When I was pregnant, one of my main concerns was about PCOS and breastfeeding. I had heard a lot of mixed stories from women about the impact of PCOS on milk supply and it worried me.
I have two children and was not able to breastfeed either of them but that was largely due to very difficult births as opposed to problems with PCOS. Personally, my milk supply was amazing.
So, if you pregnant with PCOS, you may have the same questions about how PCOS will impact on your breastfeeding. Let’s answer some of those for you.
How does PCOS affect breastfeeding?
There is no one definitive answer to this question as every woman experiences PCOS differently. However, the main concern with PCOS and breastfeeding is that the condition can cause a reduction in milk supply. There seem to be a number of reasons for this, which we’ll get into.
PCOS can affect Breast Tissue Development
We know that Polycystic Ovary Syndrome causes a hormonal imbalance with high estrogen levels and lower than normal progesterone levels (progesterone is produced after ovulation). This hormonal imbalance can lead to the development of cysts on the ovaries.
It is thought that this same hormonal imbalance may also impact on the development of breast tissue and breast growth. This could mean that women with PCOS have less developed breast tissue, glandular tissue in particular. Glandular tissue is responsible for the production of breast milk and poorly developed glandular tissue may impact on milk production, resulting in insufficient milk supply (1).
PCOS can cause Insulin Resistance which Impacts Breastfeeding
Insulin resistance is a common symptom of PCOS. Insulin resistance means that the body’s cells are less responsive to the hormone insulin. This can cause a number of problems, one of which is an increase in the levels of androgens (male hormones) in the body.
The high levels of androgens associated with insulin resistance can impact on milk production. Androgens stimulate the production of prolactin (the hormone responsible for milk production). However, high levels of androgens can lead to a decrease in prolactin. This decrease in prolactin can then lead to a low milk supply.
PCOS, Obesity and Breastfeeding
Like me, I am sure that you are well aware of the struggle to lose weight with PCOS. It s one of main symptoms of Polycystic Ovary Syndrome (PCOS). If you’re struggling with weight, you’re not alone.
Some studies suggest that between 38% and 88% of women with PCOS are overweight or obese (2).
- And that has a huge impact on breastfeeding in a number of ways (3):
- Less skin to skin contact at birth
- Delayed milk coming in
- Higher rates of complications during pregnancy and birth which can then impact on breastfeeding.
PCOS can cause Gestational Diabetes which Causes Low Milk Supply
We know that women with PCOS are at increased risk of developing gestational diabetes during pregnancy. Gestational diabetes is a type of diabetes that only occurs during pregnancy and usually goes away after the baby is born.
Gestational diabetes generally develops in the second half of pregnancy when the placenta starts to produce high levels of hormones, which can make the body’s cells less responsive to insulin. This can cause blood sugar levels to become too high.
So what does all of this have to do with breastfeeding? Well, gestational diabetes can cause low milk supply.
Dr. Sarah Riddle conducted a study that found that breastfeeding mothers who had gestational diabetes are 2.4 times more likely to struggle with low milk supply than mothers without diabetes.
Now, just because women with PCOS are “at increased risk for” or there is a “higher incidence of” something, doesn’t mean that you are automatically going to have issues with low milk supply and breastfeeding as a whole.
In fact, the Australian Breastfeeding Association suggest that only about a third of women with PCOS will struggle with milk production and of those, only a third will struggle to produce milk at all.
There are definitely things you can do to improve breastfeeding success with polycystic ovarian syndrome.
Breastfeeding and PCOS – 11 Ways to Improve your Success
Pre-pregnancy Health is Important
We know that women with PCOS can have a harder time getting pregnant than women without PCOS.
And getting your PCOS under control as much as possible before trying to conceive will not only boost your fertility, but will also help to ensure that you are doing everything you can to have a healthy pregnancy.
This will also help to manage insulin levels and may lower your risk of developing gestational diabetes.
Keep Your Blood Sugar Stable During Pregnancy and After Birth
As we have already discussed, gestational diabetes is more common in women with PCOS.
But, even if you don’t develop gestational diabetes, keeping your blood sugar levels stable during pregnancy is important.
There are a few things you can do to help keep your blood sugar levels stable:
- Eat a balanced diet that is high in fiber and low in refined carbs
- Exercise regularly
- Monitor your blood sugar levels
If you are struggling to keep your blood sugar levels stable, speak to your healthcare provider about what options are available to you.
Consider Taking Inositol
Inositol is a type of carbohydrate that is found in fruits, beans, grains, and nuts.
It can also be made in a laboratory.
Inositol is one of the most researched supplements for women with PCOS and it has been shown to help alleviate a number of symptoms. One particular study showed that my-inositol helps to improve insulin sensitivity in pregnant women with PCOS, leading to improved gestational diabetes outcomes (4).
Inositol is also 100% safe to take during pregnancy and breastfeeding.
Eat a Good PCOS Diet to Help Improve Milk Supply
We know that the hormonal imbalance we so often see in PCOS leads to a lot of the nasty symptoms of PCOS. It also know that it can lead to some problems breastfeeding.
So, doing all we can to manage our overall PCOS symptoms can help to improve breastfeeding success.
One of the ways to do this is by following a good PCOS diet. You can find out more about that here.
There are also a number of foods that are especially good for increasing milk supply. These include:
- Oats
- Flaxseed
- Fenugreek
- Brewer’s Yeast
- Garlic
- Ginger
- Fennel
- Cumin
- Anise
- Caraway
You can find a more comprehensive list of galactagogues here.
Get Some Support
Breastfeeding is hard work, there is no doubt about that. But it can be especially challenging when you are dealing with PCOS.
