It is common to have questions about PCOS and breastfeeding. Many women who suffer from polycystic ovary syndrome (PCOS) will also experience fertility issues. To make matters worse, if someone with PCOS is able to get pregnant, they are then often faced with the challenge of breastfeeding.
PCOS is a common cause of low milk supply, which can be very difficult on a new mother. Due to the fact that awareness about PCOS and breastfeeding has recently increased dramatically, women and doctors now know the classic symptoms of PCOS, including acne, excess facial hair, male-pattern hair loss, irregular menstrual cycles, ovarian cysts, and insulin resistance.
A current leading cause of infertility in women is PCOS, and if left untreated, it can cause heart disease, type 2 diabetes, and certain types of cancer. Women, however, are now learning to successfully manage their PCOS with diet and healthy lifestyle changes.
What is Polycystic Ovary Syndrome (PCOS)?
PCOS, affecting 10-15% of women, is a hormonal imbalance that can range in severity of symptoms from woman to woman. Due to the vast variability, there is no clinical definition of PCOS that is globally accepted.
Instead, a PCOS diagnosis is made following the appearance of a combination of symptoms. Some of these symptoms include fertility problems, an irregular menstrual cycle, frequent miscarriages, acne problems, excessive body hair, weight gain, insulin resistance, and head-hair loss.
PCOS symptoms typically begin in adolescence, but in some women they may not show up until early to mid 20s. PCOS is treatable, although there is no cure.
Despite our growing knowledge and understanding of this syndrome, there continues to be very little discussion about PCOS and breastfeeding. Here are some important things to note about PCOS and breastfeeding.
PCOS’s Effect on Milk Supply
According to Lisa Marasco, an International Board Certified Lactation Consultant, reveals that there is a connection between low milk supply and PCOS. PCOS can interfere with breastfeeding in several different ways.
Because of the hormonal imbalances that occur in PCOS, it is common for sufferers to have low breast tissue development while they are going through puberty and pregnancy. Having fewer menstrual cycles as a young teenager can cause a lower amount of estrogen that is needed in order to develop mammary tissue.
Two of the major hormones that are involved in lactation are prolactin and oxytocin. Having higher levels of androgen hormones, women experience interference with their prolactin reaching the necessary receptors.
Additionally, if prolactin receptors are underproduced during pregnancy, the production of milk will be produced. Estrogen is also known to stop lactation, especially directly following delivery.
Women suffering from PCOS usually have an “estrogen dominance” imbalance. If following birth, estrogen levels are not decreased, the estrogen in the body has the potential to interfere with milk production.
Women whose insulin is affected may less breast growth and milk production than those with healthy insulin resistance. Insulin is an important factor in milk production, along with cortisol and prolactin.
In the 1940s, researchers were able to document that women with PCOS hace a lower amount of glandular tissue than those without PCOS. This impacts the function of the breast.
Some women with PCOS have large breasts, but they are filled with fatty tissue, rather than the glandular tissue that is needed for milk production. A lack of glandular tissue results in insufficient milk production, which causes some women suffering from PCOS to have difficulty breastfeeding.
Managing and treating PCOS symptoms around the time of pregnancy can certainly help to ensure a successful experience breastfeeding. PCOS can be managed naturally with diet, supplements, and exercise.
Breast milk supply is likely to decrease when hormones are not balanced. You can help your body to maintain a proper hormone balance by maintaining a healthy lifestyle and making proper dietary choices. This will allow your body to function correctly to create breast milk.
Improving the resistance of insulin is key to restoring the balance of hormones. Insulin resistance results in an increase in androgen hormones because it causes the blood levels of insulin to increase.
High levels of androgens are the root cause of many of the symptoms of PCOS, such as other hormone deficiencies which may negatively impact breast development and the successful creation of milk.
Metformin is often prescribed to improve insulin resistance. Some natural ways to improve insulin resistance include taking myo-inositol, which is a B vitamin.
Using Positive Breastfeeding Practices is Vital to Maintaining Supply
Beginning a breastfeeding regimen following delivery can be difficult, even for new mothers who are not suffering from PCOS. Research has shown that the sooner breastfeeding is started after the delivery of a baby, the higher likelihood that breastfeeding will be a success.
This means that it is best for expecting mothers to set the stage for successful breastfeeding long before they deliver. During pregnancy, talk to your doctor about your intentions to breastfeed, and develop a plan to breastfeed that incorporates your need for skin-to-skin contact directly after birth, working with a lactation consultant to help with positioning the baby correctly, avoiding supplemental formula if possible, breastfeeding on demand following birth, and avoiding the use of pacifiers.
Skin to skin contact when your baby is an infant helps maintain milk supply, due to its release of oxytocin, which stimulates the production of breast milk as well as the let-down reflex. Getting as much sleep as possible and drinking a lot of water also contributes to the success of breastfeeding.
