Galactagogues (substances claimed to increase supply)

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

At least 95% of mothers are able to produce more than enough milk for their baby(ies), especially when accurate support and information is obtained (1). 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 2681800 686 268.

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. There have been a couple of quality scientific studies done which show that domperidone appears to be an effective galactagogue too (2,3).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 problems (4).

  •  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 (5).

 One recent (2011) well designed study compared domperidone and metoclopramide as galactagogues (6). 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 fenugreek as a galactagogue. Further well designed human trials are required before its potential efficacy as a galactagogue can be established. So far it appears promising, although the current scientific evidence is only based on an animal study and a small preliminary study on humans (7,8,9).

 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 team on 03 9885 085503 9885 0855 or email us.

  •  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. Akre, J., (1989), Infant feeding. The physiological basis. Bulletin of the World Health Organization, 67 Supplement: 1–108.
  2. Da Silva O, Knoppert D, Angelini M, Forret P, (2001), Effect of domperidone on milk production in mothers of premature newborns: a randomized, double-blind, placebo-controlled trial, CMAJ. 164:17-21.
  3. Wan E, Davey K, Page-Sharp M, Hartmann P, Simmer K, Ilett K, (2008), Dose-effect study of domperidone as a galactagogue in preterm mothers with insufficient milk supply, and its transfer into milk, Br J Clin Pharmacol, 66(2):283-298.
  4. Jones W, Breward S, (2011), Use of domperidone to enhance lactation: What is the evidence?, Community Practitioner 84(6):35-37.
  5. West D, Marasco L, (2009), The Breastfeeding Mother’s Guide to Making More Milk, McGraw Hill, USA.
  6. 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 [Epub ahead of print].
  7. Alamer M, Basiouni G, (2005), Feeding effects of fenugreek seeds (Trigonella foenum-graecum L.) on lactation performance, some plasma constituents and growth hormone level in goats, Pak J Biol Sci, 25:28-46.
  8. Nice, FJ, (2011), Common Herbs and Foods Used as Galactogogues, ICAN: Infant, Child & Adolescent Nutrition, 3(3):129-132.
  9. Swafford S, Berens P, (2000), Effect of fenugreek on breast milk volume, ABM News & Views, 6(3):21.

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

© Australian Breastfeeding Association February 2012