Milk Production in Mothers with and without Signs of Insulin Resistance

Maternal obesity is associated with shortened breastfeeding duration. Insulin resistance is a physiologic hallmark of obesity and may underlie lactation difficulties in obese and other insulin resistant mothers. Our objective is to compare 24-hour milk production in mothers with signs of insulin resistance (IR) versus those without. We examined baseline data from the MALMS study, a randomized placebo-controlled trial of metformin to augment low milk supply. Baseline eligibility includes: mother 1–8 weeks postpartum, healthy term infant that is currently requiring formula supplement to achieve sufficient growth, but mother has strong desire to improve breast milk production. Mothers fitting this description were referred to the study by area health care providers. At baseline, all women complete a weighed record of milk production over 24 hours and undergo evaluation for trial eligibility, including the following signs of IR: fasting plasma glucose ≥ 95 mg/dL, abdominal obesity, recent gestational diabetes...