If you’re a breastfeeding mother (or even if you’re not), you’ve probably either heard, seen, or used a lactation supplement or aid of some sort.
Some examples include: lactation cookies, drinks such as teas, herbal supplements and more. But can all these things really help boost milk supply? And are they safe? Lets take a deeper look into the science and studies behind lactation supplements and aids and see…
*Disclaimer: This blog is intended for informational purposes only. The information on this blog should not be used as a substitute to medical advice or medical treatment. As always, your Primary Care Provider, a doctor, or another health professional is your best resource for specific questions and medical advice. If you believe you or a loved one are experiencing a medical emergency, please contact 911.*
What is a lactation “aid” or supplement?
Another word for a lactation aid or supplement is galactagogue, meaning “an agent that stimulates the secretion of milk or increases milk flow”. So – it is exactly what it sounds like, something that aids you with lactation.
Medications are sometimes used for this purpose (ie. domperidone, metoclopramide) however the general consensus is that breastfeeding/lactation counselling and adjustment of things like technique, positioning and so on, are preferred to use the of any medication. Studies are lacking in regards to the use of metoclopramide for this purpose, however the increase in milk production caused by domperidone is supported by evidence (it is not approved for this use in the USA though). There also appears to be minimal side effects from the use of domperidone in the pregnant population (they are generally mild if reported though do increase with increasing doses).
Herbal supplements are commonly used as well. These are usually given as a tea or in capsule form, however there are also other liquid formulations and “lactation cookies”. Studies on the use of these are limited. The studies that do exist on them, like with fenugreek for example, have conflicting results. One study from 2011 showed a significant increase in the production of milk, while another from 2006 did not.
In regards to both pharmaceutical and herbal galactagogues there is a definite need for further research.
Will they help me with milk production?
It’s hard to say whether or not one of these options may help you since trials and studies have shown mixed results (except for, as I mentioned, domperidone whose positive impact on milk production is generally supported by research; however, it is not a recommended first line of action).
There was a recent systematic review (however – due to the limited research, there were only 5 studies included) on the effectiveness of fenugreek – it was shown in 4 out of 5 studies to increase milk production. However, when it was compared to palm date and Coleus amboinicus it didn’t quite match up. C. amboinicus is traditionally used in Indonesia as a galactagogue – however, there is barely any research on it and the one study that does exist has conflicting conclusions. Palm dates on the other hand, have been studied more and seem to be superior to both in regards to early postpartum increase in milk supply.
As with many things – it may require some trial and error. On the behalf of scientists/people in STEM – it will also require more research.
But is it safe?
If you are prescribed pharmaceuticals, your doctor or care provider should go over the risks with you. Generally, the side effects are minimal with domperidone and there doesn’t appear to be much transfer via breast milk. Metoclopramide on the other hand (which has less evidence supporting its use for this purpose anyways) poses an increased risk for postpartum depression. There are also risks with long-term use of this drug. If either are prescribed to you, your doctor/provider will discuss any specific risks more in-depth.
In regards to the herbal supplements – fenugreek seems to be recognized by the U.S. FDA as relatively safe – as a flavouring. For medicinal purposes, it has been reported to have minor side effects such as GI upset and gas, as well as more serious side effects such as liver toxicity. Keep in mind that there are, again, limited studies on this herb. Large doses of fenugreek should be avoided because they may impact blood sugar levels. Fenugreek also interacts with the drug warfarin. An odd but not harmful adverse effect is that it causes a “maple syrup” like scent to be given off by bodily excretions such as urine and sweat.
In regards to specific products – I couldn’t find many studies. A recent study on Mother’s Milk Tea showed no adverse effects from its use over a 30-day period or in the longer term (first year of baby’s life).
It should be noted that a limitation of this study was that it couldn’t measure how effective the tea was – firstly, because the population they studied were breastfeeding (not pumping for example, where you can objectively measure the amount of milk) and secondly because the mothers using the tea actually already reported having adequate milk supply prior. So how helpful it would be to someone who actually has low supply is hard to say.
