Breasfeeding and PCOS - did anyone struggle to bf DC1 but manage with their second?

[Benjy]

I have PCOS and conceived DD after treatment with Clomid. She was born last July. I wanted very much to BF her but my breasts never increased in size, never got hard and my milk never came in.

DD had a good latch but would suck for a very short while - no more than a minute - and then either fall asleep or break off. As her latch was good (it didn't hurt, her jaw was moving well, latch was checked by midwives and health visitors) I imagine she just wasn't getting any reward for her effort.

I saw a couple of GPs about the problems I was experiencing and neither offered any reason for low milk supply nor offered my any treatment. I have since discovered from another thread on this site and Kellymom that 30% of women with PCOS experience this problem and that a drug called domperidone can be prescribed to increase milk supply.

I am pregnant with DC2 and I desperately want to be able to breastfeed this time. My breasts are not increasing in size again so I am worried I might experience the same problems. My midwife has referred me to a breastfeeding nurse for help before the birth. I also plan to see my consultant and GP before the birth and would like to be able to give them as much information about the link between PCOS and low milk supply in some women so I can get a prescription for domperidone if I need it. Does anyone have any more information other than the links I've already posted?

I am having a caesarean this time, which I know is likely to make it harder. The hospital staff added to my difficulties last time by encouraging me to supplement with formula as DD wasn't feeding at all (I was still latching her on to stimulate milk supply). I don't want to do that this time as I now know it is not unusual for babies not to feed shortly after birth but I don't know for how long it is safe to allow this to go on before I should supplement for baby's sake. Does anyone know?

I would also be interested in hearing from any women who had these problems with their first DC but managed to BF their second.

I know this is long, sorry. I wanted to fit in everything that might be relevant.

Congratulations on wanting to breastfeed and for persevering. I always felt I wasn't producing enough milk, I was told to rest and eat more. But I found making sure I took in plenty of liquid before bfing really helpful even though no one told me this. If you have large smoothies made with bananas and honey you'll produce milk for England. In fact any milkshake will do well (or equivalent).

Try expressing too, even if it's hard at first.Practice makes perfect but you need to be warm and relaxed. (sometimes it's easier by hand than a machine)You can increase your supply this way, and freeze any extras.

Do you have to have a c section? 2nd natural births are always easier and quicker. I don't know any one who has successfully bfed after having one.

I would say don't completely rule out formula (or expressed milk in a bottle)as a top up in the eves only, I did that and successfully bfed for one year, just topping him up once in the eves. Good luck!

Hi - no experience of PCOS but had a similar experience without. Had a myriad of problems but amongst them was a major latch problems which meant supply wasn't stimulated and just seemed to come and go. Whole experience was very traumatic and painful and was dreading it second time round (and posted here for help). This time has been completely different. The first few weeks were still hard but in a manageable way and by about 6 weeks things had settled right down, by 8 it was fairly easy, now at nearly 4 months I don't think about and although I have never grown to love it its definately no problem. Not all of these might be relevant Things that helped were..

1. Having a different baby! For most people there is no reason to believe that problems will occur again (although I don't know anything about PCOS). I didn't believe this till I experienced the difference between a nightmare experience and a 'normal' hard but doable experience.

1. Used Lansinoh from the very first feed. It is miracle stuff and I only had soreness on days 4 and 5 and after that the odd bit ocassionally for the first 4 weeks but never really agonising.

1. Taking each day at a time, then weeks etc. My goals were daily for the first 2 weeks, then it became 3 weeks, 4 weeks, 6 weeks, 8 weeks - no need for goals after that!! Everyone will tell you this and I was cynical about how it worked but it does, although perhaps a more subconscious approach rather than active thought process when you set out.

1. Some people will strongly disagree with me for this but I used the very odd bottle of formula in the first few weeks. Not in the first week and never more than 1 in a 24 hour period and only when I really felt I was on the verge of giving up. It gave me the odd evening off to regain my sanity and in my personal circumstances I think this kept me going. It caused no supply difficulties even though I have never had a bountiful supply - no more than's needed, I never had a leak in my life until now when DS2 is starting to sleep through. I think the last bottle he had was around 5 weeks. Eventually I was just taking an 'emergency' bottle to bed with me (he was a very very slow feeder) and realised I hadn't used it in a week.

1. Listen when people tell you it does get better. The first weeks are hard work, prepare yourself for that but know that gradually the period between feeds at night will lengthen, the feeds will get shorter - it still amazes me now that a bf can last 15 minutes which is quicker than DS1 sunk a bottle at this age! Try andimagine yourself at 3 months and think how you will feel.

