Safety and Efficacy of Galactogogues: Substances that Induce, Maintain and Increase Breast Milk Production

Abstract

Poor production of breast milk is the most frequent cause of breast lactation failure. Often, physician prescribe medications or other substances to solve this problem. The use of galactogogues should be limited to those situations in which reduced milk production from treatable causes has been excluded. One of the most frequent indication for the use of galactogogues is the diminution of milk production in mothers using indirect lactation, particularly in the case of preterm birth. The objective of this review is to analyze to the literature relating to the principal drugs used as galactogogues (metoclopramide, domperidone, chlorpromazine, sulpiride, oxytocin, growth hormone, thyrotrophin releasing hormone, medroxyprogesterone). Have been also analyzed galactogogues based on herbs and other natural substances (fenugreek, galega and milk thistle). We have evaluated their mechanism of action, transfer to maternal milk, effectiveness and potential side effects for mother and infant, suggested doses for galactogogic effect, and recommendation for breastfeeding.

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

“…[4,8] In turn, mothers may develop movement disorders such as acute dystonic reactions. [4] Antiemetics exploited for their blocking of dopamine receptors also have safety concerns. [8] Metoclopramide is structurally related to the antipsychotic sulpiride and not recommended during breastfeeding.…”

“…[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 which enhance lactation by increasing serum prolactin.…”

“…[4,8] In turn, mothers may develop movement disorders such as acute dystonic reactions. [4] Antiemetics exploited for their blocking of dopamine receptors also have safety concerns.…”

Modulatory Effect of an Isolated Triglyceride from Fenugreek Seed Oil on of α-Amylase, Lipase and ACE Activities, Liver-Kidney Functions and Metabolic Disorders of Diabetic Rats

“…This has led to a growing interest in the production and marketing of fenugreek. The seeds of fenugreek are known to have hypoglycaemic 5 , hypocholesterolemic 6 , gastro-intestinal and hepato-protective effects 7,8 , antioxidant properties 8 , and also it stimulates lactation in women 9 .…”

Complementary, Holistic, and Integrative Medicine: Advice for Clinicians on Herbs and Breastfeeding

“…(9) Galactagogues are herbs or medications that increase breast milk production ( Table 1). The use of herbal galactagogues dates back several thousands of years, with Hippocrates suggesting that "If the milk should dry up .…”