Wednesday, 16 November 2011

PCOS and Breastfeeding

"There are several different ways that PCOS could potentially interfere with lactation. Breast development largely occurs during puberty and pregnancy as the result of estrogen, progesterone, and during pregnancy, prolactin. Estrogen mediates ductal growth, while progesterone mediates alveolar growth. It is well known that many if not all PCOS women are deficient in progesterone; depending upon the onset of PCOS, there is a hypothetical potential for disruption of alveolar growth during adolescence, not to mention during pregnancy. A recent case study in the Journal of Human Lactation noted a mother who was diagnosed with lactation failure due to insufficient mammary tissue who developed more breast tissue with her second successful pregnancy after treatment of secondary infertility with pre- and post-conception progesterone therapy; she went on to produce a full supply of milk. This case seems to lend credence to the progesterone deficiency theory.

In addition to the progesterone contribution to breast development, there are also the hormones estrogen and prolactin. While estrogen levels can be high in the peripheral tissues of some PCOS women, it has also been noted that androgens, which are generally high with PCOS, can down-regulate both estrogen and prolactin receptors. In essence, a woman could produce enough hormones but not have enough receptors to utilize them, thus limiting their influence upon breast tissue.

Another level of potential disruption lies in the lactation process itself. It is believed that the drop in progesterone at parturition serves to initiate production of mature milk. As this occurs, a process takes over which is driven by two major hormones, prolactin (affects production) and oxytocin (affects delivery). Prolactin receptors begin to develop during pregnancy, and then continue to multiply during the early postpartum period in proportion to the frequency of nipple stimulation. If receptor development was inhibited, the effectiveness of the circulating hormone would be diminished, thus limiting milk production.

Estrogen is a known inhibitor of milk production, especially in the early postpartum period. If the receptors are not down-regulated and the circulating estrogen levels are high, this too could potentially disrupt lactation.

Insulin also plays a vital, though less well-known, role in milk production. Women with uncontrolled diabetes mellitus will not make enough milk. Given this fact, what might be the effect of insulin resistance, which appears to be a significant factor in PCOS, upon lactation? The breast is a sensitive target organ for insulin; if insulin cannot be taken in quickly and efficiently enough, this too could hypothetically cause lactation problems."

Read full interview here:


It never ends, does it? You overcome one challenge and there's another one possibly lurking around the corner


Aluta continua!

No comments:

Post a Comment