A self case study on metformin use in pregnancy and lactation outcome.
History: 35 year old female on 4th pregnancy with 2 previous 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 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.
On 10-5-14
Current weight:80-81kg.
At ~5 weeks pregnant Bra size is 36E (14E in NZ sizes). This is unchanged from before pregnancy.
Breast measurement:106.5
Waist measurement:87
Feeling: Energetic, low nausea, no cravings.
Other supplements taken: Folic acid (since prior to pregnancy), vitamin B complex(since prior to
pregnancy).
On 18-5-14
Current weight: 80kg
At ~6 weeks pregnant Bra size is 14E( in NZ sizes)..
Breast measurement: 107
Waist measurement: 85
Feeling: mild nausea. One vomit incident early in the week.
Other supplements taken: Folic acid (since prior to pregnancy), vitamin B complex(since prior to
pregnancy). Prenatal vitamin. (b vit and prenatal every other day)
On 25-5-14
Current weight: 80-81kg
At ~7 weeks pregnant Bra size is ( in NZ sizes)..14E
Breast measurement: 108
Waist measurement:86
Feeling: Nausea, some gagging and vomiting. 2 spotting sessions, no lessening of symptoms (getting
worse if anything).S
Other supplements taken: Folic acid (since prior to pregnancy), vitamin B complex(since prior to
pregnancy). Prenatal vitamin. (b vit and prenatal every other day)
On 1-6-14
Current weight:81
At ~ 8weeks pregnant Bra size is 14E( in NZ sizes)..though often feeling slightly small
Breast measurement:110.5
Waist measurement:86
Feeling: Nausea, some vomiting, brown spotting on Wednesday along with cramping, feeling more
sick. EDD confirmed at Jan 12th, heartbeat seen 140bpm.
Other supplements taken: Folic acid (since prior to pregnancy), vitamin B complex(since prior to
pregnancy). Prenatal vitamin. (b vit and prenatal every other day)
On 7-6-14
Current weight:81
At ~ 9 weeks pregnant Bra size is 14E ( in NZ sizes)..
Breast measurement:112
Waist measurement:88 at bottom of ribcage,103 across navel
Feeling:Nausea, vomiting, breast tenderness which comes and goes. Tiredness, short of breath. V
minor spotting on Wed of this week.
Other supplements taken: Folic acid (since prior to pregnancy), vitamin B complex(since prior to
pregnancy). Prenatal vitamin. (b vit and prenatal every other day)
On 15-6-14
Current weight: 80
At ~ 10 weeks pregnant Bra size is 14E ( in NZ sizes)..though L side is filling cup
Breast measurement: 114
Waist measurement: 103 (navel)
Feeling: Lessened nausea, but still gagging. Less vomiting. Have head cold today. Insomina at night.
Belly feels protruding.
Other supplements taken: Folic acid (since prior to pregnancy), vitamin B complex(since prior to
pregnancy). Prenatal vitamin. (b vit and prenatal every other day)
On 21-6-14
Current weight:81
At ~11 weeks pregnant Bra size is 14E ( in NZ sizes)..
Breast measurement:114
Waist measurement:105 across navel
Feeling:better, less queasy. More emotional. Some heartburn. Insomnia frequent.
Other supplements taken: Folic acid (since prior to pregnancy), vitamin B complex(since prior to
pregnancy). Prenatal vitamin. (b vit and prenatal every other day).
Blood sugar Hba1C measured at 30. Minor scare as Dr’s said too low, but MW said fine. All other
antenatal bloods fine.
On 29-6-14
Current weight:82
At ~ 12 weeks pregnant Bra size is 14E ( in NZ sizes)..
Breast measurement:115
Waist measurement: 100 across navel
Feeling: much less nausea, still some gagging. More tired. Very little breast tenderness. Good scan at
11-4. One wiggly baby with all relevant bits.
Other supplements taken: Folic acid (since prior to pregnancy), vitamin B complex(since prior to
pregnancy). Prenatal vitamin. (b vit and prenatal every other day). Last week of folic acid.
On 5-7-14
Current weight:82
At ~13 weeks pregnant Bra size is 14E ( in NZ sizes)..not fitting 14F, but 14E a bit small on left.
Breast measurement:117
Waist measurement:105 across navel
Feeling: better lately, though nausea resurge in last few days. No vomiting though.
Other supplements taken: Out of folic acid this last week, vitamin B complex(since prior to
pregnancy). Prenatal vitamin. (b vit and prenatal every other day).
On 13-7-14
Current weight:83-with water retention occasionally at 85.
At ~14 weeks pregnant Bra size is 14E ( in NZ sizes)..not fitting 14F, but 14E a bit small on left.
Breast measurement:116
Waist measurement:105 across navel
Feeling: Nausea mostly gone, present sometimes in evenings. Increased appetite and cravings.
