Short on time? Then the key things to know are:

• Polycystic ovary syndrome affects up to 15% of women and can have an impact on fertility, pregnancy, birth and breastfeeding
• Women with PCOS often have less periods during puberty which can interrupt breast development, later impacting their ability to produce breast milk
• PCOS can cause low milk supply due to a lack of prolactin (an essential milk producing hormone) or can cause oversupply
• Various treatments can help to increase milk supply including metformin, inositol, domperidone and various herbs or supplements
• A lactation consultant can help you to understand your choices and support you with low or too much milk supply

 

What is PCOS?

Polycystic ovary syndrome (PCOS) is a complex hormonal condition affecting up to 15% of women. It is also known as one of the leading causes of infertility.

Due to hormonal imbalances, PCOS can affect fertility, pregnancy, birth and lactation in a number of ways. PCOS can affect early breast development, milk production in pregnancy, pregnancy and birth risks, and effects on early postnatal milk supply.

How does PCOS affect breastfeeding?

What many people do not know is that women with PCOS may struggle to produce breast milk, either having a low milk supply or too much. It is recommended that women with a diagnosis of PCOS have careful monitoring by their health care provider before and after birth.

In addition, parents with PCOS may want to consider an individual prenatal lactation consultation with an IBCLC. A lactation consultant can talk to you about your PCOS as well as possible other underlying conditions and how they may affect your supply.

Breast development

Firstly, it’s possible for PCOS to affect early breast development. When PCOS leads to irregular and fewer menstrual cycles, especially in early puberty, this then leads to fewer opportunities for the mammary tissue to develop in the breasts. With the common release of progesterone, this also has the potential to disrupt the development of the breasts’ ducts, lobules and alveoli of the mammaries.

Higher levels of the hormone androgen are common in PCOS and can lower the rate of both prolactin receptors and estrogen receptors. Estrogen is essential to breast development in puberty and pregnancy, and limited estrogen receptors may lead to poor breast development. A dominance of estrogen in the body may also suppress prolactin, the hormone essential to milk production.

Milk supply

PCOS can affect milk production during pregnancy too. This is often due to:

• A lack of breast changes during pregnancy (which is often linked to lower milk supply and breastfeeding duration)
• Limited prolactin, an essential hormone in milk production
• Insufficient glandular tissue
• Other contributors more common in women with PCOS including insulin resistance, hypothyroidism and other thyroid disorders

It is also worth mentioning that pregnancy problems such as hypertension, gestational diabetes, preeclampsia and preterm birth occur more often in people with PCOS.

What to do if you have PCOS and breastfeeding problems

If you have PCOS and low milk supply, make sure that you haven’t overlooked the most common causes of your supply issues:

• Start with the basics of attachment, positioning and effective feeding - a lactation consultant can help address these areas
• Make sure your underlying hormonal problems such as insulin resistance, thyroid dysfunction, high androgens and other imbalances are all treated
• If you haven’t recently had your bloods tested, it might be worth asking your GP to run some bloods

How to increase low milk supply with PCOS

Metformin for PCOS and breastfeeding

Some but not all parents with PCOS have found that taking Metformin in conjunction with the appropriate diet and exercise increases their milk supply. Metformin, which improves PCOS symptoms for many women (even when they aren’t clearly insulin resistant) has reportedly boosted milk production. Inositol, which appears to work similarly to Metformin, has also been recommended as a natural and lower risk remedy for PCOS and insulin resistance.

Domperidone

Domperidone may help in the improvement of PCOS milk supply when low prolactin levels are increased.

Herbs or supplements

Some women report the use of herbs and supplements have helped to overcome low milk supply. These include:

• Goats rue
• Black seed oil
• Fennel
• Saw palmetto
• Cinnamon
• Malunggay
• Resveratrol
• Magnesium
• Chromium
• Calcium

The National Polycystic Ovary Syndrome Association suggests fibrous foods like barley and brown rice, or calcium rich foods like sesame, almonds, apricots, dates or figs may also help to increase the production of breast milk.

PCOS and diet changes

Just two cups of coffee every day increases early follicular phase E2 (a natural point in the cycle for an estrogen surge) by about 70%. Considering estrogen dominance is common in those with PCOS, it is recommended to reduce caffeine to 100mg or less every day. In addition to cutting the coffee, many people with insulin resistance find a carb controlled, low sugar, dairy-free diet very helpful.

Exercises after meal times also can be quite helpful too. So break out the baby carrier or pram and enjoy the fresh air!

When it comes to Metformin, Insotol, Domperidone, herbs and supplements it is always best to speak to your health care provider about your PCOS, other underlying conditions and your milk supply.

Get help with PCOS and breastfeeding

A lactation consultant can support you with your feeding at birth and beyond - this includes discussing your choices in supplementation for low supply. An IBCLC can also talk about how to safely cope with common oversupply problems and how they may affect feeding your baby.

Get more breastfeeding support and advice at Naytal. Discover how to breastfeed multiple babies, harvest colostrum and the symptoms of tongue tie.

**If you are feeling overwhelmed by PCOS or any other underlying conditions that may be affecting your milk supply, speaking to an expert could really help. Book an online appointment with one of our lactation consultants at a time that suits you to get specialist advice with any concerns.