I received a reply from Rebecca Waddell and have quoted it below.  

"Lisa, There does appear to be some association between 
PCOS and lactation problems. Both Dr. Thatcher and Dr. Sills on 
INCIID believe there is an issue, but have reported that it has not 
been officially studied and should be . . . in other words, doctors 
recognize the appearance of a link, but have no idea exactly why it 
happens, or in what percentage of PCOS women. Dr. Thatcher 
assumes it is the hormone derangement -- but whether it is 
elevated LH, elevated androgens, elevated prolactin, or some issue 
with blood sugar/insulin levels is unclear. 

"The infertility list I run for overweight women is about 50% PCOS 
and the regular overweight and pg list (most there w/o fertility help) 
is at least 20% PCOS. I am not sure the percentage on the mom's 
list, but it seems significant. I do see that more of the PCOS 
women who want to nurse have some trouble doing so. It seems 
that most of the women who give it a real go and don't succeed 
have PCOS.

"I think some of the issues may also be psychological -- not just 
with PCOS, but with larger women in general. With PCOS there is 
an association with depression and poor body image, and there are 
similar issues with simply being big. You hear people rely on the 
pump as a gauge of milk supply, even if, like me, the nipple rubs in 
the flange and hurts like h*ll. A lot of women aren't comfortable 
nursing in public because they are ashamed of their bodies (I am a 
bit like this -- I couldn't care less if you see my breasts, but I really 
like my belly covered).

"I think that one has to be very careful in assuming infertility is the 
problem . . . especially if one doesn't know what the cause of 
infertility was. Male-factor would never cause milk supply issues. 
Blocked tubes from PID probably wouldn't either. Nor a uterine 
septum or polyps . . . basically the only kind of IF that might is IF 
related to hormone levels.

Bec"
http://fertilityplus.org

Hope this is helpful,
Lisa Dugan
LLL Leader 
Southern NJ

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