I'm still hoping that someone out there has had some experience working with
breastfeeding moms who have this syndrome.  It is characterized by erratic
menstrual cycles, obesity and/or hairiness caused by excessive androgen in
the system; estrogen levels are apparently also high, especially as estrogen
is stored in the fat that they accumulate with the syndrome.  One report
mentions that prolactin levels may actually be elevated in 20% of the cases
(baseline 20-30), but other than that mention, I am suspicious that the high
estrogen may interfere with lactation.

I've currently got two moms who both conceived unexpectedly, had good breast
growth during pregnancy, yet have FTT babies and very little milk now at the
3 week mark despite good breastfeeding management and good suck on baby's
part.  MDs disinterested, though one mom is starting metoclopramide today as
a blind counter-action.

Has anyone else dealt with otherwise unexplainable lactation failure where
the moms have this history?  I'm desperately seeking more information on how
they can be helped, what hormonal imbalances may be affecting lactation and
what can counteract it.  Wish I had motilium in the arsenal!

BTW-- for those who read my previous post on the topic, one of these moms
also had heavy bleeding.  She had a night of cramping a week later, passed a
golf-ball sized clot, and the bleeding resolved within the next 24 hrs.
Unfortunately for her, however, she had continued abdominal pain and also
ended up with an emergency appendectomy following what I think was
undiagnosed retained placental fragment (they didn't do an ultrasound until
AFTER she passed the clot and was still in pain).  It's been 6 days, and even
though she had surgery, I expected to see *some* rebound in the milk supply
after the clot passing episode, but instead supply has declined further.  So,
it seems to me that there may have been two issues, and now we are down to
the hormones.

Would love any input, brainstorming, suggestions, hints, etc.

-Lisa Marasco, BA, IBCLC