1. Relax - I felt so much pressure first time round but this time I looked at my beautiful strong DS1 and reminded myself if it didn't work out then formula is simply not poison and for some babies people it is a godsend and in some medical situations a lifesaver. BF'ing is just another part of parenting and in every area most of us will strive to do what is best but no-one will succeed to optimise every single part of parenting. The guilt I felt first time round was agonising until I gained some perspective further away from the birth and seeing BF'ing in a different way helped me relax and succeed. However this may just be my own psychological response, others may need a more black and white approach for motivation.

Hope this helps in some way. Good luck, I hope it goes well

oh also tell all of your hospital m/wives before the birth that even though you are 2nd timer you lack confidence b'fing and need help and also any midwife that looks after you post birth and at home. Ask nicely but be firm with yourself about making sure you get the help you need. Made a world of difference to me as I can tend towards being over accommodating to others (busy midwives, dont want to be any trouble etc)

SOrry for multiple posts I just realised although i went on and on about what made me continue breastfeeding I didn't explain why I answered your posts! I mentioned I've never had a bountiful supply this time around but DS2 was a very sleepy baby and only sucked for a very short time at first. This made it very hard work as I had to feed constantly to get my supply up - I actually agreed to be hospitalised for one night so feeding could be monitered as there were concerns about weight gain. All seems a bit of a blur now and can't believe I forgot but that is why I needed to really work at continuing.

SOrry should have left well alone!

hi, i have PCOS and failed (in my eyes) to bf ds1, but am still bf ds2 at 15mo.

i am not sure if there is much good evidence on PCOS=bf problems when i looked last, but certainly anecdotally it seems common.

recent thread with lots of posters saying their breasts didn't increase in size in preg etc but still plenty of milk and success in feeding their lo. (title something like my boobs don't work and crap). and i'm sure there are lots of women who have bf after a C section. in fact i have several friends that have, 1 bf for 18months.

could you see a bf counsellor (eg NCT, BfN, ABM) before the birth? not sure what bf nurse means, might mean nurse with a brief course in bf. or might mean fantastic lactation consultant.

i totally agree with peppermint pig points 1-3. I had 2 weeks as my bf goal with ds2. then 3 weeks etc.

some women can use occasion or regular formula with no detrimental effect on bf, but for others it may cause the baby to prefer the ease of feeding from the bottle and/or supply issues for mum. If may not have helped you with your dc1 as you say.

i found expressing such a depressing experience with ds1, all that effort for tiny amounts, that i didn't bother with ds2 and that took the pressure off me a bit. it is not representative of how much milk the baby is getting and all the faff of sterilising was another task i didn't need. however it might help if your milk i slow at coming in; another friend of mine expressed for 7 days before finally her milk came in and she then bf fabulously for 6 months (had the biggest baby i have ever seen! and she had a c section.)

you may have had enough supply but a slow let down, and a sleepy baby. this time you may have a more alert baby who will persist sucking and get the let down and the milk. i have heard relaxation techniques may help with let down, lots of skin to skin contact, co-bathing and co-sleeping (even if just for naps in the day) and having a certain place you feed, so when you sit in that chair your body is already preparing to let down. and lots of rest and good food for you. doesn't help SUPPLY but i think it helped my LET-DOWN. mine is ridiculously slow, but i have persevered and we have both learnt patience. well sometimes!

you might also like to look at a nursing supplementer (google it) for top ups if required.

well done for wanting to bf again, that is brilliant, and all the best with it.

Thank you for giving me such full replies.

PCOS raises circulating levels of testosterone in the blood and it is thought that these increased levels of male hormone can interfere with the formation of glandular breast cells during puberty. So some adult women with PCOS have fewer milk producing cells in their breasts than the average woman; they produce the most they can but it is not enough to meet the needs of their baby. It is estimated that 30% of women with PCOS have this problem; the rest produce an adequate or even an over-supply of milk so if anyone else with PCOS is reading this thread it does not follow that you will have problems breastfeeding too. It is certainly worth having a go if that's what you want to do.

Peppermintpig, thanks for the points you made. I'm really glad it worked out for you a second time. Hopefully it will for me too.

Weasle, I have the name and number of my local NCT BF cousellor so I will ring her soon and try and arrange some support after the birth. I am also thinking of hiring a lactation consultant if I can afford to. Thanks for the supplement suggestion. I will probably buy one so if I have to feed formula again it doesn't necessarily mean the end of breastfeeding. I did express by hand and used a medela swing pump but only got a few drops each time I tried. It didn't increase my supply. Midwives checked my technique; in fact one had a go for me (with my agreement!) but couldn't get anything either. I hope this time it's different.