Other supplements taken: vitamin B complex(since prior to pregnancy). Prenatal vitamin. (b vit and
prenatal every other day).
On 20-7-14
Current weight:83+
At ~15 weeks pregnant Bra size is 14E ( in NZ sizes)..not fitting 14F, but 14E a bit small overall.
Breast measurement:116
Waist measurement:107 across navel
Feeling: better lately, not much nausea. Some breast tenderness, ligament cramping. Colostrum
coming from right breast. White/yellow(faint), thick, mucousy (notable as has been clear in past).
Molly still having a breastfeed in the evening every day to ever 3rd day. Increased sex drive.
Other supplements taken: Vitamin B complex(since prior to pregnancy). Prenatal vitamin. (b vit and
prenatal every other day). Need to get more vit B.
On 26-7-14
Current weight:83-4
At ~16 weeks pregnant Bra size is 14E ( in NZ sizes)..not fitting 14F, but 14E a bit small on left. Have
swapped to looser or stretchy bras.
Breast measurement:116
Waist measurement:106 across navel
Feeling: much better. Nausea rare. Otherwise same as previous week.
Other supplements taken: Out of vitamin B complex this week. We restart next week. Prenatal
vitamin all this week.
On 04-8-14
Current weight:84-85
At ~17 weeks pregnant Bra size is 14E ( in NZ sizes).with some fitting 14F, but 14f a bit large on right.
Have swapped to looser or stretchy bras as finding the structured bras to uncomfortable.
Breast measurement:116
Waist measurement:108 across navel
Feeling: much better. Nausea rare. Came back strongly yesterday and today. Baby kicks seem slower,
but still early, possible growth spurt.
Other supplements taken: B vitamins MWF. Prenatal vitamin all this week.
On 10-8-14
Current weight:84-85
At ~18 weeks pregnant Bra size is 14E ( in NZ sizes)..not fitting 14F, but 14E a bit small on left. Have
swapped to looser or stretchy bras almost exclusively.
Breast measurement:116
Waist measurement:106 across navel Both unchanged
Feeling: much better. Nausea rare.
Other supplements taken: vitamin B complex MWF Prenatal vitamin SaSutTTh
On 26-8-14
Current weight:84-85, down from 85-86 in past week
At ~20 weeks pregnant Bra size is 14E ( in NZ sizes)..not fitting 14F, but 14E a bit small on left. Have
swapped to looser or stretchy bras.
Breast measurement:117
Waist measurement:108 across navel
Feeling: mostly normal, skipped last week I guess? Had anatomy scan, all good. Another girl, so no
other explanation for not feeling as sick and milder symptoms this time. Slightly more baby
movement past few days, otherwise baby can be felt moving but not very active compared to other
two. Very teary last few days.
Other supplements taken: vitamin B complex MWF Prenatal vitamin SaSutTTh
On 31-8-14
Current weight:85+
At ~21 weeks pregnant Bra size is 14E ( in NZ sizes)..not fitting 14F, but 14E a bit small on left. Have
swapped to looser or stretchy bras.
Breast measurement:114
Waist measurement:112 across navel
Feeling: mostly normal baby can be felt moving but not very active compared to other two. Sorer
back and hips last week.
Other supplements taken: vitamin B complex MWF Prenatal vitamin SaSutTTh
On 6-9-14
Current weight:85+
At ~22 weeks pregnant Bra size is 14E ( in NZ sizes)..not fitting 14F, but 14E a bit small on left. Have
swapped to looser or stretchy bras exclusively.
Breast measurement:116
Waist measurement:113 across navel
Feeling: mostly normal. baby has become more active lately.
Other supplements taken: vitamin B complex MWF Prenatal vitamin SaSutTTh
On 14-9-14
Current weight:85-86
At ~23 weeks pregnant Bra size is 14E ( in NZ sizes)..not fitting 14F, but 14E a bit small on left. Have
swapped to looser or stretchy bras exclusively.
Breast measurement:118
Waist measurement:115 across navel
Feeling: mostly normal. baby has become more active lately. Snacky. Probably gaining due to
increased snacking on higher carb foods.
Other supplements taken: vitamin B complex MWF Prenatal vitamin SaSutTTh
On 21-9-14
Current weight: 86+
At ~24 weeks pregnant Bra size is 14E ( in NZ sizes)..not fitting 14F, but 14E a bit small on left. Have
swapped to looser or stretchy bras exclusively.
Breast measurement:118
Waist measurement:113 across navel
Feeling: mostly normal. baby has become more active lately. Snacky. Probably gaining due to
increased snacking on higher carb foods.
Other supplements taken: vitamin B complex MWF Prenatal vitamin SaSutTTh
On 28-9-14
Current weight: 86+
At ~25 weeks pregnant Bra size is 14E ( in NZ sizes)..not fitting 14F, but 14E a bit small on left. Have
swapped to looser or stretchy bras exclusively.
