Breastfeeding and obesity in PCOS

ABSTRACT

Introduction: Polycystic ovary syndrome (PCOS), a common condition affecting up to 18% of reproductive-aged women, has complications including reproductive, metabolic and psychological dysfunction. There is a strong potentially bidirectional association of obesity with PCOS. Women with PCOS both have a higher risk of obesity and greater longitudinal weight gain and obesity increases the prevalence and severity of the reproductive, metabolic and psychological features of PCOS. In limited observational studies, PCOS is proposed as a potential factor contributing to lower breastfeeding initiation and duration.

Areas covered: A narrative review using PubMed was performed covering the areas of the association of obesity and PCOS with breastfeeding success and interventions for improving breastfeeding success. Obesity impacts on breastfeeding success related to factors including impaired lactogenesis, mechanical difficulties, psychological considerations and an increased likelihood of having a caesarean section. The common coexistence of obesity in PCOS is the likely key contributor to the breastfeeding problems observed in PCOS, given the contribution of obesity to reduced breastfeeding initiation and duration.

Expert review: Facilitating breastfeeding is crucial for optimising maternal and infant health benefits, highlighting the importance of lactation support for overweight and obese women with or without PCOS.

KEYWORDS:

• Polycystic ovary syndrome
• lactation
• obesity
• insulin resistance
• hyperandrogenism
• weight gain

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

L Moran is supported by a South Australian Cardiovascular Research Development Program Fellowship; a program collaboratively funded by the National Heart Foundation of Australia, South Australian Department of Health and the South Australian Health and Medical Research Institute. C Harrison is supported by a post-doctoral fellowship from the National Heart Foundation of Australia, A Joham is supported by a post-doctoral fellowship from the National Health and Medical Research Council and H Teede is supported by a fellowship from the National Health and Medical Research Council.