Hilary,

The only thing I might consider (not having any more experience than reading
A LOT and one friend with PCOS who suffered lactation failure after her
first baby) is whether/how she managed the PCOS during each pregnancy.

Because PCOS is a syndrome with symptoms that may come and go, each
pregnancy/"hormone collection" will be different, even in the same woman and
definitely from woman to woman.

The reading I've done as well as sessions I've attended on this topic
suggest that glucophage/metformin during pregnancy seems to help many
women...something about keeping the blood sugar in check during the
pregnancy that allows the lactation tissue to do its thing.  

Again, PCOS is so tricky because of all the variables involved - one mother
might have insane oversupply while another mother finds herself in the
confusing situation you're working with.  

I don't know exactly what, if any, conclusions you might draw once you
discover whether she took glucophage/metformin during either pregnancy, but
it might provide a jumping off point for someone else who does know where to
look next.

--Diana in NY

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