I have a few questions about treating women with PCOS and low supply.  I have a woman right now who's 3 days post-op C/S with PCOS.  She used Metformin to get pregnant.

When she had her first baby, she had a severe allergic reaction following her surgery and was given multiple meds to treat the allergic reaction.  Subsequently, her milk didn't come in until the 9th pp day and then she never had enough to sustain her baby and gave up at around 6 weeks.  She really wants to breastfeed this time.

I spoke with her today and her milk isn't in yet.  Do those of you working with these women wait and see what happens with milk supply?  Would she respond to either Reglan or Domperidone (available locally)?  Or is Metformin the better choice and if so, what dose is recommended?  My collaborating physician says they usually start at 500 BID or 850 qd and then increase up to 2000 a day to get them pregnant but I can't find anything about treatment for low milk supply.  Resources for using Metformin for treatment for low milk supply?

Thanks very much for your help.
Patti Gardner, CNM, IBCLC

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