by Anne Eglash MD, IBCLC, FABM
Are herbal medicines used to increase milk supply safe during breastfeeding? Many breastfeeding women take galactogogues, which are substances that are believed or known to increase milk supply. Because the majority of galactogogues are herbs, health care providers often have a lack of knowledge regarding safety and effectiveness of these substances. The research data on herbal substances is often not as robust nor as available as the data on prescription medications.
In the journal Breastfeeding Medicine, Dr. Phil Anderson writes a regular column entitled Lactmed Update, summarizing information on certain medication and supplement topics from the National Library of Medicine’s Lactmed database In the November 2017 issue, he reviewed various herbs that are commonly used during lactation.
What do you think are true statements regarding the use of herbs during lactation? (choose 1 or more):
- Homeopathy is typically safe during breastfeeding because the remedies lack any molecules from the substances they are made from.
- Barley and hops have been shown to increase serum prolactin.
- All plants that contain phytoestrogens will drop the supply, such as black cohosh.
- Fenugreek should be avoided when the mother or infant are allergic to legumes such as peanuts and chickpeas.
- Torbangun, also known coleus amboinicus, has been used as a galactogogue safely in Indonesia for hundreds of years.
- Herbs that are considered GRAS (Generally Regarded as Safe) by the US Food and Drug Administration are considered safe during breastfeeding.
See the Answer
Answers: A, B, D, E, not C or F
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Milk Mob Comment by Anne Eglash MD, IBCLC, FABM
There are a few popular galactogogues, namely shatavari and fenugreek, which contain phytoestrogens. Although I have seen rare mothers complain about a drop in milk supply from these substances, for the most part the response is an increase in supply, if any response at all. According to Dr. Anderson, these weak estrogens block the estrogen receptors in the breasts, thereby competing with maternal estrogens, which are stronger.
A GRAS designation by the US Food and Drug Administration for a certain substance is based on the quantity typically consumed when eaten as a food, and does not pertain to the high amounts taken for medicinal use. Therefore, an herb considered GRAS cannot be considered 100% safe in high quantities.
Even though hops, most typically found in beer, can increase the prolactin level, remember that alcohol can inhibit the oxytocin level. Therefore, beer might have a negative effect on milk supply, depending on how much is consumed.
The National Library of Medicine Lactmed database is an excellent resource for herbal substances as well as prescription medications. This is important to know, since enormous numbers of breastfeeding mothers take supplements to increase their milk supply, improve their energy, or to enhance their diets when they feel that they don’t have time to eat well. Odd reports do occur, such as liver toxicity in premature or young infants, or other major negative effects for mother or infant with certain combinations of supplements. So, it is always worth checking Lactmed for periodic updates regarding any herbal supplements that you tend to recommend to breastfeeding mothers.
Sally Wodicka
Thanks, I wish we could have an entire conference on the use of herbs as galactogogues.
Mary Polk
Interesting article. Do you have any evidenced based research articles that supports Fenugreek and blessed thistle help support milk production. Some lactation consultants are reluctant to suggest supplements because they say it is not proven therefore will not suggest it,
MilkMob
Toxnet Lactmed (https://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm) is an excellent resource for evidence on herbs during lactation.
Alice Carroll
It’s interesting to know that barley also has some properties that affect one’s breast milk. I’m interested in looking for an herbal breastfeeding support supplement because I want to be able to find a good way to make sure that my body will be prepared to be a mom. I want to look for a good way to make it easier to feed my baby whenever.
Venus Clark
I am looking for a book that has all the natural herbs that are safe or state not to use. Is there such a book? I really want this to be in book form so I can add it to my shelves to use as a reference after I read it. I have other books for medicinal purposes and like to try to keep our family as natural and as safe as possible.
IABLE
The resource I use for evidence-based information on supplements is https://naturalmedicines.therapeuticresearch.com/