What is polycystic ovarian syndrome?
Polycystic ovarian syndrome (PCOS) is a complex hormonal condition that affects 5% to 10% of women of reproductive age. Features of PCOS can include fertility problems, acne, obesity, excess body hair growth and an increased risk of developing type 2 diabetes.
PCOS and milk supply
Little research has been done on PCOS in relation to breastfeeding. A possible connection between PCOS and a low milk supply was initially presented in a case study in 2000 of 3 mothers with PCOS who also had low milk supply. It is thought that PCOS may possibly interfere with the hormones required for the breast to develop milk-producing tissue.
In 2008, a study of 36 mothers with PCOS and 99 mothers without PCOS concluded that mothers with PCOS appear to have a reduced breastfeeding rate in the early postnatal period as compared to mothers without PCOS. By 3 months however, breastfeeding rates were equal between mothers with and without PCOS. The researchers in this study also found a possible negative link between ‘pre-androgen’ hormone levels in PCOS mothers and breastfeeding rates. This may provide a possible reason why some mothers with PCOS have problems with low milk supply.
However, it is important to know that many mothers with PCOS have no problem with milk supply and breastfeed successfully. More studies are needed before any connection between PCOS and breastfeeding can be confidently stated.
Importance of breastfeeding for mothers with PCOS
Women with PCOS have an increased risk of developing type 2 diabetes, later in life. As well, babies born to mothers with PCOS have an increased genetic risk of developing type 2 diabetes. Since breastfeeding helps to protect a mother and her baby from developing type 2 diabetes later in life, this makes breastfeeding for a mother with PCOS of particular importance.
Breast changes during pregnancy
Many mothers notice that their breasts change in the following ways during pregnancy to prepare for breastfeeding:
- Early breast tenderness is common and is often the first sign of pregnancy for many women.
- Some mothers notice darkening in colour of their areola/nipple.
- ‘Bumps’ around the areola (called Montgomery’s glands) typically get bigger. These glands make a fluid which helps to keep the areola and nipple supple and also helps to get rid of germs.
- Breasts increase in size. When this occurs varies from woman to woman, but most women by the end of their pregnancy have noticed some breast growth.
- Breasts start producing colostrum (the first milk that the breasts make). Some women can express tiny amounts of this anywhere from 16 weeks of pregnancy, while others don’t notice it at all until after their baby is born.
These changes indicate that your breasts are developing well for breastfeeding. If you haven’t noticed any of these changes you may wish to consult your medical adviser or lactation consultant.
What can be done to maximise breastfeeding success?
Whether a mother has a concern about her ability to make milk or not, there are steps that can be taken to maximise her potential to breastfeed. This could include seeking guidance from a lactation consultant or medical adviser.
Part of this guidance may include taking steps to use non-medical options for pain relief during labour (eg TENS, hypnotherapy, water, massage, heat packs, focused breathing); being in skin-to-skin contact with your baby without delay after birth, followed by 24-hour rooming in with your baby; demand feeding your baby ensuring optimal positioning and attachment avoiding supplementation unless clinically indicated; and avoiding artificial teats and dummies.
Mothers who have problems with low supply may find it helpful to speak with their medical adviser about the use of certain medications which may help to maximise milk supply. Depending on the individual situation, some medical advisers might use a galactogogue to help maximise supply.
Mothers who have ongoing problems with low milk supply may find it helpful to use a breastfeeding supplementer, which allows a baby to receive any necessary supplementary milk while still feeding at the breast.