Galactagogues

When Heracles was a baby his father Zeus took him from his mortal mother Alcmene and let him nurse at his wife Hera’s breast while she was sleeping. When she awoke she thrust the infant Heracles from her in a rage and milk flooded the night skies, thus creating the milky way. The Greek name for galaxy Γαλαξίας or Galaxias is derived from the word for milk, gala. The theme of milk is not isolated to Greek mythology, the Romans, Egyptians and even older Greek stories all have some reference to milk, whether it be from the gods or astral cows.

And galaxy is where we get the term ‘galactagogue’ from. Galactagogues, or lactogenic herbs are supplements that are said to increase milk supply. As you can imagine, in a society where ‘low supply’ is one of the key reasons for the end of a breastfeeding relationship, galactagogues are in high demand.

Rubens, Birth of the Milky Way

I follow a lot of breastfeeding support pages and not a day goes by where someone doesn’t ask about supplements to boost their supply or offer some secret recipe that will guarantee more milk. These posts always make me sigh, it’s not that I don’t love breastfeeding support. It’s just that no matter how well placed these suggestions are they can just be one more booby trap interfering with the breastfeeding relationship.


That’s not to say that these remedies don’t work, some of them can be very efficacious. But if you have the basics wrong then no galactagogue on earth will successfully increase your supply in the long term. So if someone tries every galactagogue under the sun but doesn't fix a poor latch, then they are destined to fail and that can be really hard on nursing mamas.

So before we dive in to taking supplements the first thing we need to do is establish any obstacles to supply. Common obstacles are having a caesarian birth pre labour, reduced skin to skin contact, early routines, reduced breast stimulation, timed feeds, poor latch, certain medications, lack of sleep, stress and poor support.

Routines


Some of these things are easy to resolve, for example if you are engaging in a strict routine or timing breastfeeds then taking a step back and letting baby dictate the pattern will help immeasurably. If baby can’t dictate supply then supply will drop, unlimited access to the breast, especially in the first 72 hrs is one key factor to ensuring supply meets demand. The sooner baby gets to the breast after birth is also an indicator. If you have a surgical birth it’s important to push for contact with your baby as soon as is possible. If nothing prevents you, immediate skin to skin for at least 90 minutes and longer is ideal. Kangaroo care for premature babies whenever possible is gold standard even if they cannot nurse.


Stress


Stress is another obstacle. Contrary to popular belief stress does not explicitly affect supply but it does inhibit let down and loss of supply can be a secondary effect. If mum is stressed out and tired then a roster of drop off meals, friendly helpers and house tidiers would be ideal. A supportive partner even more so. A shoulder rub, foot soak or relaxing bath can help relieve the stress and release the hormones responsible for milk production and let down. Someone to bring you snacks and drinks of water can take the pressure off and simply taking time to breathe and be mindful can take you out of the stress loop. Remembering that your first and only task is to provide for your baby, can help you re-prioritise.


Touch

If you are doing a lot of tight swaddling, sleeping baby alone and limited carrying or holding of baby then you both might be experiencing a lack of skin to skin contact which will inhibit milk production. The reason for this is twofold, first off skin to skin contact releases oxytocin which is not only the bonding hormone but is responsible for let-down. Secondly babies naturally know how to build supply by kneading, massaging, pummeling and stroking the breast. If they are swaddled tightly or have reduced physical access to the breast then this can limit their ability to maintain supply. I often think of babies as little milk farmers, they know how to nurture their ‘crop’ of milk.  Taking a ‘babymoon’ in bed with baby for even a couple of days can help immeasurably. Wrapping baby close to the chest without clothes on, or even giving safe co-sleeping a go will help boost oxytocin levels and help mum become more responsive to baby’s cues. Skin to skin is even more vitally important for mums who have had medical births or pre-labour caesarians.

Medicines

Your Doctor may not be up to date on how certain medications affect breastfeeding and some over the counter drugs can inhibit supply as well, especially some painkillers, hayfever, or cold and flu meds. Before taking anything, contacting your local La Leche group is a good idea. They have access to documentation on a huge variety of medications and can let you know which ones to avoid. They can also let you know which medications are safe. Often mothers are told to end breastfeeding simply because a health professional is not sure about the effects of a medicine they wish to prescribe, when another medicine will do perfectly adequately or the the medicine is in fact safe.


