High prevalence of galactagogue use among breastfeeding mothers in U.S.

A recent study published in the Journal of the Academy of Nutrition and Dietetics describes the prevalence of galactagogue use among breastfeeding mothers in the United States and their perceived effects on milk production. Galactagogues are substances used for stimulating milk production.

Study: Use of Galactagogues to Increase Milk Production Among Breastfeeding Mothers in the United States: A Descriptive Study. Image Credit: Nina Buday / Shutterstock.com

Background

According to the American Academy of Pediatrics recommendations, infants should be exclusively breastfed for the first six months of their life, with breastfeeding continued for 24 months or longer. However, only 26% of U.S. infants exclusively consume breast milk at the age of six months, with 35% partially consuming breast milk at the age of 12 months.

Inadequate milk production is the most commonly reported reason for breastfeeding cessation in the U.S. Frequent and effective removal of milk from the breast through infant suckling or breast pumping is needed for sufficient milk production. Human milk production can also be impaired by certain risk factors, including obesity, diabetes, genetics, prior breast surgery, and the use of certain medicines.

Galactagogues are substances that are frequently consumed by mothers to increase milk production. These substances include food items, beverages, herbal supplements, and pharmaceuticals. However, due to a lack of information on safety and efficacy, the Academic of Breastfeeding Medicine does not recommend using galactagogues to increase milk production.

In the current study, scientists determine the prevalence of galactagogue use among U.S. mothers and the perceived effects of galactagogues on milk production.

Study design

A cross-sectional online survey was conducted between December 2020 and February 2021 on a total of 1,294 adult women who were breastfeeding a singleton child and residing in the U.S. Self-reported current or previous use of galactagogues and their perceived effects on milk production were obtained from the survey.

Study participants were asked to provide only current breastfeeding experiences to avoid recall errors. They provided information on their intake of foods or beverages, a combination of herbal products, any herbal products in isolation, or any pharmaceuticals.

The survey also included questions to determine the intake of 18 foods, food groups, or beverages, ten herbal supplements, two pharmaceuticals, and other galactagogues. For each affirmative answer, the participants reported whether the galactagogue intake increased, reduced, maintained, or didn’t affect their milk production.

The information on sociodemographic, birth, and breastfeeding characteristics was collected from the participants. Perceived insufficient milk production and breastfeeding self-efficacy were assessed using valid questionnaires.

Important observations

About 82% of participants are non-Hispanic White, and the average maternal age was 31 years. Most of the infants were less than 12 months old.

Perceived insufficient milk production was reported by 15% of participants. First-time breastfeeding was reported by 47% of participants.

Galactagogue intake and its perceived effect on milk production

Regarding the prevalence of galactagogue use, about 58% of participants reported using any galactagogues, 55% reported using any foods and beverages, 28% reported using any herbal products, and 1.4% reported using any pharmaceuticals.

Regarding specific galactagogue use, less than 5% of participants reported using wine, non-alcoholic beer, fennel, milk thistle, blessed thistle, moringa, goat’s rue, stinging nettle, alfalfa, shatavari, domperidone, or metoclopramide.

More than 40% of participants identified oats, lactation cookies, brewer’s yeast, alcoholic beer, sports drinks, and combinations of herbal products as effective galactagogues for increasing milk production.

Impact of maternal characteristics on galactagogue use

A significantly higher intake of galactagogues was reported by mothers who were comparatively older or currently employed. A higher intake of galactagogues was also observed among mothers who delivered through a cesarean section or first-time breastfeeding.

Regarding other breastfeeding-related characteristics, perceived insufficient milk production, low breastfeeding self-efficacy, infant latching difficulties, breastfeeding pumped milk, and formula milk supplementation were associated with higher galactagogue use.

Mothers breastfeeding two or more children of different ages at the same time reported significantly lower use of galactagogues.

Study significance

The study reveals a high prevalence of galactagogue use among breastfeeding mothers in the U.S. In particular, mothers with perceived insufficient milk production, first-time breastfeeding mothers, and those breastfeeding pumped milk are more likely to use galactagogues.

Given the study findings, the scientists highlight the need for future studies investigating the safety and efficacy of commonly used galactagogues. Supportive initiatives are also needed to educate breastfeeding mothers about best practices for increasing milk production and meeting breastfeeding goals.

