Background. Failure to exclusively breastfeed is often caused by a perception of insufficient breastmilk supply. Galactogogues are frequently prescribed in these circumstances, but this is supported by sparse scientific data with safety concerns for both mother and infant. The exact extent of galactogogue use in South Africa (SA) is not well known. Objectives. To assess breastfeeding behaviour, galactogogue use and perceived galactogogue side-effects among patients attending International Board Certified Lactation Consultant (IBCLC) private practices. Methods. We administered a self-developed, expert-reviewed questionnaire in five IBCLC private practices within the Cape Town Metropole, SA. All patients attending the practices during an 8-week period were invited to participate. Results. Data from 104 participants were included in the study. An exclusive breastfeeding rate of slightly more than 50%, associated with greater parity (p=0.029), was found. Perceived lack of breastmilk predicted galactogogue use (p=0.013). There was a high prevalence of galactogogue use (54%), with 80% of these participants using non-prescription medication. Sulpiride was the most common prescription medication used. Increased milk production was reported by 41% (n=23) of galactogogue users, while 30% (n=17) reported no effect. Most reported side-effects were minor. Conclusions. Prevalence of galactogogue use exceeded other published data. Sulpiride was most frequently prescribed, despite not being recommended during breastfeeding. A large group of participants reported poor efficacy. The effect of vaginal delivery and immediate skin-to-skin contact after delivery on milk production might be smaller than previously reported in mothers who are personally motivated to breastfeed. Healthcare practitioners should acknowledge breastfeeding mothers' concerns regarding insufficient milk supply and emphasise correct breastfeeding technique. Exclusive breastmilk is the optimal feeding for infants up to 6 months of age. S Afr J Obstet Gynaecol[1] Breastfeeding has been associated with short-term benefits such as providing the child's first immunity and reducing infant morbidity and mortality associated with infections.[2] Long-term benefits include lower mean blood pressure and total cholesterol in adulthood, and improved performance in intelligence tests. [2] However, mothers struggle to achieve exclusive breastfeeding and according the World Health Organization (WHO)᾽s global database on infant and young child feeding the rate of exclusive breastfeeding in South Africa (SA) is among the lowest in the world, at 11.6% in infants <4 months and 8.3% in infants ≤6 months of age, compared with a global rate of 38%.[3] There are many contributing factors leading to low breastfeeding rates, but the most common reason is insufficient breastmilk supply. [4] Galactogogues are often prescribed to augment breastmilk supply in resource-rich environments.[5] Galactogogues are dopamine antagonists such as antipsychotics, antiemetics and natural supplements wh...