A self case study on Metformin use in pregnancy and lactation outcome.
History: 35 year old female on 4th pregnancy with 2 living children. Previous low supply with undiagnosed cause. Child #1 needed 400 ml supplement daily (while using at breast supplementing device), child #2 needed 300ml/day. Child #2 was treated for ULT and PTT and mother did herbal regimen (including alfalfa, goat’s rue and others) during and after pregnancy with minimal improvement.
Lots of previous trouble losing weight. Prior to starting metformin normal but slightly high cholesterol, triglycerides and sugars. Always passed glucose tolerance tests. Started metformin (1500mg) when child #2 was 3-4 months old (approximately February 2013). Weight 110-115kg (lost 5kg by cutting down on carbohydrates).
Over the next year lost over 30 kg with minimal diet changes. Increased metformin dose to 2500mg/day.
Maintained this dosage throughout pregnancy.
Things I noticed during pregnancy:
Breast growth from 106cm at 5 weeks to 122cm at 39+2 weeks (delivery day). On day 9 postpartum breasts were 126cm in circumference, but have since reduced to 122 cm.
Significantly noticeable darkening of areolas during pregnancy. In previous pregnancy were only slightly darkened. Darkening faded somewhat toward 38-39 weeks.
Weight gain was slowed from previous pregnancies. Not much gain until 10+ weeks (previously up to 5kg gain in first trimester) and 15kg gain overall. Not ideal, but much reduced from 20-30kg gains experienced in past.
Morning sickness was lessened from previous pregnancies (all same sex), with much less vomiting and reduced queasiness.
Birth was elective c- section (previous two births were urgent/unplanned c-sections while in labour).
Overall summary and observations:
Baby gaining 100g+ weight per week from end of week 1 to week 6. Feeding, eliminating normally. Growth slow. Supply may be a bit low, but also have genetics for petite slow gaining babies as on demand supplementation hasn’t led to huge gains in the past.
This result required no pumping or other heroic measures. Just putting baby to breast on a 2-3 hourly schedule.
370g loss from birth to day 6, different scale variation at play as well. 700 g total gain by 6 weeks of age on the same scale.
Feel that metformin has made a noticeable difference in various ways.
Tongue tie was less significant and more easily corrected (75% anterior with thin membrane and little submucosal anchoring as opposed to two primarily submucosal ties in other children)
Adequate milk supply for the first time across 3 live pregnancies
Food intolerances are lessened. Past babies had intolerances to brassica family vegetables (including mustard for one baby), gluten, citrus, tomato, garlic, onion and possibly other things. Only minor irritation observed in baby from onion and tomato (excess gas).
Weight gain was less- 15kg gained as opposed to 30kg and 20kg with other two pregnancies.
Colostrum was clear in previous two pregnancies, but was golden yellow for this one, though there were clear times. This may also be related to breastfeeding child #2 at least once 1-2 weekly until 38 weeks pregnant.
More normal post birth hormonal progression- feeling desire to have another baby despite not wanting one and so on.
No change in gestational diabetes status (negative all times). All other blood work similar to previous pregnancies (normal with minor low platelets).
Weekly logs of weight gain, breast and belly growth, other supplements taken and symptoms were recorded.
So. I’m amazed. I have a hard time believing this is real. But things are going normally, and I’m incredibly proud of myself. Not because of breastfeeding, because honestly this current experience is much easier than my past two experiences, but because I figured it out.
I would certainly like to see clinical trials of metformin use in women with histories of insulin resistance, hyperinsulinemia, or undiagnosed low supply.