Ann,

Was this mother on Glucophage prenatally?  If so, she may benefit from it now for lactation.  Lisa Marasco has some great info re PCOS and BF.  I believe she is on LactNet.  Otherwise, a google search for her name and/or BF and Glucophage will bring up a lot of info.


Anne Duret, RN
Maternity Care Coordinator
Lactation Counselor
687-6251


Date:    Sun, 8 Apr 2007 16:46:50 EDT
From:    [log in to unmask]
Subject: PCOS

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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