A cross-sectional descriptive study of breastfeeding behaviour and galactogogue use among private-sector patients in Cape Town, South Africa

Abstract

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...

Special foods and local herbs used to enhance breastmilk production in Ghana: rate of use and beliefs of efficacy

“…The current study showed that most lactating women obtained information on selected foods and special herbs from the home mostly parents and grandparents. Contrary to the ndings of the current study, some studies have reported the internet as a major source [11] , for other studies, friends and family [21] and health service providers [22,23] were the main sources of information on breastmilk production aids. Our results are consistent with the study by Budzynska et al [24] in which most cultures transfer knowledge of breastmilk productions aids from generation to generation.…”

Special foods and local herbs used to enhance breastmilk production in Ghana: rate of use and beliefs of efficacy

“…The current study showed that most lactating women obtained information on selected foods and special herbs from the home mostly parents and grandparents. Contrary to the ndings of the current study, some studies have reported the internet as a major source [11] , for other studies, friends and family [21] and health service providers [22,23] were the main sources of information on breastmilk production aids. Our results are consistent with the study by Budzynska et al [24] in which most cultures transfer knowledge of breastmilk productions aids from generation to generation.…”

“…The high prevalence of lactogogue use among lactating women in both regions is consistent with earlier studies [25][26][27] but a little higher than reported in studies from some developed countries [11,23,28]. Wealth inequality could play a role in healthcare access and delivery, respondents in the current study (a developing country setting) where healthcare access is relatively low may be less likely to seek professional advice from healthcare professionals -resorting to information from the family on which foods and special herbs could be used to support breastmilk production.…”

Special Foods and Local Herbs Used to Enhance Breast milk Production in Ghana: Rate of Use and Beliefs of Efficacy

“…The current study showed that most lactating women obtained information on selected foods and special herbs from the home mostly parents and grandparents. Contrary to the ndings of the current study, some studies have reported the internet as a major source [11], for other studies, friends and family [22] and health service providers [23,24] were the main sources of information on breastmilk production aids. Our results are consistent with the study by Budzynska et al [25] in which most cultures transfer knowledge of breastmilk productions aids from generation to generation.…”