Congratulations on your new baby! You’re most likely having visitors, taking phone calls from excited friends and relatives, and maybe even taking care of another child. If you’ve chosen to breastfeed your baby, breastfeeding may be a new priority with its own questions and challenges. If you are among the 1 in 10 women who have polycystic ovary syndrome (PCOS), you may have even more questions about how PCOS and breastfeeding are related.
In this article, we share interesting information about PCOS and breastfeeding. Then, we share four strategies for helping to transition into your busy new lifestyle.
PCOS and Breastfeeding 101
The main concern with PCOS and breastfeeding is an undersupply of milk. Unfortunately, we don’t know the exact reason why women with PCOS may experience a low milk supply. More than likely, however, it has to do with the hormonal imbalances associated with PCOS.
The two hormones that are directly connected to breastfeeding are prolactin and oxytocin. Many women with PCOS have higher levels of androgen hormones, such as testosterone. These androgen hormones can interfere with the way prolactin works in the body, leading to a lower milk supply during breastfeeding.
Insulin Resistance and Breastfeeding
Insulin is a hormone that controls blood sugar levels. Up to 70% of women with PCOS have insulin resistance, meaning that their cells are resistant to insulin and do not efficiently absorb glucose (sugar) from the bloodstream. Therefore, an insulin resistant person produces more insulin to help process glucose.
Women with insulin resistance are more likely to have a low milk supply. When a mother is insulin resistant, a particular gene is expressed more prominently than in others. The prominence of this gene in insulin-resistant women suggests a relationship between insulin resistance and insufficient milk supply.
Strategies to Help with PCOS and Breastfeeding
Breastfeeding can be a challenge, even if you don’t have PCOS. Some of the following strategies can help all new moms establish a good breastfeeding relationship with their little ones, while others apply more directly to women with PCOS.
1. See a lactation consultant.
With the support of a lactation consultant, you can get some help to overcome these initial breastfeeding challenges. Management of lactation challenges early can have a significant influence on milk supply. Lactation consultants can help your baby achieve an effective latch, and this is often one of the main concerns new moms have with breastfeeding.
Lactation consultants can also help with low milk supply. Some women with a low milk supply choose to supplement their milk supply, and there are ways to do this while continuing to nurse your baby.
Look for a lactation consultant who is board certified by the International Board of Lactation Consultant Examiners. Board-certified lactation consultants have the acronym “IBCLC” after their name. These health professionals can work in hospitals or private practices, and some will make home visits.
2. Exercise appropriately.
Fitting in exercise and losing the excess baby weight can be a major concern of new moms anywhere. Once you get the OK from your healthcare professional, you can try to plan your exercise and healthy eating around your new schedule.
There are many exercises you can do at home. Try to plan your at-home activity for when the baby is sleeping. If you prefer a gym workout, see if you can find a gym that offers child care for your baby once he is old enough. Some fitness centers accept babies as young as 6 or 8 weeks old, and others begin at age six months.
Another excellent option for new moms, when the weather cooperates, is to take a daily walk with your baby in a stroller or carrier. This not only allows you some exercise and time out, but it may also be beneficial for your baby. Spending time outdoors provides sensory stimulation and can potentially boost immunity and help establish good sleep patterns.
Some health experts say that nursing moms can safely include up to four 45-minute aerobic exercise sessions per week. Many experts agree that regular exercise does not affect the quantity or quality of breastmilk produced even at a high intensity.
You’ll want to know how to fit in your nursing around your exercise too. It’s recommended to feed your child or pump right before exercise, mostly for your comfort, and wait one hour after exercise to pump or feed your child. Regular exercise does not appear to affect the nursing mom’s supply of breast milk.
3. Lose weight at your own pace.
Women with PCOS may have hyperinsulinemia, abnormally high levels of insulin, which is a hormone that controls blood sugar levels. This continuous high level of insulin can lead to weight gain. Add this to post-pregnancy weight, and you may be feeling very motivated to get started on losing weight. Keep in mind that health professionals recommend trying to lose no more than 1-2 pounds per week while nursing.
The good news is that breastfeeding may help you lose weight. Most women can expect milk production to burn about 500 calories per day. If you’re sedentary, you require approximately 1800 – 2000 calories per day, if you’re moderately active you require approximately 2000 – 2200 calories, and if you’re active, you require approximately 2200 – 2400 calories per day postpartum. (Check out your exercise intensity here.) Keep in mind that nursing moms shouldn’t consume less than 1500 calories per day.
Controlling calorie intake to achieve weight loss is not recommended in the first month. After that, a weight loss of 1-2 pounds per month should not affect milk volume for nursing moms.
You may be eager to start getting in shape after delivery, but always be sure to get cleared by your health professional to exercise. The same goes for limiting your calorie intake since you’ll need to eat healthfully to supply enough nutrients to your baby and maintain a good milk supply.
4. Take a high-quality postnatal supplement.
Health professionals often recommend a postnatal supplement, including vitamin D and choline to support an increased need for these nutrients during breastfeeding.
Vitamin D is important for your baby’s overall growth and development. Breast milk is generally too low in vitamin D to meet your baby’s vitamin D requirements. Most women do not get enough vitamin D from food and are not exposed to adequate sunlight daily. Therefore, their breast milk doesn’t contain the amount of vitamin D recommended for their baby.
As a nursing mom, it’s important for you or your baby to supplement with enough vitamin D each day to meet your baby’s needs.
The American Academy of Pediatrics recommends giving breastfed babies 400 IU of infant vitamin D drops each day. One problem with this recommendation is that for many moms, giving vitamin D drops is difficult. Most babies do not like the taste of the drops and refuse them by mouth, and some babies still do not like that taste even when mixed into a bottle of breast milk. Also, these drops are not independently tested for content accuracy and purity.
Research has shown that less than 20% of families adhere to the recommendation to give vitamin D drops each day. This low compliance rate increases the risk of vitamin D deficiency in their babies.
As this What to Expect article explains, half of breastfeeding moms were not giving their babies vitamin D drops. A recent study asked breastfeeding moms about vitamin D supplementation, and over 85% reported that they would prefer to take a supplement themselves.
During breastfeeding, your requirement for choline is 550 mg daily. Choline supports your baby’s healthy brain development. Health experts recommend 100-300 mg in your lactation supplement because hardly anyone gets enough of this crucial nutrient through diet alone. While you’re nursing, it’s wise to eat choline-rich foods in addition to your supplement. Eggs are a terrific source of choline. One large egg supplies 147 mg choline. Choline is also in chicken, cod, wheat germ, and kidney beans.
Consider taking a supplement to supply you and your baby with these nutrients for good health.
This is a busy time, but it is so enjoyable too! There will be days when the baby is fussy, and you can’t squeeze in time to exercise, and there will also be days when you want to sleep when the baby is sleeping. Remember to be kind to yourself. Be sure to give yourself time to adjust and time to enjoy this new lifestyle.
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