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Thread: Could this indicate a problem?

  1. #1

    Default Could this indicate a problem?

    Hello, I am 21 weeks pregnant with my first child. I am very much dedicated to and looking forward to nursing him for as long as he wants to, but I am starting to worry that I may have trouble with it. I have PCOS and just found information on the forums about how many women with PCOS struggle with a low milk supply. I know my mother and sister both have, although I don't know for sure if they have PCOS (though I think it is likely). My breasts have always been pretty small (between an A and B cup, I would say, and I have wondered for a few years if that could be because of hormonal issues when they were developing. I'm concerned that what is there is just fat and underdeveloped mammary tissue. Since I got pregnant, I have been expecting (according to what I read in all the pregnancy literature) that my breasts would grow, but so far they haven't at all (I think my areolas have though - TMI, but I don't know if it's a good indicator or not). My latest 21-week update said to even expect some leakage. Is it a bad sign that my breasts have not grown at all? I'm not trying to borrow trouble here and have unnecessary worry, but at the same time, I really do not want to give my son formula, and if there is anything I can be doing now to help or things I could have prepared to start taking after birth, I would like to just be prepared emotionally and practically for potential problems so I don't get overwhelmed in the post-partum period. Any input or advice is greatly appreciated. Thanks!

  2. #2
    Join Date
    May 2006
    Posts
    20,998

    Default Re: Could this indicate a problem?

    Welcome to the forum and congratulations on your pregnancy!

    The always reliable kellymom.com has a page on PCOS: http://kellymom.com/bf/concerns/mother/pcos/. I'd definitely look through those links.

    My understanding is that about 70% of women with PCOS experience either normal supply or oversupply. So if you believe those dimly remembered statistics, your chances of having plenty of milk are excellent.

    Breast growth isn't something that happens to all moms. A lot of changes in breast size are related to weight gain, and if you haven't gained much weight you might not see much expansion in your cup size. If you're experiencing other changes in your breasts- tenderness, soreness, changes in your nipples and areolas- those are good indications that your breasts are changing in pro-breastfeeding ways.

    Not all moms have colostrum leakage. Colostrum starts to be produced in small amounts starting around the beginning of the second trimester. But that doesn't mean you're going to see it. Some moms leak a lot, some very little or not at all. I personally never saw any evidence of colostrum until the third trimester, and then it was just a very occasional, very scanty crust of dried colostrum.

    You definitely don't want to borrow trouble at this point. But it's great that you want to be proactive about getting breastfeeding going right, so here are some things you can do to improve your chances of breastfeeding successfully.
    - Go to a La Leche League meeting. This is a great way to meet other moms and moms-to-be, and also to get a sense of resources in your area. The moms and leader(s) can give you the skinny on what to expect at the hospital (if you're planning a hospital birth), will likely know the lactation consultants in your area, and can suggest breastfeeding-friendly pediatricians.
    - Find a lactation consultant, preferably an IBCLC, and call her up. If you run into problems after your baby is born, you want to bring her in ASAP.
    - Fill up your freezer with heat and serve meals. You're not going to have time to cook once your baby arrives.
    - Strive for the best birth possible. Breastfeeding usually gets off to the best start when both mom and baby are healthy and strong after birth.
    - Avoid induction of labor unless it is medically necessary. Induced labors are typically more painful and require more interventions than spontaneous labors, including interventions like instrumental delivery and c-section which can complicate breastfeeding.
    - Be informed about your labor pain relief options. In particular, narcotic pain relievers cross the placenta and can result in babies being born sleepy and unwilling to nurse. But even epidurals have potential complications, like maternal fever which will necessitate a trip to the NICU for the baby as the fever is indistinguishable from infection. This is not to say you have to have an all-natural birth. Rather, it is to say "know your options, know the potential complications, and choose carefully among them".
    - When your baby is born, assuming everyone is healthy, have your baby placed immediately on your bare chest. This is the best place for your baby to warm up, and most babies will nurse within a few minutes of birth if given the opportunity to do so. And nursing will help your body expel the placenta and will reduce postpartum blood loss.
    - Delay all routine newborn procedures (weighing, measuring, footprints, bath, eye ointment, etc.) for at least an hour following birth, giving you and your baby a chance to nurse and bond.
    - Room in with your baby. You'll nurse more often and learn his nursing cues faster, and there will be less chance that a "helpful" nurse will give your baby a bottle or a pacifier in order to let you rest.
    - If you decide to send your baby to the nursery- and I want to emphasize that this is a CHOICE that is not the hospital's but yours- make a sign for his bassinet that says "I am a breastfed baby. No bottles or pacifiers please. Bring me to my mom as soon as I show hunger signs, or every 2 hours if I don't."
    - Nurse on demand, unless you have a sleepy or non-demanding baby. Non-demanding babies should be proactively woken to nurse every 2-3 hours.
    - Do not limit the baby's time at the breast. Some people will tell you that 10 minutes per side is "enough", but that is not true; feeding times vary widely even at the earliest ages.
    - Allow your baby to "finish the first breast first", then offer the second breast when he finishes the first one. If he still seems hungry after unlimited time at the second breast, swap him back to the first one.
    - If nursing is very painful, ask for immediate help with positioning and baby's latch. (This is where the IBCLC's phone number may come in very handy, as many hospitals do not have highly trained lactation consultants on staff.)
    - If the hospital offers you a formula gift bag, don't take it, and don't keep a "just in case" can of formula in your house.
    - When you go home, surround yourself with helpful people. Your visitors should cook, clean, obtain takeout, walk your dog, sweep your floor, do your laundry, etc. They should not be entertained or fed by you, feed the baby with a bottle, or say anything negative about breastfeeding or your efforts to breastfeed.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3
    Join Date
    Aug 2013
    Posts
    42

    Default Re: Could this indicate a problem?

    this is so helpful. my sister is 31weeks pregnant now and she has also PCOS. she wants to nurse her baby as soon as she arrives but worrying a lot if she can make more milk because of her condition. she must read this too for encouragement. thanks a lot..

  4. #4
    Join Date
    Jun 2009
    Posts
    5,472

    Default Re: Could this indicate a problem?

    I will add to mommal’s list a recommendation to get & read the books The Womanly Art of Breastfeeding (8th edition) and, if you want more info specifically about milk production, the book Making More Milk.

  5. #5

    Default Re: Could this indicate a problem?

    Thank you so much for the reassurance and recommendations! I think I will try to see if there is a La Leche League group nearby. I didn't know that women went before they had kids!

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