Latch


The most common issue with poor supply is related to latch, indications of a bad latch can be pain during feeds, a damaged or flattened nipple when the feeds end, a frustrated baby who doesn’t fall into a good suck suck swallow pattern and long feeds that end with a still hungry baby. Latch is vital because if the breast isn’t being emptied then milk production falls and baby gets hungrier and hungrier and in the earlier days they can become weaker very quickly. If you suspect your latch is not great then seek help, a friend who has a lot of breastfeeding experience is a good start but you will get the most knowledgeable support from a La Leche leader or Lactation consultant. Dr JackNewman has some great videos on the topic and also covers breast compressions which help immeasurably.



Medical Conditions


 There are other reasons for low supply including PCOS (polycystic ovary syndrome), IGT (insufficient glandular tissue), thyroid issues and breast surgery. If you have a more complex issue going on then it’s really important you have a health professional assisting you. These conditions don’t rule out breastfeeding but you will need a lot of support and perseverance. A naturopath can help in some instances and if supplementary feeding is happening then using a tube feeding system is your best bet for nurturing supply. Again your local La Leche organisation will have a host of resources that can help you along.


Once you have ruled out all of the above and you would still like to boost supply then the following galactagogues can help. It might be that upon facing one of the difficulties above your supply needs help getting back up or it may be that you want to pump for future supply or simply want a little help to meet demand. Some people will use lactogenic herbs to bring in supply for adoptive feeding or to help keep supply up for a premature or preterm baby. It’s important to realise that different women will respond differently to the many options available so what works really well for one person may not be so effective for another. It’s worth trying a few things.


Fennel Foeniculum vulgare:  Fennel does not directly affect your supply but it does improve your ‘let down’ it is perfect for the four o’clock fuss, stressed mums or babies who experience sore tummies, as it is also carminative. Great for mums who find it hard to express due to let down issues. You can get it as a tincture from an herbalist, or make your own tea or decoction with fennel seeds. You can find them at most organic, health or ethnic stores. Twinings also make a tasty fennel tea which is pricey but convenient. Fennel tea is a great ‘go to’ for new mums who aren’t having supply issues but want a soothing tea that facilitates breastfeeding.


Safe in pregnancy? Not in high doses. Tea is fine


Fenugreek Trigonella foenum-graecum: Fenugreek is one of the most common galactagogues and can be purchased in capsule form. Doses usually have to be quite high (3 grams + a day) for it to be effective but once supply is boosted you can stop taking them providing breast stimulation is sufficient. Taking lots of fenugreek can make you smell like maple syrup and may cause a sore tummy in some people if taken in very large doses. It’s important to note that even though Fenugreek is considered very safe, that in the large doses recommended for increasing milk supply it is not recommended during pregnancy.

Safe in pregnancy? No

Oats Avena sativa: Oats support lactation and aside from that, are a nutritious powerhouse that will help stabilise blood sugars. Found in a bowl of porridge near you

Safe in pregnancy? Yes

Dark beer: When my mum gave birth in Ireland she was given a pint of Guinness to bring her milk in. While I don’t suggest mothers glug down beer to support breastfeeding a small glass of an eveningwon’t hurt. Normally alcohol inhibits letdown but the beta-glucan in the malt, brewers yeast and hops all have a lactogenic effect which means dark beer can act as a galactagogue. But if you prefer not to be a lush you can get brewers yeast, malt and hops individually and take them as supplements. Be wary though, too many hops can make you drowsy!  Light beers will not work. For more information on how beer works as a galactagogue I highly recommend this blog, the lactogenic diet.

Safe in pregnancy? Not recommended


Brewers yeast Saccharomyces cerevisiae: This is often seen as an ingredient in nursing cookies or tigersmilk. It is a great galactagogue and can be easily disguised in baking. Because brewers yeast is a food it can be eaten to taste. Brewer's yeast comes from the Saccharomyces cerevisiae fungus and is a great source of B vitamins, including niacin, pantothenic acid, pyridoxine, folic acid, thiamine, riboflavin, and biotin. Brewer's yeast also contains trace minerals such as selenium and chromium, which are a great health booster for nursing mothers. If you are prone to fungal or yeast infections then brewers yeast may not be for you.

