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It's PCOS Awareness Month in September so I thought it was a good time to share some information about PCOS (Polycystic Ovarian Syndrome) and breastfeeding.  My interest in this topic is two-fold:
<ol>
	<li>Even though I was never diagnosed with PCOS I've had so many of the symptoms I really wondered if I could have PCOS - I really feel for women because it's such a little understood disorder - gosh they <a title="Whats in a Name? There’s more to PCOS than cysts…a lot more!" href="http://www.hormonesoup.com/whats-in-a-name-theres-more-to-pcos-than-cysts-a-lot-more/" target="_blank">can't even agree on a name for it!</a></li>
	<li>I feel so fortunate to have been able to successfully breastfeed my three babies and really consider it one of the great joys of being a mother.</li>
</ol>
So when I came across a research article that talked about PCOS potentially causing a decreased milk supply in breastfeeding moms I knew I had to do some more research and share some information.

Many women with PCOS struggle with infertility, like I did, and it has become one of the most widely addressed issues associated with the disorder.  Infertility is also often the reason women eventually get diagnosed.   But women have to spend so much time and energy researching and pursuing getting pregnant that there can be little room for focusing on what comes after the baby is here.  I know I just remember thinking breastfeeding would be easy - it's nature at it's finest, isn't it?!  But sadly, even women who do ask questions about PCOS and breastfeeding can be given pat reassurances that it won’t be an issue. When possible, the time to educate yourself on the impact of PCOS on breastfeeding is when you start thinking about trying to conceive. Advanced planning has the potential to prevent or minimize problems before you are in the throes of adjusting to life with a newborn or experiencing postpartum mood disorder and also frantically trying to remedy a supply issue.

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I find it interesting that when it comes to PCOS and breastfeeding, women with the disorder are divided almost evenly into three categories:
<ul>
	<li>One third will experience <strong>no issues</strong> at all</li>
	<li>One third will struggle with issues of <strong>oversupply</strong></li>
	<li>One third will experience issues with <strong>decreased milk supply</strong>.</li>
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Because two thirds of all women with PCOS will experience nursing issues, if you want to breastfeed your baby, advance planning is recommended.

I found some great resources and articles about PCOS and breastfeeding on a blog called <a title="Kelly Mom - PCOS &amp; Breastfeeding" href="http://kellymom.com/bf/concerns/mother/pcos/ " target="_blank">KellyMom.com</a> - she is a Lactation Consultant and mother of three.  She shares tons of links and information like this:

According to Lisa Marasco, IBCLC, there are many ways that PCOS can impact breastfeeding. She breaks it down into five points:
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	<li>With PCOS that has its onset in puberty breast tissue may not develop properly due to lack of estrogen. Further breast tissues development takes place during pregnancy, so even when onset is after puberty, breast tissue can be affected.</li>
	<li>Even when women with PCOS have adequate estrogen, elevated levels of androgen hormones can lead to interference with prolactin reaching its receptors.</li>
	<li>During pregnancy, it is possible that not enough receptors will be formed to receive the prolactin that does make it through.</li>
	<li>Many women with PCOS experience insulin resistance. Insulin resistance can play a role in affecting breast growth and milk synthesis.</li>
	<li>Estrogen inhibits lactation. This is why birth control pills aren’t recommended during breastfeeding. In PCOS “estrogen dominance” is common.</li>
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<h1>Optimizing Your Chances for Successful Breastfeeding with PCOS</h1>
The good news is that there are many steps you can take to optimize your chances at having a successful breastfeeding relationship with PCOS. One way of being proactive is to seek help before problems begin. During your pregnancy, connect with a local IBCLC or La Leche League group. You’ll find incredible support and a wealth of information. Other things you can do to assist your body in preparing for breastfeeding include:
<ol>
	<li><strong>Addressing insulin resistance</strong> by going on a low-glycemic diet. Once you begin breastfeeding, you will find that your cravings for sugar increase and this is normal. The body does actually need more sugar while nursing, but it should come from naturally sweet foods like fruit, yams and beets. Eating every two to three hours while nursing will also help your body to regulate blood sugar levels.  I remember feeling like I needed to eat all the time when I was nursing and no wonder - just think about what your body is doing!  With PCOS, being careful about food choice is even more important.</li>
	<li>Incorporate <strong>stress management</strong> techniques into your lifestyle. The importance of this is two-fold. Stress exacerbates PCOS symptoms and it also impacts milk supply. Daily walks, meditation, time alone for a nice bath or other leisurely activity, and journaling are all great ways to keep stress at bay.</li>
	<li><strong>Get SLEEP! </strong> Gee how I wish I had listened to this one!  Sleep is actually more important to our health than we ever realized.  More and more research is coming out about how important sleep is to our overall health.  This is easier said than done with a newborn, but it really is ok to let the housework wait and nap when the baby naps or ask for help or even pay for help if you have trouble asking and can afford it!   In North America we are programmed to believe that new mom's should be running marathons and be back to "doing-it-all" in no time at all - don't buy into that for a second. There's no other time in your life when it is the perfect opportunity to nurture yourself, along with your baby.</li>
	<li>Some <strong>herbal teas</strong> are said to help with milk supply - I'm not an expert but here's some ideas that you could look into:  Goat’s Rue is theorized to help develop glandular tissue, and herbs like dandelion, red raspberry leaf, alfalfa, nettles, and red clover are longtime favorites of mothers trying to boost their milk supply.  As always, check with a practitioner and do your research before you try anything.</li>
	<li>If you need <strong>pharmaceutical assistance</strong> in boosting your milk supply, there are options: both Metformin and Domperidone are used for this purpose.  For more information check out one of the leading experts in the world - his facebook page <a title="Dr. Jack Newman - Facebook" href="https://www.facebook.com/DrJackNewman" target="_blank">Dr. Jack Newman</a> has a lot of information about the safety and efficacy of various drugs while breastfeeding.</li>
	<li>For me, I breastfed <strong>frequently</strong> - yup I felt like a milk machine for a while - because I was worried about developing a milk supply.   And didn't (well tried not to) listen to people who commented, "You're breastfeeding <em>again</em>??!!"  Never mind what other people say - do what's right for you and your baby.  Remember that there's a supply and demand relationship when nursing a baby.</li>
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The good news is that while breastfeeding might be impacted by PCOS, there is a lot you can do to increase your chances of being able to nurse your baby. With adequate support and intervention, most women with PCOS can at least partially breastfeed their babies, and remember if you have your heart set on breastfeeding MOST women with PCOS will be able to breastfeed without supplementation. If, despite your best efforts, you have to supplement your supply, remember that every drop contains powerful nutrients and immune boosting components are still benefitting your baby.  And besides, the time your baby spends at the breast is never wasted, even if it is more about comfort and connection than nourishment.

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