Galactagogues (substances claimed to increase supply)

Galactagogues are foods, herbs or medications that may help to increase breastmilk supply. The use of a galactagogue requires consultation with a lactation consultant and/or medical adviser.

Most mothers are able to produce more than enough milk for their baby(ies), especially when accurate support and information is obtained. The majority of mothers who think that they have a low milk supply problem actually don’t. If you feel you have a low milk supply problem, you may find it helpful to look at our article on increasing your supply and/or call one of our trained breastfeeding counsellors on our Breastfeeding Helpline on 1800 686 268.

By far, the most important way to establish and then maintain a good milk supply is for breastmilk to be removed often and well. This is commonly referred to as the supply and demand basis of breastfeeding - meaning the more milk removed from your breasts (and the more often), the more milk they'll make and vice versa.

Galactagogues only work when breastmilk is being removed frequently and effectively from a mother’s breasts. When all factors contributing to a low supply have been identified and addressed, then galactagogues may help to speed up the process.

While there are many substances that have been used by mothers for centuries that are claimed to help them make more breastmilk, there is limited scientific evidence to prove their effectiveness. Many cultures have special foods that are thought to enhance milk production. These vary and may contain active ingredients to fulfil this purpose. However, they have not been formally studied. This article provides the current best available information on a few common galactagogues used in Australia.

Prolactin is a woman’s main breastmilk producing hormone. Most medications that act as galactagogues work by increasing prolactin levels.

Examples of Galactagogues:

  • Domperidone (MotiliumTM)

Domperidone is a prescription drug used for decades for gastrointestinal disorders. The most recent systematic review of five randomised control trials of women expressing for premature babies demonstrated a moderate increase in daily breastmilk volume of 88.3mL/day with the use of domperidone compared with placebo (1). These studies suggest that domperidone has few side effects. However, there have been recommendations that domperidone not be used in women with a history of cardiac arrhythmias (2).

  •  Metoclopramide (MaxolonTM)

Metoclopramide is another prescription drug used to treat gastrointestinal disorders. Metoclopramide has been used for nearly three decades to increase breastmilk production. However, it crosses the blood-brain barrier, unlike domperidone. This means that metoclopramide has the potential to cause central nervous system side effects such as restlessness, drowsiness, fatigue and depression (3).

One 2011 study compared domperidone and metoclopramide as galactagogues (4). This study showed that there were no statistically significant differences between these two drugs in terms of increased milk production or side effects. This study found that, in the women in this study, both domperidone and metoclopramide were very effective at increasing breastmilk production and had minimal (and all non life-threatening) side effects.

  •  Fenugreek

Fenugreek is enjoyed in many parts of the world as a culinary herb/spice. It has historically been used as a galactagogue for both human mothers and dairy animals throughout the world for many years. There is limited formal scientific evidence on the effectiveness of fenugreek as a galactagogue or about its safety (2). There have been reports of maternal allergic reactions to fenugreek (5).    

Conclusion

A galactagogue works best when a mother has low prolactin levels (ie when there is a genuine, not a perceived, low milk supply issue), and after a mother has received support and education to improve her breastfeeding or expressing technique. It will only work in conjunction with improved management of regular and efficient milk removal.

For further information

  • Drug information centres in Australia

For further and current information about the use of medicines/drugs (including galactagogues) during breastfeeding (or pregnancy), contact the Medicines Information Centres in your state or the NPS Medicines Line. Click here to find these phone numbers.

  • ABA's Breastfeeding Information and Research team

ABA's Breastfeeding Information and Research team has more detailed and fully referenced articles on galactagogues. These articles can be obtained by ABA professional members or on a fee-for-service basis. For further details, contact the Australian Breastfeeding Association.

  •  The Breastfeeding Mother’s Guide to Making More Milk

By Diana West (IBCLC) and Lisa Marasco (IBCLC) is a valuable book that includes a thorough section on galactagogues.

References

  1. Grzeskowiak LE, Smithers LG, Amir LH, GrivellRM (2018), Domperidone for increasing breast milk volume in mothers expressing breast milk for their preterm infants: a systematic review and meta-analysis. Eur J Clin Pharmacol 74(8):1071-1075
  2. Brodribb W, Academy of Breastfeeding Medicine (2018), ABM Clinical Protocol #9: Use of Galactogogues in Initiating or Augmenting Maternal Milk Production, Second Revision 2018.
  3. West D, Marasco L (2009), The Breastfeeding Mother’s Guide to Making More Milk, McGraw Hill, USA.
  4. Ingram J, Taylor H, Churchill C, Pike A, Greenwood R (2011), Metoclopramide or domperidone for increasing maternal breast milk output: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 97(4):F241-245.
  5. Tiran D (2003), The use of fenugreek for breast feeding women. Complement Ther Nurs Midwifery 9:155-156.

The information on this website does not replace the advice of your health care provider.

© Australian Breastfeeding Association January 2019

Last reviewed: 
Jan 2019