What is a Galactagogue?
Galactagogues are substances that increase breastmilk production. They are commonly used to increase a dwindling milk supply or to help initiate lactation in the case of induced lactation or re-lactation.
When should I use a Galactagogue?
Galactagogues should be considered once all other methods of increasing milk production have been tried. These methods should continue while the Galactagogue is being used and include:
- Ensuring your baby is breastfeeding properly to effectively empty milk from your breast. Ask your midwife or Lactation Consultant to check your baby’s position and latch to your breast and milk transfer during a feed.
- Breastfeeding your baby frequently will help to stimulate the production of more breastmilk. Breastfeeding 2-3 hourly during the day and 3-4 hourly at night should increase your milk supply. Feed more often if your baby is hungry for more feeds. Do not try to create a routine for your baby by not feeding on demand, particularly while trying to establish breastfeeding.
- Expressing more breastmilk approximately one hour after your baby has fed. If you express immediately after your baby has fed, you may only obtain a small amount of milk as your baby may have just emptied your breast(s) of the majority of the milk. Waiting for one hour will be plenty of time for your breasts to produce more milk and will also leave time for them to fill again after expressing, in time for when your baby is ready for his next feed.
- Having frequent skin-to-skin contact with your baby – this will promote the production of Oxytocin, a vital breastfeeding hormone.
- Avoiding dummies and nipple shields unless you have been advised to use a nipple shield by a lactation consultant. Dummies can inhibit demand feeding as they restrict the breastfeeding cues that your baby will display to tell you she is hungry. They can also cause nipple confusion if introduced too early, resulting in baby having difficulty latching onto your breast and feeding effectively. Nipple shields can reduce how effectively your baby empties milk from your breast (milk transfer) and therefore milk supply.
- Avoiding using formula unless you have been advised to top baby up with formula by a medical professional. Formula feeds substitute for breastfeeds, this means your baby will breastfeed less frequently so your body will receive less stimulation to produce milk.
- Ensuring you are eating a healthy balanced diet to provide yourself with enough high quality nutrition to produce sufficient breastmilk.
- Making sure you are keeping yourself well hydrated by drinking enough water.
- Being well rested. Having a new baby means you are more than likely sleep deprived; it is very important that even if you can’t sleep, you rest. This means not keeping yourself too busy. Accept offers of help from family and friends – having someone shop, clean and/or cook for you fairly frequently can make a huge difference, don’t be afraid to ask for help from people who you trust. If you can have a nap during the day, this may help you catch up on missed overnight sleep.
- Trying to reduce your stress levels by incorporating stress-management techniques such as Vimala McClure’s controlled belly breathing.
- Once you have done all of the above, a galactagogue may complement your efforts.
Which Galactagogue should I use?
There are two main categories of galactagogues; pharmaceutical and herbal. Some people also choose to use homeopathic remedies. Here we will discuss some of the most common herbal and pharmaceutical galactagogues.
FENUGREEK is the most commonly recommended herbal galactagogue. It can be taken as a seed oil (usually in capsule form), a tea or a liquid solution. The usual recommended dose is 6g a day in divided doses, no adverse effects via breastmilk have been reported. Adult side effects include maple syrup odour in urine and sweat, diarrhoea, low blood sugar levels and shortness of breath.
BLESSED THISTLE TEA is also sometimes used as a galactagogue (1.5-3g up to three times a day) although there is no evidence for its effectiveness at increasing milk supply. There are no known side effects to breastfed babies and the only known adult side effect is stomach irritation when taken in very large quantities.
GOATS RUE increases milk supply in cows and sheep and is another frequently used galactagogue in the form of a dry herb capsule, tea or liquid (tincture) solution.
Other herbs used include
- Brewer’s yeast
- European Vervain
- Black Seed
- Milk thistle
DOMPERIDOME is the most commonly prescribed galactogogue. It is usually used to treat heartburn, reflux and vomiting but it also increases maternal milk supply. As a galactagogue it is usually prescribed in a dose of 10-20mg three to four times a day and once you are producing sufficient milk the dose should be slowly reduced before you stop taking it to avoid a sudden decline in your breastmilk supply. Only a very miniscule amount of Domperidone is found in breastmilk and there are no known side effects in babies who drink the breastmilk of mothers who take Domperidone. Adult side effects can include dry mouth, itching, headache and abdominal cramps. Very rarely it can exacerbate heart conditions so consult with your doctor before starting this medication if you have a heart condition.
METOCLORPROMIDE is primarily used to treat reflux, nausea and vomiting but has also been shown to be an effective galactagogue. You may be prescribed 1omg three times a day. Once you see an improvement in milk supply it is important that you do not immediately stop taking the medication as this may suddenly reduce your milk supply. You should slowly reduce your dose as guided to by your lactation consultant, midwife or doctor. Small amounts of the drug are found in breastmilk but this is less than the dose that is given to babies to treat reflux and no side effects have been reported in babies whose mothers use Metoclorpromide as a glactagogue. Adult side effects include cramping, diarrhoea, movement disorders such as spasm and restlessness, and depression. It is not advisable to take this medication if you have a history of depression.
It is very important that you seek the advice of a health professional who knows about breastfeeding, before commencing a galactagogue, if you are concerned that you are not producing enough milk to feed your baby.