Galactagogues
are drugs, herbs and foods that increase breastmilk supply. Many cultures around the world have a traditional concoction of food or drink they insist that new mothers consume, for this purpose.
The MOST important thing to drive your milk supply is to empty your breasts frequently, so don't consider taking a medication or large dose of an herbal supplement unless you're getting lactation support and removing milk well.
Click here
to view the video for an ideal breastfeeding session.
Foods
Eat what you want, in moderation, but don't waste money on expensive lactation cookies, etc.- Some experts have identified the following foods that may increase milk supply:
- Moringa, Brewer's yeast, oatmeal, hops, garlic, ginger, basil, onion, dill, coriander, anise, chamomile, marshmallow, green vegetables, and nuts.
Drugs and Herbs
If you consider using drugs or herbs, understand the cost, the risks, and the lack of scientifically proven benefits. A perceived increase in milk supply while taking a galactagogue could be from concurrent improved breastfeeding management, the cure of time, or perhaps a placebo effect. As a last resort, some lactation consultants continue to encourage the use of medications and herbs to increase milk supply. However, the expert evidence says otherwise -- see the references below.Causes of low milk supply
There are a variety of reasons for a low milk supply. Perhaps your baby, or a pump, didn't effectively empty your breasts in the first few days or weeks, so your milk production didn't get established. Perhaps your breast tissue is insufficient or your had surgery on them. Or, perhaps your hormones aren't aligned, or there was complication during labor and delivery. Sometimes a well established milk supply decreases over time – for all sorts of reasons.How to increase milk supply
Click here to learn more about things you can try to increase your milk supply. Improved breastfeeding management is critical, but it is a reality that some issues can’t be fixed. Sometimes, you must simply redefine success. Get help to establish a sustainable feeding plan that hopefully includes some breastmilk.Information about Specific Galactagogues
Herbal supplements:
Fenugreek, goat’s rue, milk thistle (Silybum), oats, barley, dandelion, millet, seaweed, anise, basil, blessed thistle, fennel seeds, marshmallow, moringa leaf, shatavari, and torbangun, among others.- These are available over the counter.
- They are not regulated by the FDA, so there are no manufacturing or dosing standards, and contaminants may be present.
- There are potential allergic reactions and anaphylaxis, due to cross reactions with ragweed and related plants, peanuts, chickpeas, soybeans, and green peas.
- Side effects include diarrhea, maple syrup body odor, asthma, bleeding, dizziness, flatulence, hypoglycemia, loss of consciousness, skin rash or wheezing.
- There are possible drug interactions with warfarin, heparin, hypoglycemics, insulin, antiplatelet drugs, aspirin, feverfew, primrose oil and many other herbals.
Domperidone and Reglan
These drugs are "dopamine antagonists," so they block the function of dopamine. This increases low prolactin levels, and theoretically increase milk supply. These drugs are more typically used to treat nausea and gastrointestinal problems.
- Domperidone was taken off the market in USA in 2004 due to deaths from heart arrhythmias. This occured after intravenous use, and many experts believe the pill form is not so risky. Some mothers get the drug by ordering it online from other countries. Perhaps because of differences in state laws, some USA prescribers are willing to risk their medical license and will assist mothers to get the drug.
- Reglan side effects can be significant. This drug can exacerbate anxiety and depression. Irreversible abnormal body movements (tardive dyskinesia) can occur in the mother if it’s taken more than 3 months.
The Expert Evidence
The 2018 Academy of Breastfeeding Medicine - Protocol #9 - “Use of Galactogogues in Initiating or Augmenting Maternal Milk Production, Second Revision 2018” reviewed and summarized the research and evidence related to galactagogue use. View the protocol here: https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/9-galactogogues-protocol-english.pdf
A 2013 American Academy of Pediatrics clinical report, “The Transfer of Drugs and Therapeutics into Human Breast Milk: An Update on Selected Topics” can be found at http://pediatrics.aappublications.org/content/early/2013/08/20/peds.2013-1985
Kay Anderson MD, IBCLC
5/23