Breast measurement:120
Waist measurement:114 across navel
Feeling: mostly normal. baby has become more active lately. Snacky. Probably gaining due to
increased snacking on higher carb foods. Sore muscles in upper abdomen, and inconstant weight
spiking. Increased scatic pain on LH side
Other supplements taken: vitamin B complex MWF Prenatal vitamin SaSutTTh
On 4-10-14
Current weight: 87
At ~26 weeks pregnant Bra size is 14E ( in NZ sizes)..not fitting 14F, but 14E a bit small on left. Have
swapped to looser or stretchy bras exclusively.
Breast measurement:118
Waist measurement:117 across navel
Feeling: mostly normal. baby has become more active lately. Snacky. Probably gaining due to
increased snacking on higher carb foods. Sore muscles in upper abdomen, and inconstant weight
spiking. Increased scatic pain on LH side
Other supplements taken: vitamin B complex MWF Prenatal vitamin SaSutTTh
On 11-10-14
Current weight: 87+
At ~27 weeks pregnant Bra size is 14E ( in NZ sizes)..not fitting 14F, but 14E a bit small on left. Have
swapped to looser or stretchy bras exclusively.
Breast measurement:118
Waist measurement:120 across navel
Feeling: mostly normal. baby has become more active lately. Snacky. Probably gaining due to
increased snacking on higher carb foods. Have tried to reduce carb intake somewhat by limiting fruit,
but birthday cake, Wednesday chocolate habit and other circumstances have not accommodated.
Increased scatic pain on LH side
Other supplements taken: vitamin B complex MWF Prenatal vitamin SaSutTTh
On 18-10-14
Current weight: 88-89
At ~28 weeks pregnant Have swapped to looser or stretchy bras exclusively. Bra size unknown.
Breast measurement:118
Waist measurement:120 across navel
Feeling: mostly normal. baby has become more active lately. Snacky. Probably gaining due to
increased snacking on higher carb foods. Have tried to reduce carb intake somewhat by limiting fruit,
Increased scatic pain on LH side. Polycose test today. Instances of central front SPD pain.
Other supplements taken: vitamin B complex MWF Prenatal vitamin SaSutTTh
On 26-10-14
Current weight: 90
At ~29 weeks pregnant Have swapped to looser or stretchy bras exclusively. Bra size unknown.
Breast measurement:119
Waist measurement:120 across navel
Feeling: mostly normal. baby has become more active lately. Snacky. Probably gaining due to
increased snacking on higher carb foods. Have tried to reduce carb intake somewhat by limiting fruit,
Increased scatic pain on LH side.
Other supplements taken: vitamin B complex MWF Prenatal vitamin SaSutTTh
On 3-11-14
Current weight: 90
At 30 weeks pregnant Have swapped to looser or stretchy bras exclusively. Bra size unknown.
Breast measurement:121
Waist measurement:122 across navel
Feeling: mostly normal. baby has become more active lately. Snacky. Probably gaining due to
increased snacking on higher carb foods. Have tried to reduce carb intake somewhat by limiting fruit,
Increased scatic pain on LH side. Other supplements taken: vitamin B complex MWF Prenatal vitamin
SaSutTTh
On 9-11-14
Current weight: 91
At 31 weeks pregnant Have swapped to looser or stretchy bras exclusively. Bra size unknown.
Breast measurement:118
Waist measurement:123 across navel
Feeling: mostly normal. baby has become more active lately. Snacky. Probably gaining due to
increased snacking on higher carb foods. Have tried to reduce carb intake somewhat by limiting fruit,
Increased scatic pain on LH side.
Other supplements taken: vitamin B complex MWF Prenatal vitamin SaSutTTh
On 15-11-14
Current weight: 91+
At 32 weeks pregnant Have swapped to looser or stretchy bras exclusively. Bra size unknown.
Breast measurement:120
Waist measurement:123 across navel
Feeling: mostly normal. baby has become more active lately. Snacky. Probably gaining due to
increased snacking on higher carb foods. Have tried to reduce carb intake somewhat by limiting fruit,
Increased scatic pain on LH side.
Other supplements taken: vitamin B complex MWF Prenatal vitamin SaSutTTh
On 22-11-14
Current weight: 92+
At 33 weeks pregnant Have swapped to looser or stretchy bras exclusively. Bra size unknown.
Breast measurement:120
Waist measurement:127 across navel
Feeling: mostly normal. baby has become more active lately. Snacky. Probably gaining due to
increased snacking on higher carb foods. Have tried to reduce carb intake somewhat by limiting fruit,
Increased scatic pain on LH side.