Several days following delivery, breast milk production begins, and will continue to produce based upon supply and demand. The more frequently a baby breastfeeds, the more milk will be produced by your body.
People who suffer from PCOS who experience difficulty with breast milk supply can try pumping in between feedings to increase the demand on the breast. The more the breast is stimulated, the more milk the body is able to produce.
Rather than switching to bottle feedings if trouble arises, it may be better for those who suffer from PCOS to use a breastfeeding supplementer during feedings. This tool consists of a container, worn on a cord around the mother’s neck, with very thin tubing that is used to carry milk that has been expressed from a container to the nipple.
When a baby feeds with a breastfeeding supplementer, milk comes through the tubing and goes into the baby’s mouth in addition to any milk that is able to come from the breast. This helps the baby stay in the habit of feeding from the breast.
How Can Women with PCOS Regulate Milk Production?
While not all women will suffer from a low milk supply, it is important to learn to regulate your supply if you have PCOS. Working with breastfeeding experts is a great place to start for this.
It is reported that about one third of women who have PCOS do have maintain a normal supply of milk, which another third have an overproduction of milk. While one third of women suffering from PCOS have a low supply, only about a ninth of women have no supply at all.
How to Help Underproduction
Remember that any breast milk is beneficial to the baby, so even if trying to help underproduction is not successful, it is no fault of the mother. Moving to formula is perfectly fine, as long as your baby is being fed.
Women with PCOS have severe sugar cravings, which can be difficult to handle. Certain supplements, including chromium and vanadium, are able to help reduce these sugar cravings.
Insulin resistance also plays a large role in sugar cravings. It is beneficial to follow a diet to improve the sensitivity to insulin, including avoiding foods that cause a high spike in blood sugar, and instead choosing foods that have a low glycemic index.
Beginning dietary changes prior to pregnancy is the most effective way to keep blood sugar under control to help milk production. Do not begin an extreme diet that may lead to nutritional deficiencies, but make positive changes to your food choices and even opt to consult a nutritionist who specializes in PCOS.
It is important to remember that breastfeeding decreases blood sugar, which affects other areas of your health. The removal of blood sugar may cause additional sugar cravings, but this is actually the signal that your body needs naturally sweet whole foods like carrots, barley, beets, millet, yams, rice, fruit, and sweet almonds, which also boost milk supply.
While breastfeeding, a woman suffering from PCOS can beat sugar cravings, maintaining steady levels of blood sugar by eating healthy, whole foods every two to three hours. Consuming healthy fats and lean protein every time you eat will help keep blood sugar levels steady.
Women with PCOS are often trying to lose weight, due to their disposition to carry extra weight. Actively trying to lose weight during breastfeeding can very easily damage an already low milk supply. Even a small weight loss can greatly decrease milk supply.
Stress levels have a significant impact on milk production, so stress should be maintained as much as possible. Even if it may seem impossible, take time for yourself away from the baby to rest and enjoy yourself again.
Take up yoga for PCOS, relax in a warm bath, or meditate to help decrease stress levels. Exercising is also a proven way to decrease stress hormones, and this can be done with the baby by taking your baby for a walk or dancing around the house with your baby.
Try as much as possible to sleep when the baby sleeps, and even let the baby sleep in your room so you do not need to get up for middle of the night feedings. Ignore any necessary chores while you have an infant to keep your body working at its optimum potential to produce milk.
Women with PCOS should avoid caffeine, because adrenaline, which is a stress hormone, is stimulated by caffeine. Many women who have suffered with low milk supply report an increse in their supply when their caffeine intake is reduced.
PCOS and Breastfeeding Supplements
Herbal supplements are available to increase milk supply such as fennel, goat’s rue, kale, milk thistle, verbena, chasteberry, and fenugreek. These can safely be taken by a mother to naturally increase milk supply.
Progesterone supplements used during pregnancy can also help to support an adequate supply of milk. Additionally, taking metformin during pregnancy can help support great milk supply in pregnant women with PCOS, and may even support the development of the breasts during pregnancy.
Medications can also be prescribed to help increase milk supply, such as metoclopramide. While this seems like a final resort, it is important to note that giving formula to a baby is also perfectly fine, even though it is not the first recommended method for feeding a baby.
PCOS and Breastfeeding Can Be Successful
Breastfeeding has health benefits for both the mother and the baby that are well-documented by the American Academy of Pediatrics, as well as the World Health Organization. All women, especially those who suffer from PCOS, should feel encouraged to breastfeed and have support available in order to do so successfully.
While it is very important to know of the potentials of PCOS interfering with breastfeeding, it is also just as important to know that women with PCOS are not detined to fail in their breastfeeding journey. Despite having PCOS, many women do not experience issues with their milk supply or have trouble successfully breastfeeding.
PCOS may or may not affect one’s ability to breastfeed. While it may cause a higher chance of having a low milk supply, there are several things you can do to encourage milk production and successfully work through breastfeeding, despite having PCOS.