Background: Exclusive breastfeeding for infants up to 6 months is widely recommended, yet breastfeeding rates are relatively low in the US. The most common reason women stop breastfeeding early is a perceived insufficiency of milk. Galactagogues are herbal and pharmaceutical products that can help increase milk supply; however, data on their efficacy and safety is limited. Lactation consultants, obstetricians, and other health providers are an important point of contact for breastfeeding women experiencing challenges with lactation. This study explored providers' perceptions, experiences, and practices in relation to galactagogue recommendation.
Method: A cross-sectional survey was conducted among a convenience sample of English-speaking health providers in the US who counsel breastfeeding women and their infants.
Results: More than 70% of respondents reported to recommend galactagogues. The most frequently recommended galactagogue was fenugreek with respondents indicating that they recommend it either 'always' (8.5%) or 'most of the time' (14.9%) and 'sometimes' (46.8%). More than 80% of the respondents indicated that galactagogues were useful for their clients and only one-third reported side effects. Reasons for refraining from recommending galactagogues were insufficient evidence of its efficacy and safety. Respondents reported a wide variety of sources of information used for their own education about galactagogues.
Discussion: Despite little evidence regarding safety and efficacy, some galactagogues are widely recommended and often perceived to be useful. However, concerns about their efficacy and safety remain. In order to assure both providers and users about safety and efficacy, more robust studies as well as better pharmacovigilance systems are needed.
Keywords: clinical decision making; human milk; lactation; lactogenesis; nutrition.
Conflict of interest statement
The authors report no conflicts of interest in this work.
Maternal experiences with and sources of information on galactagogues to support lactation: a cross-sectional study.Int J Womens Health. 2017 Feb 27;9:105-113. doi: 10.2147/IJWH.S128517. eCollection 2017. Int J Womens Health. 2017. PMID: 28280392 Free PMC article.
The Use, Perceived Effectiveness and Safety of Herbal Galactagogues During Breastfeeding: A Qualitative Study.Int J Environ Res Public Health. 2015 Sep 7;12(9):11050-71. doi: 10.3390/ijerph120911050. Int J Environ Res Public Health. 2015. PMID: 26371019 Free PMC article.
A Review of Herbal and Pharmaceutical Galactagogues for Breast-Feeding.Ochsner J. 2016 Winter;16(4):511-524. Ochsner J. 2016. PMID: 27999511 Free PMC article. Review.
What Evidence Do We Have for Pharmaceutical Galactagogues in the Treatment of Lactation Insufficiency?-A Narrative Review.Nutrients. 2019 Apr 28;11(5):974. doi: 10.3390/nu11050974. Nutrients. 2019. PMID: 31035376 Free PMC article. Review.
Perspectives and attitudes of breastfeeding women using herbal galactagogues during breastfeeding: a qualitative study.BMC Complement Altern Med. 2014 Jul 2;14:216. doi: 10.1186/1472-6882-14-216. BMC Complement Altern Med. 2014. PMID: 24985246 Free PMC article.
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- WHO The optimal duration of exclusive breastfeeding Report of the expert consultation. 2001. Available from: http://www.who.int/nutrition/publications/infantfeeding/WHO_NHD_01.09/en/
- Innocenti declaration on the protection, promotion and support of breastfeeding. Florence, Italy: 1990. Available from: http://www.who.int/about/agenda/health_development/events/innocenti_declaration_1990.pdf.
- American Academy of Pediatrics Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827–841. - PubMed
- American College of Obstetrics and Gynecology Breastfeeding in underserved women: increasing initiation and continuation of breastfeeding. Committee Opinion No 570. Obstet Gynecol. 2013;122:423–428. - PubMed
- Lawrence RA. Breastfeeding, a Guide for the Medical Profession. 2nd ed. St. Louis, MO: Mosby; 1985.