk might have elevated sodium levels that would stress the
kidneys?

Glucophage does carry with it a small risk of lactic acidosis. Candidate
patients are routinely screened for good kidney function. The amount of
glucophage that passes into the milk is relatively small-- Tom Hale
estimated that the mean exposure of the infant was .28% of the maternal
weight-adjusted dosage, well below the 10% threshhold of concern. I'm
not sure if the concern would change if the infant had impaired renal
function; if Tom is following lactnet, hopefully he will address this
more thoroughly. In the meantime, it might be interesting to analyze the
mother's milk while baby is being worked up. Kathy, please do keep us
updated on what you and the parents find out.

~Lisa Marasco, MA IBCLC

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