Boosting Breastmilk with Herbs – Is it Possible?
No, a galactagogue is not the latest hero in Star Wars but rather foods, herbs or medicines that claim to increase breast milk supply. Today, we will focus on the common herbal galactagogues, not pharmaceutical galatagogues (such as domperidone and metoclopramide).
You may have heard of some commonly used herbal galactagogues, such as; fenugreek, milk thistle alfala, shatavari, garlic, ginger and malunggay. So where does the evidence lie when it comes to herbal galactagogues and should you be taking them to help increase your supply?
Supply & Demand Basis of Breastfeeding
First and foremost, without doubt, the most important way to establish and maintain good milk supply is for breast milk to be removed often and well. This is what’s commonly referred to as the supply and demand basis of breastfeeding. Basically, the more milk removed from your breasts, and the more often, the more milk you will make, and vice versa. The reason I want to highlight this point is because no galactagogue will have a significant impact if breast milk is not being removed effectively and frequently from the breastfeeding mother - Australian Breastfeeding Association, 2019. Boring, but true.
A systematic search was done looking at the use of these galactagogues for breastfeeding - Bazzano et al, 2016. Here’s a summary of what was found:
- In one study, mothers who were treated 3 times a day a fenugreek seed (in a tea) produced significantly more breast milk than mothers in the placebo (control) group. However, in another study, mothers of full-term babies who were treated with 600mg capsules of fenugreek seeds 3 x daily for 1 month did not show a significant difference in milk production compared to the placebo group. All in all, current evidence regarding the efficacy of fenugreek in increasing milk production is insufficient. While there is strong anecdotal (not reliable evidence as based on personal accounts, rather than research) evidence for the use of fenugreek among breastfeeding mothers, this is not supported by strong, research studies
- 2 studies investigated the effectiveness of malunggay leaves in mothers who delivered babies at term. One study showed that more milk was produced by mothers receiving treatment, compared to those who were not, however the study did not show a significant (or meaningful) difference between groups
- No significant difference was found between treatment and placebo groups in a study on the efficacy of garlic in increasing breast milk production in healthy mums who were exclusively breastfeeding their babies
- Potential benefit was seen in one study which looked at using Silymarin (a milk thistle extract) to increase breast milk production, however more evidence was suggested to support this possibility
- As with any herbal products, including teas, tinctures and capsules – there may be lack of regulation when it comes to safety and adverse effects of herbal galactagogues are not well understood in breastfeeding mothers. Caution must be taken.
The Bottom Line
- More high-quality evidence is needed to support the recommendation of herbal galactagogues by clinicians and lactation consultants.
- Limited information is available for both clinicians and patients to make informed decisions on the use of herbal galactagogues.
- There is lack of information and consistency around dosage form (capsule vs seed), dosage amount (1000mg? 2 capsules? 1 capsule?), when therapies is best started (2 weeks postpartum? 12 weeks postpartum?) and how long the treatment/therapy should last (1 month, 2 months, 5 months?)
So what can you do if you are concerned regarding your milk supply?
- Make sure you are offering frequent, and effective feeds. If you are unsure, see a lactation consultant - https://www.breastfeeding.asn.au/roles/lactation-consultants
- It is important to follow a healthy, balanced diet whilst breastfeeding. If you are unsure, book in with an Accredited Practicing Dietitian, who specialises in pregnancy and breastfeeding - such as myself! :)
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