Zaradi znanih dobrobiti za mater in otroka naj bi dojenje vzpostavili v prvi uri po rojstvu, dojenje pa naj bi bilo edini način hranjenja novorojenčka v prvih šestih mesecih. Pri ženskah s sindromom ...policističnih jajčnikov (PCOS) opisujejo slabšo uspešnost dojenja, kar bi bilo lahko povezano z visokim deležem debelosti med njimi. Debelost in PCOS zavirata tako začetek dojenja kot tudi ohranjanje dojenja. Do zdaj v populacijskih raziskavah neodvisne povezave med PCOS in uspešnostjo dojenja niso prepoznali. Zapoznela laktogeneza je pogosta zlasti pri materah z debelostjo oziroma s sladkorno boleznijo. Razlogi za prenehanje dojenja so lahko fiziološki, psihološki, osebni in okoljski. Endokrinološki razlogi za manjšo uspešnost dojenja pri bolnicah s PCOS se skrivajo v spremenjenem hormonskem stanju matere. Povišana raven androgenih hormonov po porodu poleg drugih dejavnikov dodatno ovira razvijajočo se laktacijo. Tudi spremenjena inzulinska dinamika lahko doprinese k slabšemu izidu dojenja. V prispevku obravnavamo moteno laktogenezo pri ženskah s PCOS ter možne ukrepe za izboljšanje uspešnosti dojenja s poudarkom na pomenu obvladovanja materine debelosti pred nosečnostjo, med nosečnostjo in po njej. Slabši uspehi pri vzpostavitvi dojenja in krajše trajanje dojenja pri ženskah s PCOS so ključna področja ukrepanja. Vse matere s PCOS bi morali spodbujati k dojenju in jim nuditi učinkovito strokovno podporo.
Because of its known benefits for mother and baby, breastfeeding should be introduced within the first hour after birth and should be the only way to feed a newborn for the first six months. Women ...with polycystic ovary syndrome (PCOS) have been described as having a poorer breastfeeding success rate, which may be related to their high obesity rate. Both obesity and PCOS inhibit breastfeeding initiation and maintenance. To date, in population-based studies no independent association between PCOS and breastfeeding performance has been identified. Delayed lactogenesis is particularly common in mothers with obesity or diabetes. Reasons for stopping breastfeeding may be physiological, psychological, personal and environmental. Endocrinological reasons for the reduced breastfeeding success in PCOS patients lie in the altered hormonal status of the mother. In addition to other factors, elevated levels of androgen hormones after childbirth further impede the developing lactation and altered insulin dynamics may also contribute to a poorer breastfeeding outcome. In this paper, we discuss impaired lactogenesis in women with PCOS and possible measures to improve breastfeeding success, with emphasis on the importance of managing maternal obesity before, during and after pregnancy. The key areas for action in women with PCOS are poorer breastfeeding initiation and shorter breastfeeding duration. All mothers with PCOS should be encouraged to breastfeed and provided with effective lactation support.
