Galactagogues
Introduction
Galactagogues are medications or other substances believed to assist initiation, maintenance or augmentation of maternal milk production.
The routine use of galactagogues is not recommended because there is
- Limited evidence to support their efficacy
- Oral galactagogues (natural therapies or drugs) for increasing breast milk production in mothers of non-hospitalised term infants, 2020
- Efficacy and Safety of Domperidone and Metoclopramide in Breastfeeding: A Systematic Review and Meta-Analysis, 2021
- Because of potential safety concerns.
- Domperidone - risk of arrythmias
- Metoclopramide - CNS adverse effects and risk of tardive dyskinesia
Hence, before initiating a galactagogue, women should attempt nonpharmacologic methods of increasing milk production such as
- Ensuring adequate hydration
- Skin-to-skin holding with baby
- Self-breast massage
- Relaxation techniques
- Unrestricted frequency and duration of breastfeeding
Dosage Regimens
The most commonly used prescription agents are dopamine receptor antagonists, primarily metoclopramide and domperidone.
Dosage in most published studies
- Domperidone
- 10 mg 3 times daily for 4 to 10 days.
- Metoclopramide
- 10 mg 2 or 3 times daily for 7 to 14 days.
Herbs
Data on the use of herbal galactagogues are even more limited.
- Fenugreek is the most widely used herbal agent. Of note, it can affect the international normalized ratio (INR). Hence, women who are taking warfarin may be wise to avoid use of fenugreek.
Summary
While there is not a strict list of foods to avoid while breastfeeding, it is generally recommended to maintain a balanced diet and limit certain foods or beverages.
External Links
- LactMed
- The use of galactagogues in the breastfeeding mother, 2012
- Use of domperidone as a galactagogue drug: a systematic review of the benefit-risk ratio, 2015
- The Effect of Metoclopramide on Prolactin Levels in Breastfeeding Mothers: A Systematic Review and Meta-Analysis, 2017
- Domperidone for Lactation: What Health Care Providers Need to Know, 2017
- Drugs affecting milk supply during lactation, 2018
- Drugs affecting milk supply during lactation with Dr Treasure McGuire, 2018
- Galactagogues (substances claimed to increase supply), 2019
- Oral galactagogues (natural therapies or drugs) for increasing breast milk production in mothers of non-hospitalised term infants, 2020
- Efficacy and Safety of Domperidone and Metoclopramide in Breastfeeding: A Systematic Review and Meta-Analysis, 2021
- Can I Eat That? I’m Breastfeeding, 2022
- Are There Foods to Avoid While Breastfeeding?, 2023
- Foods (and Other Things) That Can Decrease Your Milk Supply, 2023
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