{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:04:23Z","timestamp":1792047863302,"version":"4.4.0"},"reference-count":37,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2019,1,10]],"date-time":"2019-01-10T00:00:00Z","timestamp":1547078400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["NIH 5 K12 HD051953"],"award-info":[{"award-number":["NIH 5 K12 HD051953"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["NIH 5UL1TR001425-03"],"award-info":[{"award-number":["NIH 5UL1TR001425-03"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hum Lact"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Metformin improves insulin action, but feasibility in treating low milk supply is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research aim:<\/jats:title>\n                    <jats:p>\n                      To determine the feasibility of a metformin-\n                      <jats:italic>versus<\/jats:italic>\n                      -placebo definitive randomized clinical trial in women with low milk production and signs of insulin resistance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Pilot trial criteria included: Mother 1\u20138 weeks postpartum (ideally 1\u20132 weeks), low milk production, and \u22651 insulin resistance sign; and singleton, healthy, term infant. Eligible mothers were randomly assigned 2:1 (metformin:placebo) and instructed in frequent milk removal for 28 days with option to stop at 14 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      From 02\/2015 through 06\/2016, we screened 114 women, completed baseline assessments on 46, and trialed 15 (median, 36 days postpartum). Comparing metformin-assigned (\n                      <jats:italic>n<\/jats:italic>\n                      = 10) to placebo (\n                      <jats:italic>n<\/jats:italic>\n                      = 5), 70% versus 80% continued to day 28; peak median change in milk output was +8 versus \u201358 mL\/24 hr (\n                      <jats:italic>p<\/jats:italic>\n                      = .31) and 80% peaked at Day 14 for both groups; 0% versus 20% desired to continue assigned drug after study completion; 44% versus 0% reported nausea\/vomiting. Post-hoc, median peak change in milk output was +22 (metformin completers,\n                      <jats:italic>n<\/jats:italic>\n                      = 8) versus \u201358 mL\/24 hr (placebo + non-completers,\n                      <jats:italic>n<\/jats:italic>\n                      = 7,\n                      <jats:italic>p<\/jats:italic>\n                      = .07). At baseline assessment, median milk production was significantly lower in those with (\n                      <jats:italic>n<\/jats:italic>\n                      = 31), versus those without (\n                      <jats:italic>n<\/jats:italic>\n                      = 15) signs of insulin resistance (\n                      <jats:italic>p<\/jats:italic>\n                      = .002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      Although results trend toward hypothesized direction, trial feasibility concerns include late enrollment and only 20% of metformin-assigned participants sustaining improved milk output to Day 28, with none perceiving metformin worthwhile. Better tools are needed to identify and treat metabolically-driven low milk production.\n                      <jats:italic>Registered at ClinicalTrials.gov (NCT02179788) on 02\/JUL\/2014.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0890334418819465","type":"journal-article","created":{"date-parts":[[2019,1,10]],"date-time":"2019-01-10T18:54:20Z","timestamp":1547146460000},"page":"261-271","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":31,"title":["Feasibility and Acceptability of Metformin to Augment Low Milk Supply: A Pilot Randomized Controlled Trial"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3213-7186","authenticated-orcid":false,"given":"Laurie","family":"Nommsen-Rivers","sequence":"first","affiliation":[{"name":"University of Cincinnati, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Thompson","sequence":"additional","affiliation":[{"name":"University of Cincinnati, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Riddle","sequence":"additional","affiliation":[{"name":"University of Cincinnati, Cincinnati, OH, USA"},{"name":"Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Ward","sequence":"additional","affiliation":[{"name":"University of Cincinnati, Cincinnati, OH, USA"},{"name":"Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Wagner","sequence":"additional","affiliation":[{"name":"University of Cincinnati, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen","family":"King","sequence":"additional","affiliation":[{"name":"University of Cincinnati, Cincinnati, OH, USA"},{"name":"Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,1,10]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2011.9998"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192644"},{"key":"e_1_3_3_4_1","article-title":"Standards of medical care in diabetes","author":"American Diabetes Association","year":"2012","unstructured":"American Diabetes Association. 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