As a certified lactation counselor, one of the first things I usually get asked about in the postpartum period are galactagogues.
For those that do not know, galactagogues are a group of foods or substances that are believed to increase milk supply. And they are popping. up. everywhere.
From tinctures and powders to lactation cookies and bars, galactagogues are suddenly all the rage. So this article will break it down for you, covering whether they work, what the research says, and how to move forward.
What are Galactagogues?
Galactagogues are any food, drug, or substance that promotes or increases break milk supply and flow. While there are a few prescription pharmaceutical galactagogues out there, today we will just be covering common food and herb based galactagogues. These substances are often taken in a supplement or tea form, but a lot of them may also be incorporated into recipes.
It is important to note that galactagogues have their reputation due to decades and decades (and sometimes even centuries) of passed down cultural education, either through healing modalities such as Ayurveda, or simply from mother to mother. But as such, science has not caught up or even fully explored this area. This means that research on galactagogue is limited, poor quality, and simply not robust enough to draw any conclusions. With this in mind, I do want to point out that a *lack of evidence* is not the same as saying it does not work or research does not support its use. I believe it is important to understand the limits of the peer review process, and recognize that due to corporate interest along with ethics, it is difficult to incentivize and produce studies looking at the impacts of herbs on breastfeeding women. So to date, much of what we have to go off in this area are anecdotal reports, poorer quality studies, and, the most important, a deep rooted history of their use in various cultures.
So all I can do now is provide a bit of context and education – but from there the choice is yours.
A Note On Building Supply
I’d be amiss if I did not mention that the number one way to make milk is to remove milk. The more mom is breastfeeding and expressing milk, the more it signals to her body to produce more. Many breastfeeding mom’s are concerned about a low supply, however, it is typical to underestimate how much milk you’re actually producing. If you are concerned about your breastmilk supply, I recommend speaking with your doctor or working with a CLC.
However, a few quick rules of thumb are if baby is…
- sucking and swallowing during feedings
- nursing 8-12 times in a 24 hour period
- appearing happy and relaxed after feeding
- gaining weight as expected
- having 3-4 stools every day by 4 days of age
it is a great sign that your milk supply is right where it needs to be. But of course, please quell any fears by working with a healthcare provider.
The Most Common Galactagogues
Galactagogues have long been used for breastfeeding support across various cultures. From fenugreek to goat’s rue, flaxseeds to oats, it sometimes feels like an ever ending list.
The following galactagogues are a few that have recently gained popularity in the West – Fenugreek, Milk Thistle, Goat’s Rue, Oats and Lactation Cookies. However, please note that this is not an exhaustive list. As always, if you are thinking of introducing a herb or supplement into your diet, please consult with a health care practitioner, CLC, and/or herbalist.
- History and Claims: Fenugreek is an herb that has a long history in Traditional Chinese Medicine and Ayurveda as a galactagogue. It is known for its nutty taste and nutrient density, with 1 Tbsp providing 20% of the daily value for iron.
- What the Research Says: Fenugreek is one of the few galactagogues that has a bit of research behind it. One meta-analysis of 4 studies looking at fenugreek as a galactagogue found that fenugreek significantly increased the amount of breastmilk produced compared to placebos. Another study of 66 mothers similarly found that fenugreek tea increased breast milk supply more than a placebo. And finally, this study reported that breastmilk volume increased and prolactin levels were higher 3 days postpartum among new mothers that drank fenugreek tea compared to those that did not, indicating that it may help to play a role immediately after birth. However, research has been mixed, with many studies showing no significant difference.
- Other Considerations: Fenugreek is considered generally safe (on the FDA GRAS list), but may cause a sweet, maple-syrupy body odor when ingested. It may also lowers appetite and blood sugar, so be aware of these impacts during the postpartum period, and speak to your healthcare provider if you have diabetes or hypoglycemia.
- Takeaway: Fenugreek is one of the few galactagogues where research is promising. That coupled with its long term history in TCM and Ayurveda and general mark of safety from the FDA makes it one of the more worthwhile galactagogues to consider.
- History and Claims: Milk thistle, also known as silymarin, is an herb native to the Mediterranean region. It has been used as a galactagogue in both Europe and India for centuries.
