Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Winter;16(4):511-524.

A Review of Herbal and Pharmaceutical Galactagogues for Breast-Feeding

Alessandra N Bazzano  1 , Rebecca Hofer  1 , Shelley Thibeau  2 , Veronica Gillispie  3 , Marni Jacobs  1 , Katherine P Theall  1
Affiliations
Review

A Review of Herbal and Pharmaceutical Galactagogues for Breast-Feeding

Alessandra N Bazzano et al. Ochsner J. 2016 Winter.

Abstract

Background: Therapeutic approaches to addressing insufficient lactation are available but remain poorly understood. Current trends in maternal health, such as increasing rates of obesity, delayed age at childbearing, and high rates of cesarean section, may be associated with physiological challenges for lactation that cannot be managed by counseling alone. Women who have not had success with counseling alone, including adoptive mothers seeking to induce lactation, may use galactagogues (pharmaceutical and herbal compounds used to increase lactation). We present a review of selected studies of galactagogues and data indicating popular demand for such products.

Methods: A systematic search was conducted for published studies on the use of galactagogues for breast-feeding. The following databases were searched: MEDLINE (PubMed), EBSCO (Academic Search Complete), and EMBASE. The search was conducted between July 15, 2015, and August 18, 2015; only English language articles were included, and we imposed no restrictions on publication date. Two authors independently reviewed the studies and extracted data.

Results: Blinded, placebo-controlled clinical trials of 2 pharmaceutical galactagogues (domperidone and metoclopramide) and 5 popular herbal galactagogues (shatavari, fenugreek, silymarin, garlic, and malunggay) were identified. All of the studies identified for domperidone showed a significant difference in milk production between the treatment and placebo groups. Of the 6 trials of metoclopramide, only 1 study showed a significant difference in milk production compared to placebo. Results of the clinical trials on herbal galactagogues were mixed. Our review of the evidence for the efficacy of popular pharmaceutical and herbal galactagogues revealed a dearth of high-quality clinical trials and mixed results.

Conclusion: Health providers face the challenge of prescribing or recommending galactagogues without the benefit of robust evidence. Given the suboptimal rates of exclusive breast-feeding worldwide and the availability and demand for medical and herbal lactation therapies, controlled trials and analyses investigating these medicines are urgently warranted.

Keywords: Breast feeding; galactogogues; health policy; lactation.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Flow chart of selection of studies.
Figure 2.
Figure 2.
Mean breast milk production results in select randomized controlled trials of domperidone and placebo.-
Figure 3.
Figure 3.
Google Trends analysis: relative popularity of the search term “increase breast milk” worldwide.
See this image and copyright information in PMC

References

    1. Horta BL, Victora CG. Long-Term Effects of Breastfeeding: A Systematic Review. Geneva, Switzerland: World Health Organization; 2013. http://apps.who.int/iris/bitstream/10665/79198/1/9789241505307_eng.pdf?ua=1. Accessed August 11, 2015.
    1. Horta BL, Victora CG. Short-Term Effects of Breastfeeding: A Systematic Review on the Benefits of Breastfeeding on Diarrhoea and Pneumonia Mortality. Geneva, Switzerland: World Health Organization; 2013. http://apps.who.int/iris/bitstream/10665/95585/1/9789241506120_eng.pdf?ua=1. Accessed August 11, 2015.
    1. World Health Organization. Protecting, Promoting and Supporting Breast-feeding: The Special Role of Maternity Services. A Joint WHO/UNICEF Statement. Geneva, Switzerland: World Health Organization; 1989.
    1. American College of Obstetrics and Gynecology. Breastfeeding in Underserved Women: Increasing Initiation and Continuation of Breastfeeding. Committee Opinion No 570. Washington, DC: American College of Obstetrics and Gynecology; 2013. - PubMed
    1. National Center for Chronic Disease Prevention and Health Promotion. Breastfeeding Report Card: United States/2014. Atlanta, GA: Centers for Disease Control and Prevention; 2014. http://www.cdc.gov/breastfeeding/pdf/2014breastfeedingreportcard.pdf. Accessed August 11, 2015.