PCOS and Breastfeeding: Tips for Improving Milk Supply

Polycystic Ovary Syndrome (PCOS) is a common hormonal condition that affects many women in their fertility life. Women with PCOS typically have insulin resistance, and the insulin buildup is considered the main cause of developing PCOS [1].

This hormonal imbalance can lead to various symptoms, including irregular menstrual cycles, excess hair growth, acne, and weight gain [2]. PCOS can also lower fertility health and increase the risk of complications during and after first pregnancy. One such complication that women may experience because of PCOS is difficulty with breastfeeding.

In this article, we will explore the association between PCOS and breastfeeding and guide you on how you can overcome breastfeeding challenges to support the growing baby.

PCOS and Female Fertility Health

The World Health Organization (WHO) states that PCOS is one of the leading causes of infertility in women [3]. The condition can disrupt the normal process of ovulation, which is the release of an egg from the ovaries each month. Women with PCOS usually experience irregular menstrual cycles with irregular ovulation patterns.

In addition to causing problems with ovulation, the hormonal imbalance in PCOS can also affect the quality of eggs [4]. This further harms fertility health and reduces the chances of conception, making it important to understand the conception definition and the factors that influence it.

If you are experiencing the symptoms of PCOS or have been diagnosed with this condition, remember that management of this condition is possible through medications and lifestyle modifications. If you are unable to conceive naturally with PCOS, treatment options like assisted reproductive technologies can help.

Breastfeeding and PCOS

Even if a woman overcomes fertility challenges in PCOS and successfully conceives, life after conception and pregnancy can also be challenging. For example, many women with PCOS face problems when breastfeeding.

Studies have shown that PCOS can lower milk production in lactating mothers [5]. The primary reason for this is hormonal imbalance, which interferes with the body’s ability to produce and release milk effectively.

How Hormonal Imbalance in PCOS Impact Breastfeeding?

The two hormones that majorly regulate breast milk production and release are prolactin and oxytocin. Prolactin stimulates milk production in the mammary glands, while oxytocin helps release the milk.

Women with PCOS typically have insulin resistance that results in higher levels of insulin and androgens. A 2021 study shows that insulin resistance can negatively impact prolactin hormone levels in the blood [6]. A 2018 study shows that women with PCOS breastfeeding can have lower oxytocin levels compared to women without PCOS [7].

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These studies explain how PCOS can directly impact the lactation process and harm the breastfeeding capacity of women. PCOS can also indirectly impact lactation by causing obesity. Studies show that obesity has a negative impact on the duration of breastfeeding, and women with increased BMI are less likely to develop successful breastfeeding [8].

How to Overcome Breastfeeding Challenges With PCOS?

It is possible to increase milk production and release for women with PCOS struggling to breastfeed. Here are some tips that can help you improve milk supply:

1. Frequent Nursing: Studies show that frequent stimulation and emptying of the breast can improve milk production [9]. If you are a woman with PCOS struggling with low milk production, you must breastfeed your baby more often to stimulate milk production.
2. Skin-to-Skin Contact: Studies show that touch, gentle pressure, and warmth increase the production of oxytocin [10]. You must increase your skin-to-skin contact with the baby to stimulate oxytocin, improving blood flow.
3. Healthy Lifestyle: Obesity can harm the capacity of breastfeeding, meaning that you need to focus on maintaining a healthy weight to support the lactation process after pregnancy. Physical activities like exercise can help you maintain a healthy weight and promote hormonal balance for effective lactation.
4. Medications and Supplements: Some medications or herbal supplements may help boost milk supply. However, it is important to consult your doctor before taking any such supplements.

Conclusion

PCOS is one of the common health conditions that many women face during their reproductive age. It is a condition that develops mostly due to insulin resistance and raised levels of insulin buildup in the body. PCOS can cause several problems, such as irregular menstrual cycles and weight gain, but one issue that not many women notice is reduced breastfeeding capacity.

The association between PCOS and breastfeeding is because of the hormonal imbalance that occurs in the body due to this condition. PCOS can imbalance hormones like prolactin and oxytocin, which regulate the production and release of milk for breastfeeding.