- What the Research Says: Research is very limited, however, one study found that milk thistle may increase breast milk supply by 85%. Other studies have looked at the impacts on a combination of milk thistle with other galactagogues, such goat’s rue, and have found promising results. But again, much of the research is limited or poorly designed with some conflicting results.
- Other Considerations: Milk thistle is considered generally safe, but can have side effects such as nausea and diarrhea. More notably, when taken in combination with other medications it may interfere with their metabolism so be sure to speak with your healthcare provider before introducing this herb. Milk thistle can also impact blood sugar balance, so should be taken with caution by anyone with diabetes or hypoglycemia.
- Takeaway: Milk thistle may be beneficial for milk supply, however, its benefits are currently rooted in traditional medicine approaches and anecdotes rather than science.
- History and Claims: Goat’s rue is a flower native to Europe and Eastern Asia. It is primarily used as a galactagogue in France and other European countries and is often consumed in combination with other herbs or taken as a supplement.
- What the Research Says: Currently, the research on Goat’s rue is limited. Several studies have found some results that support the use of Goat’s rue, however, many of them have been poorly conducted or controlled. One study (as mentioned above) looked at milk thistle in combination with Goat’s Rue and found a significant effect on breastmilk production. Another study, which surveyed 238 women, found that those who used a goat’s rue supplement felt they had improvements in breastfeeding and supply – while not an actual measure of breastmilk production, it does speak to the emotional health benefits that either these galactagogues – or their placebo effect – can have.
- Other Considerations: Goat’s Rue may cause headaches, jitteriness or weakness, however it is generally considered safe. As with the other herbs, Goat’s rue may impact other medications, blood sugar and blood pressure, so speak with a healthcare provider before initiating this herb.
- Takeaway: Goat’s Rue has not proven to be an effective galactagogue, however, research is pointing in the right direction.
- History and Claims: Oats are likely not new to most mamas. But did you know that many consider them a galactagogue? Plus, they’re loaded with B vitamins, minerals like iron, and healthy carbohydrates such as fiber, all of which can support mothers milk and her body during the postpartum period.
- What the Research Says: There is no research looking at the impacts of oats on milk supply.
- Other Considerations: Oats can easily be a part of a healthy diet – in fact, the US Department of Human Services recommends oatmeal as a part of a balanced and healthy diet for breastfeeding mothers. However, if you have celiac disease, note that cross reactions to the proteins in oat may occur.
- Takeaway: If you enjoy oats, go for them. They may boost supply but they will also certainly help provide a healthy base for a breakfast.
- History and Claims: Lactation cookies are a relatively new trend that combines several common galactagogues to form a cookie. Most recipes use ground flaxseeds, brewer’s yeast and oats, all of which have purported milk boosting benefits. However, many of these ingredients also contain vitamins and minerals that may generally support lactation and postpartum recovery, such as zinc, iron, B vitamins, and more.
- What the Research Says: Research is none existent.
- Other Considerations: While it depends on the recipe, some of these cookies may be laden with sugar. Opt for recipes that use whole eggs and/or nut butters for extra protein and fat, and consider using maple syrup, dates or honey instead of a conventional sweetener.
- Takeaway: If you are feeling like a sweet, then why not try a lactation cookie. While it may not impact supply, it also is unlikely to cause any harm.
The Bottom Line:
Galactagogues have been used for centuries across various cultures to improve breastfeeding and support lactation. However, while many mothers use these herbs and foods and reports breastfeeding benefits, there is a clear gap in research on many of these herbs and plants. As such, in the absence of research, there is little evidence that these galactagogues are harmful, and similarly, if we were to make a recommendation based solely on research, there is not enough to ensure 100% safety.
In an abundance of caution, as the research catches up, the safest and best approach is to speak with your doctor, dietitian, or healthcare provider before introducing anything new into your daily regiment and then proceed in a way that feels most comfortable to you.
Informed choice is the ultimate empowerment.
As as a final note, if you are someone that is struggling with supply or breastfeeding, reach out to a certified lactation counselor (CLC) or international board certified lactation counselor (IBCLC) for assistance before turning to galactagogues. While many galactagogues are considered safe for consumption, working with a CLC is a safer and more effective way to get assistance and support throughout your breastfeeding journey.
Disclaimer: this article is not providing medical guidance or recommendations, always consult with your healthcare provider before adding a supplement or herb. This information is purely for educational purposes.