Safe in pregnancy? Yes


Alfalfa Medicago sativa L: This is a galactagogue that helps support the glandular tissue of the breast, and can be taken through the last trimester of pregnancy as well as during breastfeeding. It is available from many health food stores in capsule form. Alfalfa is a wonderful superfood as well, rich in chlorophyll, calcium, magnesium, phosphorus, potassium, silicon, zinc-numerous vitamins-A, B1, B2, B3, B5, B6, C, D, E, and K-as well as essential and non-essential amino acids. Make sure you adhere to the dosage advice as it is a mild uterine toner, it has not been linked to any pregnancy complications but it is still better to be cautious.


Safe in pregnancy? Yes – in normal doses


Blessed thistle Cnicus benedictus: Blessedthistle increases the flow of gastric and bile secretion, and is said to increase milk supply by increasing blood flow to the breast tissue. You can get it from health stores as a supplement and should not increase the dose beyond what is recommended as it can act as a purgative in very high doses. For you to harness the digestive benefits you need to have it as a tea or tincture to stimulate your tastebuds with the bitterness.

Safe in pregnancy? No


Goats rue Galega officinalis: This is a great supplement for mothers with insufficient glandular tissue (IGT). Goats rue is a stinky herb that is toxic when fresh but safe when dried. It is also used to balance blood sugar. Should be avoided if you regularly have low blood sugar but fabulous if you have borderline high blood sugar. You can get it at most health food stores as a tea or a tincture.

Safe in pregnancy? No.

Garlic Allium sativum: Garlic does not actually do anything directly to boost supply but several studies have shown that garlic makes the breastmilk more pleasant for babies and as a result they spend more time at the breast. Garlic is an amazing super food so no harm in boosting your intake.

Safe in pregnancy? Yes


Hops Humulus lupulus: Hops are deeply relaxing and are useful in instances where stress is inhibiting let down, hop tea or a hop compress directly on the breast can help. Avoid hops if your baby is overly drowsy as hops are a powerful soporific and may make your baby less easy to rouse.

Safe in pregnancy? No

Nettle Urtica dioica: The function by which nettle improves supply is unknown but there is a long history attached to nettle being an effective milk booster and a number of scientific studies linking it to improved milk output in herd animals. Nettle is  a good source for calcium and iron, magnesium, manganese, phosphorus, potassium, selenium, sulfur, zinc, copper, chlorophyll, fatty acids, folate, plus vitamins K, B1, B2, B3, B5, C, and E. The minerals in nettle help build blood, and it is a wonderful tonic in the treatment of iron deficiency. Nettle is a fabulous all rounder to take during pregnancy and post partum as it will help with fatigue, blood loss and deficiency. Traditionally it is taken as a tea but you can eat cooked nettle greens or buy it in supplement form.

Safe in pregnancy? Yes

Umbel Seeds

This is a broader category that encompasses Anise, caraway, cumin, dill, fennel, and lovage. These plants all share similar properties. Umbel seeds are believed to promote supply and let down as well as offering digestive benefits for colic in babies. There are substances in them similar to oxytocin and they are mildly relaxing. In one study, umbel seeds tested on rats generated greater mammary tissue growth than was seen with rats on a control diet. Interesting to note, the seed formation of the umbelliferous plants mimics that of the milk glands and ducts in the breast. Because umbel seeds are aromatic the traditional way of taking them is steeped in tea, up to 3 cups a day.

Safe in pregnancy? Not in high doses but teas are fine.

Recipes:


Tigers milk is frequently recommended to nursing mums to improve supply, if nothing else it provides a nutrient dense meal to help nursing mums along. It’s a recipe first created by Adele Davis, in her book "Lets Get Well" (which was written in about 1970's) and included milk, milk pwder, malt, raw egg, wheatgerm and brewers yeast. 

This is my version of her recipe.

Soak overnight: 1 tablespoon of pumpkin seeds, 8 almonds and 1 tablespoon of sesame seeds

In the morning strain them and place in blender with 1 banana, ½ teaspoon of  raw cacao, 1 teaspoon honey, 1 heaped teaspoon of brewers yeast, a splash of coconut milk and 1 cup of water. Blend until smooth and drink while nursing. You can use any milk or milk analogue you like instead of water but the nuts should provide enough creaminess to omit it if you want to.


and here is my recipe for delicious lactation cookies.