Resources Used

1. Purwar, A., & Nagpure, S. (2022). Insulin Resistance in Polycystic Ovarian Syndrome. Cureus, 14(10), e30351. https://doi.org/10.7759/cureus.30351 
2. Polycystic Ovary Syndrome (PCOS). (2024, December 2). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/8316-polycystic-ovary-syndrome-pcos 
3. World Health Organization: WHO & World Health Organization: WHO. (2023, June 28). Polycystic ovary syndrome. https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome 
4. Chappell, N. R., Barsky, M., Shah, J., Peavey, M., Yang, L., Sangi-Haghpeykar, H., Gibbons, W., & Blesson, C. S. (2020). Embryos from polycystic ovary syndrome patients with hyperandrogenemia reach morula stage faster than controls. F&S Reports, 1(2), 125–132. https://doi.org/10.1016/j.xfre.2020.05.006 
5. Vanky, E., Isaksen, H., Moen, M. H., & Carlsen, S. M. (2008). Breastfeeding in polycystic ovary syndrome. Acta Obstetricia Et Gynecologica Scandinavica, 87(5), 531–535. https://doi.org/10.1080/00016340802007676 
6. Yang, H., Lin, J., Li, H., Liu, Z., Chen, X., & Chen, Q. (2021). Prolactin Is Associated With Insulin Resistance and Beta-Cell Dysfunction in Infertile Women With Polycystic Ovary Syndrome. Frontiers in Endocrinology, 12. https://doi.org/10.3389/fendo.2021.571229 
7. Jahromi, B. N., Dabbaghmanesh, M. H., Bakhshaie, P., Parsanezhad, M. E., Anvar, Z., Alborzi, M., Zarei, A., & Bakhshaei, M. (2018). Assessment of oxytocin level, glucose metabolism components and cutoff values for oxytocin and anti-mullerian hormone in infertile PCOS women. Taiwanese Journal of Obstetrics and Gynecology, 57(4), 555-559. https://doi.org/10.1016/j.tjog.2018.06.015 
8. Ballesta-Castillejos, A., Gomez-Salgado, J., Rodriguez-Almagro, J., Ortiz-Esquinas, I., & Hernandez-Martinez, A. (2020). Relationship between maternal body mass index with the onset of breastfeeding and its associated problems: an online survey. International Breastfeeding Journal, 15(1). https://doi.org/10.1186/s13006-020-00298-5 
9. Cuya, C. M., Barriga, C., Del Carmen Graf, M., Cardeña, M., Del Pilar Borja, M., Condori, R., Azocar, M., & Cuya, C. (2024). Multisensory stimulation and its effect on breast milk volume production in mothers of premature infants. Frontiers in Pediatrics, 12. https://doi.org/10.3389/fped.2024.1331310 
10. Bigelow, A. E., & Power, M. (2020). Mother–Infant Skin-to-Skin Contact: Short‐ and Long-Term Effects for Mothers and Their Children Born Full-Term. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.01921 

Frequently Asked Questions

Q: Can PCOS affect breastfeeding and milk supply?

A: Yes, PCOS can impact breastfeeding success in several ways. Women with PCOS often experience delayed lactogenesis (the onset of milk production), which typically occurs 2-5 days postpartum but may be delayed in PCOS cases due to insulin resistance and hormonal imbalances. Research indicates that approximately 25-30% of women with PCOS report lower milk supply compared to women without the condition. The insulin resistance associated with PCOS can interfere with prolactin levels and breast tissue development, making it essential to work with a lactation consultant and healthcare provider during this postpartum period.

Q: What supplements or vitamins help increase milk supply with PCOS?

A: Several supplements have shown promise for supporting milk supply in women with PCOS, including inositol (which improves insulin sensitivity), blessed thistle, fenugreek, and omega-3 fatty acids. Inositol is particularly beneficial since insulin resistance is a hallmark of PCOS, and improving insulin function may support lactation hormones. However, it's crucial to consult with your healthcare provider before starting any supplement regimen while breastfeeding. Additionally, maintaining proper nutrition and hydration, along with products designed to support reproductive health like Conceive Plus, can help optimize overall wellness during the postpartum period when transitioning from fertility support to breastfeeding goals.

Q: How soon after delivery do women with PCOS typically produce milk?

A: Women with PCOS may experience a delayed onset of milk production compared to women without the condition. While typical lactogenesis II occurs 2-5 days after delivery, some women with PCOS report delays of one to two weeks or longer due to hormonal disruptions and insufficient glandular tissue development. According to the American College of Obstetricians and Gynecologists (ACOG), early and frequent breast stimulation—ideally within the first hour after birth and at least 8-12 times per day—is critical for women with PCOS to help trigger milk production. Working with a lactation consultant experienced in PCOS can help monitor milk transfer and recommend appropriate interventions during this crucial window.

Q: Does metformin use during breastfeeding help with milk supply in PCOS?

A: Metformin, commonly prescribed to manage PCOS and insulin resistance, is considered safe to use while breastfeeding according to the American Academy of Pediatrics and FDA guidelines. Some studies suggest that managing insulin resistance with metformin may support lactation by stabilizing hormonal levels that influence prolactin and milk production. However, metformin alone is not a guaranteed solution for low milk supply, and it works best as part of a comprehensive approach that includes frequent nursing, proper latch technique, and adequate caloric intake. Discuss with your obstetrician or endocrinologist whether continuing or adjusting metformin during breastfeeding is appropriate for your individual situation.

Q: What are realistic milk supply expectations for women with PCOS?

A: While some women with PCOS produce adequate milk supplies, studies show that about 15-25% experience significant low milk supply (hypogalactia) compared to 5% of women without PCOS. Many women with PCOS can successfully breastfeed with proper support, early intervention, and consistent milk removal through frequent nursing or pumping. Setting realistic expectations—such as combination feeding if necessary—can reduce stress and support mental health during the postpartum period. Working with lactation consultants, endocrinologists, and reproductive health specialists who understand PCOS-related breastfeeding challenges significantly improves outcomes and helps women make informed feeding decisions that work best for their family.