Other supplements taken: vitamin B complex MWF Prenatal vitamin SaSutTTh
On 29-11-14
Current weight: 92+
At 34 weeks pregnant Have swapped to looser or stretchy bras exclusively. Bra size unknown.
Breast measurement:121
Waist measurement:126 across navel
Feeling: mostly normal. baby not so active this week, though I’m very busy. Waking up to pee+
insomnia every night. Hips very painful in bed, no longer able to sleep on back at all.
Other supplements taken: vitamin B complex MWF Prenatal vitamin SaSutTTh
On 7-12-14
Current weight: 92+
At 35 weeks pregnant Have swapped to looser or stretchy bras exclusively. Bra size unknown.
Breast measurement:122
Waist measurement:127-8 across navel
Feeling: mostly normal. Waking up to pee every night. Hips very painful in bed, no longer able to
sleep on back at all.
Other supplements taken: vitamin B complex MWF Prenatal vitamin SaSutTTh
On 13-12-14
Current weight: 93+ (93-95)
At 36 weeks pregnant Have swapped to looser or stretchy bras exclusively. Bra size unknown.
Breast measurement:121
Waist measurement:128 across navel
Feeling: mostly normal. Waking up to pee every night. Hips very painful in bed, no longer able to
sleep on back at all. Hungry this past week.
Other supplements taken: vitamin B complex MWF Prenatal vitamin SaSutTTh
On 20-12-14
Current weight: 93+ (93-95)
At 37 weeks pregnant Have swapped to looser or stretchy bras exclusively. Bra size unknown.
Breast measurement:123
Waist measurement:128 across navel
Feeling: mostly normal. Waking up to pee every night. Hips very painful in bed, no longer able to
sleep on back at all. Hungry this past week. Have noticed past 5-7 weeks at least that areolas very
dark, more so than previous pregnancies.
Other supplements taken: vitamin B complex MWF Prenatal vitamin SaSutTTh
On 27-12-14
Current weight: 94-95
At 38 weeks pregnant Have swapped to looser or stretchy bras exclusively. Bra size unknown.
Breast measurement:122
Waist measurement:131 across navel
Feeling: fatigued. Waking up to pee every night. Hips very painful in bed, no longer able to sleep on
back at all. Hungry or queasy this past week. Very prone to muscle soreness from activity
(vacuuming etc).
Other supplements taken: vitamin B complex MWF Prenatal vitamin daily from this week to increase
iron.
On 3/1/15
Current weight: 95+. Been snacking a lot and ham leads to high water retention (to 97-100kg even)
At 39 weeks pregnant Have swapped to looser or stretchy bras exclusively. Bra size unknown.
Breast measurement:122
Waist measurement:135 across navel
Feeling: fatigued. Waking up to pee every night. Less sore, but still no longer able to sleep on back at
all. Hungry or queasy this past week. Very prone to muscle soreness from activity (vacuuming etc).
Unable to do much activity without becoming tired. Have noticed past few weeks that previously
very dark areolas are lightened. Colostrum still present upon squeezing. Colostrum is creamy golden
white instead of previous pregnancy clear colour.
Other supplements taken: vitamin B complex MWF, Prenatal vitamin daily to increase iron.
On 7/1/15- Day of delivery at 39+2
Current weight: 96.
At 39 weeks pregnant have swapped to looser or stretchy bras exclusively. Bra size unknown.
Breast measurement:122
Waist measurement:135 across navel
Feeling: fatigued. Waking up to pee every night. Less sore, but still no longer able to sleep on back at
all. Hungry or queasy this past week. Very prone to muscle soreness from activity (vacuuming etc).
Unable to do much activity without becoming tired. Have noticed past few weeks that previously
very dark areolas are lightened. Colostrum still present upon squeezing. Colostrum has transitioned
from creamy golden to clearer colour-especially out of left side. Right side may have remaining milk
as Molly last breastfed less than 2 weeks ago?
Other supplements taken: vitamin B complex MWF, Prenatal vitamin daily to increase iron.
16-1-15
9 days postpartum.
Breast measurement is 126cm.
Tongue tie (75%) corrected by scissors at 6 days postpartum.
Feeding going better than previous children, but not necessarily convincing output, though it is
within parameters (in excess of 5 wet and 3-4 poopy per day). 10g gain from day 6 to day 8 (prior to
TT release to nearly 2 days post). Will reweigh on day 10.
Summary:
Baby gaining 100g+ weight per week. 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.
370g loss from birth to day 6, different scale variation at play as well. X 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)
Breast growth and change observed during pregnancy of 16cm circumference.
Significantly noticeable darkening of areolas during pregnancy. In previous pregnancy were only
slightly darkened. Darkening faded somewhat toward 38-39 weeks.
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 bloodwork similar to previous
pregnancies (normal with minor low platelets).
Morning sickness was lessened from previous pregnancies (all same sex), with much less vomiting
and reduced queasiness.