So, make sure you get all the support you can. This might mean joining a breastfeeding support group or seeing a lactation consultant. La Leche League offers breastfeeding support in many countries all over the world.
When I was struggling with breastfeeding, I found a lactation consultant to be invaluable.
Get some exercise during pregnancy
Exercise is important for all women during pregnancy, but it is especially important for women with PCOS.
Exercise can help to lower insulin levels and improve blood sugar control (5).
It can also help to reduce stress levels , which can be helpful in managing the symptoms of Polycystic Ovary Syndrome (PCOS).
So, aim to get 30 minutes of moderate exercise most days of the week. Walking, swimming, and cycling are all great options.
And, if you were regularly exercising before you got pregnant, you can continue doing whatever it is that you enjoy, just be sure to listen to your body and modify as needed.
Breastfeed on Demand to Make more Breast Milk
As a new mom, you would have been given advice from every body and their dog. One of the things you may have heard is that routine is important and you may be reluctant to allow your little on to feed on demand.
But, this is one of the best ways to increase your milk supply.
When your baby is born, their stomach is only the size of a marble. So, they can only take in small amounts of milk at each feeding.
As they grow, their stomach will expand and they will be able to take in more milk at each feeding.
But, in the early days, frequent, small feedings are important to help stimulate your body to make more milk.
So, don’t worry about getting into a set feeding schedule, just let your baby breastfeed on demand.
And, if you are worried that your baby is not getting enough milk, ask your healthcare provider or a lactation consultant for help.
Make Sure You are Getting Enough fluids
When you are breastfeeding, it is important to make sure that you are getting enough fluids.
You need to drink water, juice, and milk to stay hydrated.
But, it is also important to limit caffeine as it can dry up your breast milk.
So, aim for 8-10 glasses of fluids per day, and limit caffeine to 2 cups of coffee or tea per day.
Consider pumping to Increase Milk Supply
If you are struggling with low milk supply, you may want to consider pumping.
Pumping can help to increase milk production, and is a great option if you are returning to work or want to have a freezer stash of breast milk.
To increase milk production, pump after breastfeeding or every 2-3 hours during the day.
Start with 5 minutes on each side and then increase the time as you are able.
See a Doctor about your Breastfeeding Struggles
Medical professionals are an important member of your PCOS management team. If you feel that the hormonal disruption caused by PCOS is impacting on your ability to breastfeed, then see your doctor.
They may be able to prescribe medication to help with milk production or refer you to a lactation consultant.
There is No Guilt or Shame
I had really difficult births with both of my children which lead to various medical problems (Not PCOS related). This, together with my PCOS, made breastfeeding very, very difficult.
I felt such pressure to breastfeed and when I struggled so much, I felt guilty.
When my daughter was born, she didn’t breathe for 15 minutes and suffered some brain trauma. This really helped me put the whole breastfeeding thing into perspective.
At the end of the day, the most important thing for your baby is that they are loved and well-nourished (even if it is using formula).
We all know that breastfeeding is best for your baby but if you are not able to breastfeed because of PCOS or for any other reason, you do not have to feel guilty (mom guilt starts early!)
Summing it Up
Breastfeeding can be a challenge, but it is possible to breastfeed successfully when you have PCOS.
Get some support, exercise during pregnancy, breastfeed on demand, make sure you are getting enough fluids, and consider pumping to increase milk production.
And, if you are struggling, see a doctor about your breastfeeding challenges.
With the right support and management, you can successfully breastfeed your baby with PCOS.
Do you have any other tips for breastfeeding with PCOS? Share them in the comments below!
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References:
1Marasco, L., Marmet, C., & Shell, E. (2000, May 1). Polycystic ovary syndrome: a connection to insufficient milk supply? – PubMed. PubMed; pubmed.ncbi.nlm.nih.gov. https://pubmed.ncbi.nlm.nih.gov/11153345/.
2Naderpoor, N., Shorakae, S., Joham, A., & Boyle, J. (2015, March 1). Obesity and polycystic ovary syndrome – PubMed. PubMed; pubmed.ncbi.nlm.nih.gov. https://pubmed.ncbi.nlm.nih.gov/25411807/
3Ballesta-Castillejos, A., Gomez-Salgado, J., Rodriguez-Almagro, J., Ortiz-Esquinas, I., & Hernandez-Martinez, A. (2020, June 15). Relationship between maternal body mass index with the onset of breastfeeding and its associated problems: an online survey – International Breastfeeding Journal. BioMed Central; internationalbreastfeedingjournal.biomedcentral.com. https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/s13006-020-00298-5
4Tahir, F., & Majid, Z. (2019, September 16). Cureus | Inositol Supplementation in the Prevention of Gestational Diabetes Mellitus. Inositol Supplementation in the Prevention of Gestational Diabetes Mellitus; www.cureus.com. https://www.cureus.com/articles/22975
5Venkatasamy, V., Pericherla, S., Manthuruthil, S., Mishra, S., & Hanno, R. (2013, August 1). Effect of Physical activity on Insulin Resistance, Inflammation and Oxidative Stress in Diabetes Mellitus – PMC. PubMed Central (PMC); www.ncbi.nlm.nih.gov. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3782965/#
6Moghetti, P., Castello, R., Negri, C., & Perone, F. (2000, January 1). Metformin effects on clinical features, endocrine and metabolic profiles, and insulin sensitivity in polycystic ovary syndrome: a randomized, double-blind, placebo-controlled 6-month trial, followed by open, long-term clinical evaluation – PubMed. PubMed; pubmed.ncbi.nlm.nih.gov. https://pubmed.ncbi.nlm.nih.gov/10634377/
