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Date: | Sun, 8 Apr 2007 16:46:50 EDT |
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Does PCOS worsen with each pregnancy? I am working with a Mom who gave
birth to 34 week twins. She really wants to breastfeed them and get a full milk
supply so they won't need formula. About 6-8 hours after she delivered the
twins she had already tried to nurse them than I set her up with the Symphony
breast pump. She obtained about 5cc that first expressing. I noticed that
her nipples were much bigger than the flanges so changed the flange size for
future pumping. She pumped every 3 hours for 10-15 minutes and also tried to
nurse the babies.
I did not see her for a couple of days. When I did see her next she was
over 72 hours postpartum and her breast were very soft and since the first
pumping she was getting nothing. She could hand express and get a few mls. I
checked her pump out and observed her pumping. I even had her go back to the
smaller flanges. The only way she got anything with the pump was when she used
breast compression. But this amounted to only a drop. She than hand
expressed and even got a couple of sprays but that quickly subsided.
She told me that she has a 16 year old child that she had no problems
conceiving and breastfeeding. I did not ask her when she was diagnosed with PCOS
but she told me that was why she has an infertility problem. She tried for
the next 7 years to get pregnant and finally had a set of twins with IVF.
These babies were closer to full term and she breastfeed them until they were
diagnosed with Reflux than she partially weaned, they had many problems and she
did increase her supply for them. A couple years later she had another set
of twins with IVF but lost them very prematurely. The current babies were
through IVF also.
Her delivery was a c-section so I would assume that there would have been
comments made regarding the delivery of her placenta. She is having minimal
vaginal bleeding.
We are both baffled at the lack of milk production. I can feel very little
changes in her breast.
The plan I set up for her was to continue the pumping and hand expressing
every 3 hours. I gave her a small nipple shield and set up a lactation aid
with a french feeding tube in a bottle. I asked her to request a full thyroid
panel from her OB provider to rule out a low thyroid.
What am I missing here? Does PCOS worsen over time or with subsequent
pregnancies?
Any help appreciated. Will see this Mom tomorrow.
Thanks,
Ann Perry, RN IBCLC
Boston, MA
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