Journal reference:
Dr. Sanchari Sinha Dutta

Written by

Dr. Sanchari Sinha Dutta

Dr. Sanchari Sinha Dutta is a science communicator who believes in spreading the power of science in every corner of the world. She has a Bachelor of Science (B.Sc.) degree and a Master's of Science (M.Sc.) in biology and human physiology. Following her Master's degree, Sanchari went on to study a Ph.D. in human physiology. She has authored more than 10 original research articles, all of which have been published in world renowned international journals.

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Comments

  1. Jayne Freeman Jayne Freeman United States says:

    It's interesting to see that the main reason cited for cessation of breastfeeding is blamed on "low milk production" instead of recognizing that in the United States we have no universal maternal leave policy. The real reason that most women don't continue exclusive breastfeeding beyond 3 months is because they are back at work. And the smoke & mirrors trick from our government has been to give everybody free pumps -- as though that would solve the issue. I thought this article might include something about the efficacy of galactagogues but that is clearly going to have to be a different article. It was helpful however to note that women who exclusively pump, and there are a lot of them, are more likely to seek out supplements and galactagogues because they are watching their milk supply so closely and measuring every pumping session as they see it in the bottle. This is less likely to be a problem for women who are nursing from their bodies. Another interesting topic for an article might be recognizing that the quest for galactagogues is driven by the overwhelming cultural pressure to breastfeed at all costs.

    • Torrey Moorman Torrey Moorman Puerto Rico says:

      Thank you, I came here to say the same. Lack of paid maternity leave, lack of support with paid paternity leave, lack of societal support for women in general, generates a lot of stress.

      We **know** the body can't produce adrenaline and oxytocin at the same time.

      We **know** pumping is not as effective as actually feeding baby at the breast.

      The US is the only "industrialized" country that doesn't have any form of universal health care nor a minimum of 12 weeks paid maternity leave (most civilized countries have a one year minimum paid leave, in addition to some kind of partner paid leave), and the breastfeeding rates reflect the support the birthing parent actually received.

      Almost all my clients lose /see serious reduction in supply in the first 4 weeks of work. After attending a workshop with Dr Jack Newman, I talked to my clients about removing the stress of pumping, and using SNS with either artificial breast milk or donated milk instead.

      Most see a return of their own supply in less than 6 months, and 70% are still breastfeeding at age 3. We need to alleviate the stress, not push galactogogues.....

    • Shellioness Love Shellioness Love United States says:

      I agree with you 100% about that last part. Society is causing so many things to go on with women. Nowadays, it's driving me crazy. And I'm sure it's driving you all crazy too!! Not only has the society norms of what women should look like with all these fake surgeries we now have to deal with everybody being told that they need to breast feed in order to have a healthy baby. I had 2 healthy children who are now grown, 30yrs and 16yrs and I have grandchildren now too. Both of my kids were fine, healthy weren't sickly. They grew amongst their peers, there was nothing wrong with them and they did not have an ounce of breast milk except in the very beginning for like the first week but then I ran out of milk.  Other than that, they had formula, and they did just fine. So don't listen to society. Do what your body feels you need to do if you can't get breast milk coming out just leave it alone, get yourself some good formula, not the stuff that they sell here though. My daughter got some from the UK. That was the most excellent formula. Had all the ingredients that you could actually recognize. And my grandson is the thriving. Don't listen to society, please do what you know to do. Women have been having babies for long time.

  2. Sarah Smit Sarah Smit United States says:

    I agree with what everyone is saying about stress. Today's society and almost all living situations are not conducive to stress free breastfeeding or childbearing in general. I believe in adressing the root cause of something rather than looking for a bandaid cover method after the fact. However, I do not think it is necessary to scare women out of attempting to use "galactagogues". Women of all different cultures have been trying to increase breastmilk for as long as we know. There is a lengthy list of foods and herbal tinxures that seem to increase breastmilk production because of this fact, and I say it is up to the individual woman to use any of these options at her own discretion. These methods would not be passed down from generation to generation for centuries/millennia even if they were dangerous or extremely harmful to mothers or nursing children.

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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