I could only find one study on lactation cookies. It was published in 2019 and looks at a biscuit made of banana flower. It showed increased milk production and other positive effects in regards to growth for the babies receiving the milk. Honestly though, the study authors concluded that their study had “proven” that banana flower could be a good galactagogue.. which rubbed me the wrong way. How can they be so sure of their results after only one study on their specific topic and such a small sample size (<60 women)? It doesn’t mean their conclusion is wrong, but it makes me want to demand more research.
With all herbal supplements – one must keep in mind that those who make them do not have to jump through as many hoops to sell them as pharmaceutical companies. This means that herbal supplements may have different amounts of active ingredients than labelled, and that each brand selling the same supplement may not truly be selling the same product in regards to its safety. Just something to keep in mind.
Conclusion regarding safety: it’s hard to say. There aren’t many studies and herbal products aren’t regulated. Although certain herbs can be safe in certain quantities, you can’t be sure how much is in the product you are taking. My advice is if you want to pursue a certain herbal remedy for lactation, speak to your provider or a IBCLC (lactation consultant) first. You should also always let your provider know that you are taking any herbal supplements or vitamins and what they are – because as I mentioned with fenugreek above, they can interact with prescribed medications.
What can I do if I’m having milk supply issues?
Low milk supply is often the reason that women stop breastfeeding – so if you suspect you’re having issues with supply, you should (I feel like a broken record as usual) speak to your primary care provider.
They may have suggestions for you such as having baby go to breast more frequently or pumping to increase supply. You may be having issues with baby latching, or poor positioning during feeding – these can all impact supply (as if baby is not eating properly, those signals to produce more milk aren’t going to be happening inside your body). There could also be other things going on in your body that are impacting supply – even stress.
After an assessment your provider or an IBCLC will be able to counsel you on recommendations to increase supply, or help you with any other breastfeeding challenges you may have. Breastfeeding is not always (or even usually) easy. It comes with a lot of mental and physical challenges. So don’t feel too discouraged if you’re having issues – if you want to continue to pursue it (keyword: want), then there are supports available to help you achieve this. You just have to know what/who they are (your provider, an IBCLC, there are often breastfeeding clinics, public health nurses, etc.), and how to access them (ask for resources from your care provider/maternal care provider).
The internet is an excellent tool however you need to know how to use it to find reliable information. Sharing experiences with other moms is so valuable as support method, and can even be used for informational purposes (like daycare recommendations for example) but it shouldn’t be your first resource for health information. That is the role of your care provider – that’s why it is important to find one you trust and can rely on.
Your internet friend didn’t attend medical school, nursing school, or do 1000+ additional hours of breastfeeding counselling and 90+ hrs of additional breastfeeding education (or other types of schooling that would make them qualified to provide you with health-related recommendations).
“Oh but it’s just an herbal supplement!” – no! FYI: Herbal supplements have risks too.
You can still consume too much of an herb. Even very common herbs (like ones we use frequently in cooking) can have medication interactions or adverse effects if taken with other medications, or by people with certain conditions.
Someone on the internet doesn’t know your health history – so before taking anything, you should speak to a knowledgeable resource like your doctor, pharmacist, nurse/nurse practitioner, IBCLC (when it’s breastfeeding related), etc. It’s true that some providers don’t have all of the knowledge about herbs – and that’s because there is limited data on them. Ask for resources in that case where you can find more information for yourself, or speak to a pharmacist – they are so knowledgeable and (I find) sometimes overlooked in regards to their ability to provide you with answers. If you believe your provider is not providing you with info because of their beliefs (as in – they say no herbal supplements without giving you an explanation/evidence as to why not) – seek a care provider that is better matched to you.
I have listed some breastfeeding resources here, however this should not be your first resource – book an appointment to see (or “see” virtually) your care provider and discuss your concerns with them. You can work on a solution together – it doesn’t mean that use of herbs is out of the question, but that it should be carefully considered and discussed in order to make sure it is a safe decision for you (and your baby).
It is important to remember that aids like this (medicinal or herbal) should come second to lactation counselling/breastfeeding support. This is the gold standard for helping moms with any breastfeeding struggles, including those related to supply!