Galactogogues: Superfoods for Promoting Breast Milk 

A very well-known fact is that breast milk is the best and complete form of food for babies, and in India around 50-60% of children under 6 months of age are breastfed. Babies not being breastfed properly may have risk of many diseases in later life along with mother.

Milk production is very essential for optimal feeding of infants and has a direct impact on the development, growth and health of neonatal period. The significance of breastfeeding has been very well understood & acknowledged by all the Indians since antiquity as has the importance of  of few of the medical plants for augmentation of breast milk. Breastfeeding is usually influenced by nutritional and other factors (associated with health, climate, endocrinology and management) that affect milk secretion and synthesis.

It has been reported that 58% of term mothers experience problems with breastfeeding, including a perception of insufficient milk supply. If breast milk supply is actually inadequate supplementary feeds are necessary. The gap between low milk supply and babies regular need can be fulfilled with use of galactogogue, as it is a food, herb or drug that increases the supply of breast milk.

What is a Galactogogue?

Galactogogues are defined as substances that can help to promote lactation.   They can be from different sources such as pharmacological or non pharmacological (natural). Natural source of galactogogues are usually botanical or other food agents, such as leaves, oats, shatavari roots, fennel, fenugreek etc. while pharmacological galactogogues include  domperidone, metoclopramide, thyrotropin releasing hormone (TRH) and sulpiride. So, lactating mothers need to know about certain foods believed to help increase their breast production. These foods are Galactagogues.

Why is this important?

An inadequate milk production can be threatening to babies’ health and stressful to mothers. The choice of some milk booster is often influenced by local customs or familiarity. Some mothers may prefer medications, while some may prefer natural remedies. Evidence of the possible pros & cons of milk boosters is really important to assist in making informed decisions.

How do Galactogogues work?

The natural source and its properties in these  milk secretion boosters can sometimes mimic hormones which are responsible for stimulating breast milk production or can give thebody  nutrients it needs to boost   milk secretion. Galactogogues can be also found  in different herbs, lactogenic foods, or lactation supplements.

Source of galactogogues – 

Following are some of the herbs, supplements and foods that can augment breast milk secretion  :

1. Reds: Beets, Red raspberry leaf, strawberries, papaya
2. Oranges: Carrots, apricots, turmeric and salmon
3. Yellows: Chickpeas, garlic, oats and ginger
4. Greens: Fennel, dark leafy greens, moringa, alfalfa and shatavari
5. Browns and black: Almonds, sesame seeds, black tea, anise seed

Medications:

Medication is the last option only after all the other options have failed. Medications are very useful when milk is being  pumped for a premature or hospitalized infant and in a condition you have a low breast milk supply.

Domperidone and metoclopramide are two commonest prescription medications that may help to increase milk production for lactation induction, relactation, and a true low milk supply. Other drugs such as sulpiride, oxytocin nasal spray, thorazine, TRH, and human growth hormone may also have a very positive effect on breast milk supply, but are not commonly used for this purpose.

Guidelines & Recommendations

1. Proper storage and preparation of Breast Milk: How families and childcare professionals may safely transport and store expressed breast milk.
2. Food safety for infants after a natural disaster: Precautions to take when feeding the infant after a flood, hurricane or other emergency.
3. Infant safety in maternity care practices that support breastfeeding in birth facilities: Published resources on infant safety in the maternity care setting.
4. What to do if an infant or child is mistakenly fed another woman’s expressed breast milk: Treat a switch in breast milk as if an accidental exposure to other body fluids had occurred.

Effectiveness of Galactogogues

Galactogogues do not necessarily work on their own. A galactogogue mostly helps to improve the amount and also the flow of the breast milk from   breasts. For effectiveness of the galactogogues they must be used  along with frequent breastfeeding or pumping.

Safety of Galactogogues

No adverse effects or side effects are reported with the use of herbal galactogogues whereas  medications such as domperidone and metoclopramide are associated with side effects such as gastrointestinal discomfort, insomnia and depression. This makes the herbal galactogogues safe and efficacious to be used. Commercially prepared teas and lactation supplements may contain safe doses of effective herbs when they are taken as directed, but note that they often lack scientific evidence of their safety and efficacy in people who are breastfeeding. It becomes very important to know that high doses of herbs can also be dangerous and can have side effects for both, the mother  and her child.

Reference:

1. https://thebasicmeals.com/super-foods-for-breastfeeding-mothers/
2. An Overview on The Use of Galactogogues in the Breast-Feeding Mother Zaiba Kousar1 , Dr. Neeta Pattan DOI Link: https://doi.org/10.22214/ijraset.2022.40187
3. Kent JC, Gardner H, Geddes DT. Breastmilk Production in the First 4 Weeks after Birth of Term Infants. Nutrients. 2016 Nov 25;8(12):756. doi: 10.3390/nu8120756. PMID: 27897979; PMCID: PMC5188411.
4. Felipe Penagos Tabares, Juliana V. Bedoya Jaramillo, Zulma Tatiana Ruiz-Cortés, “Pharmacological Overview of Galactogogues”, Veterinary Medicine International, vol. 2014, Artic le ID 602894, 20 pages, 2014. https://doi.org/10.1155/2014/602894
5. Foong SC, Tan ML, Foong WC, Marasco LA, Ho JJ, Ong JH. Oral galactagogues (natural therapies or drugs) for increasing breast milk production in mothers of non-hospitalised term infants. Cochrane Database Syst Rev. 2020 May 18;5(5):CD011505. doi: 10.1002/14651858.CD011505.pub2. PMID: 32421208; PMCID: PMC7388198.
6. https://lovemajka.com/blogs/blog/how-galactagogues-work
7. https://www.verywellfamily.com/galactagogue-how-to-make-more-breast-milk-431854
8. Centers for Disease Control and Prevention, guidelines and recommendations for Breastfeeding. https://www.cdc.gov/
9. Asztalos EV. Supporting Mothers of Very Preterm Infants and Breast Milk Production: A Review of the Role of Galactogogues. Nutrients. 2018 May 12;10(5):600. doi: 10.3390/nu10050600. PMID: 29757199; PMCID: PMC5986480.