Lack of milk is one of the main concerns of breastfeeding mothers. Failure to know how much the baby has suckled and not calculate how much milk we produce, often generates anxiety and doubts about whether the milk the baby drinks is enough.
The vast majority of mothers are able to produce all the milk their baby needs (or their babies, in the case of twins or breastfeeding in tandem). And yet, sometimes we find babies who gain little weight or mothers who need to supplement breastfeeding with artificial formula. Can we drink something in these cases to increase milk production?
What are galactogogues?
Galactogogues are substances that stimulate milk production. We usually talk about two types: pharmacological and non-pharmacological (or natural) galactogogues.
Within the first group there are certain medications that, without being specifically designed for this purpose, can increase milk production. These Pharmacological galactogogues could only be administered under medical supervision and for a short period of time.; Like any drug, they do not lack adverse effects, so the risk and benefit of its use should be balanced.
In Babies and more Tips you will listen to increase milk production and that are falseNatural galactogogues
For thousands of years, plants, infusions and other natural products have been used to increase the production of breast milk. Especially in non-Western cultures, it is common for the parturient to offer certain plants and foods in order to increase milk production and quality.
Is there evidence that natural galactogogues work?
No. Today there is no scientific evidence that natural galactogogues work. There are several published articles about herbal galactogogues; some of them do describe an increase in milk volume and / or prolactin levels. However, all of them have a poor methodology that makes them very low quality and unreliable (few patients, very few data collected, poor follow-up, poor objective assessment ...).
It is common to hear that someone worked (mother, aunt, grandmother ...) but these personal experiences they need to be scientifically proven. Sometimes the improvement may be due to the placebo effect: knowing that we are drinking something that will increase milk, we gain confidence and it gives us the impression that we produce more.
The ABM protocol (of the Academy of Breastfeeding Medicine, Breastfeeding Medicine) states that:
“Because the current state of galactogogue research is relatively inconclusive and all agents have potential adverse effects, you cannot recommend any specific pharmacological or herbal galactogogue at this time. ”
We need therefore more studies, with an adequate methodology, to be able to determine whether or not these substances increase the production of breast milk.
In the Clinical Practice Guide to breastfeeding and in recent publications, the different articles published about natural galactogogues with similar conclusions are analyzed.
Are natural galactogogues safe?
The web par excellence for check the compatibility of medications and other substances with breastfeeding it is www.e-lactancia.org, project of APILAM (Association for the Promotion and Scientific and Cultural Research of Breastfeeding).
Some substances are safe (eg milk thistle), but others, such as anise or fennel, may have adverse effects on the infant. In fact we can find described in the literature cases of intoxication in the infant after consuming their mothers certain infusions.
For example, Rosti published in 1994 the poisoning of two infants of 15 and 20 days (who went to the Emergency Department with weight loss, hypotonia, lethargy and vomiting) after consuming their mothers large amounts of an infusion containing fennel, anise and galega and which they took with the purpose of increasing their milk production. It is important to note that infusions and other herbal preparations do not have a standardized dose of preparation and there is a possibility of interaction with other medications as well as an allergic reaction.
What are the most frequently used natural galactogogues?
- Milk thistle: from this plant its fruits are used. It has been attributed a hepatic protective effect. There are works that evaluate its effectiveness as a galactogogue in cows and humans, but are inconclusive. It has a very low risk for breastfeeding since it is hardly excreted in milk.
Beer, widely used in different cultures because of the belief that milk production increases can have the opposite effect. Alcohol increases prolactin levels (hormone "in charge of breastfeeding) but decreases the secretion of oxytocin (the hormone in charge of milk ejection), and may decrease milk production between 10 and 25%. In addition, alcohol diffuses into breast milk, affecting the infant. 0.0% beer can be consumed during breastfeeding.
Brewer's yeast It is a fungus that is used to make beer, bread and wine through fermentation. Although it has been used for this purpose, there is no conclusive evidence of its effectiveness as a galactogogue.
Fenugreek: This seed has been and is widely used to increase milk production and is included in various preparations for this purpose. Its effect has been studied in several studies, some of them do find an increase in milk production and in others there is no effect. More studies are needed to determine its effect as a galactogogue. In moderate amounts its consumption is safe during breastfeeding, however, in high doses it can produce hypoglycemia (lowering of blood sugar). In addition, it gives a smell of urine and milk to maple syrup, which would force to rule out maple syrup disease.
- Fennel: The fruits of this plant have been used to treat infant colic and as a galactogogue, but there is no evidence that milk production increases; in fact, due to its estrogenic effect, it could even decrease it. In addition, it does not lack adverse effects. Two cases of lethargy, vomiting and hypotonia are described in two infants and their mothers after taking it excessively. The e-lactancia.org website describes its consumption as unsafe during breastfeeding.
- Basil: we use it frequently as a condiment in the kitchen (I take this opportunity to remember the importance of washing it well). Traditionally it has been used in infusions and as an essential oil, giving it various properties. As with the previous ones, there is no evidence of its effectiveness as a galactogogue and, in addition, its consumption during pregnancy or lactation as well as in young children is not recommended.
- Anise: widely used culinary and infused to relieve various discomforts. Very used for years to relieve colic of the infant (and NOT currently recommended). There is no evidence that milk production increases and, at high doses, it could even decrease it, as well as being toxic. The European Medicines Agency (EMA) does not recommend its use in children under 18 years.
- Chamomile: widely used as an antispasmodic, digestive and anti-inflammatory; there is no evidence that it is effective as a galactogogue, there is only some anecdotal publication. Some of its components seem to pass into breast milk but there is no toxicity data, so its moderate consumption is considered safe during breastfeeding.
If we take herbal infusions, what precautions should we take?
- Check your compatibility with breastfeeding. As I said previously, a reliable source is www.e-lactancia.org
- Do not take too much. Many infusions are safe at low doses but can be toxic if we ingest large amounts. The "natural" is not always harmless
- If we are taking any medication, make sure that the plant does not interfere with it. Several herbal products increase the levels of anticoagulants such as warfarin or heparin.
- Use a reliable source; Sometimes one plant is confused with another with toxic properties.
In Babies and more No infusions, no juices, no water: up to six months of the baby, only exclusive breastfeedingWhat is the best way to increase milk production?
Frequent and on-demand breastfeeding with a correct technique It is the best galactogogue. Maternal self-confidence also plays an important role.
Before a mother with low milk production it is recommended to evaluate the breastfeeding technique and increase the frequency of the shots, favor skin-to-skin contact and self-confidence; remember that the vast majority of mothers are able to breastfeed their babies. Primary hypogalactia (the mother's inability to produce milk) appears in a very small percentage of women.
