|
|
A galactogogue is a substance than increases breast milk production.
When women are having difficulties with low breast milk production, a
full evaluation of breastfeeding techniques and milk transfer must be
completed before use of a galactogogue can be considered. The Academy
of Breastfeeding Medicine has a protocol
Use of Galactogogues in Initiating or Augmenting Maternal Milk Supply
(pdf).
In many countries of the world, herbs or various foods are used as
galactogogues. These include fenugreek, goat's rue, milk thistle,
beer,
(see Breastfeeding and Alcohol)
papaya, and others.
There is little scientific evidence of the efficacy of most of these foods on
increasing breast milk production. Fenugreek, which is used as a
spice and medicine in India and the Middle East has been the most
widely used to increase breast milk supply. Anecdotal reports suggest
some efficacy for fenugreek, however this data is very limited. Side
effects can include low blood sugar in the mother, maple like odor to
sweat, milk and urine, diarrhea and increased asthmatic symptoms. It
can be taken as capsules or as tea made from steeping fenugreek seeds
(
ABM Galactogogues, 2004
,
Lawrence, 2005
p405-409).
Several medications have been used as galactogogues. These include
metoclopamide, domperidone, and the antipsychotics sulpiride and
chlorpromazine. All four of these work by blocking dopamine receptors
and subsequently increasing prolactin levels. All these drugs can
have side effects including restlessness, mental depression,
confusion, anxiety, or agitation. Metaclopramide and Domperidone have
been studied the most thoroughly. Metaclopramide in a dose of 10 or
15 mg three times a day has been shown to increase baseline prolactin
levels and milk production in mothers of term and premature infants.
The mothers of the premature infants were expressing breast milk for
their infants (
Ehrenkranz, 1986
,
Kauppila, 1981
).
Domperidone is not available in the United States. However, studies
performed in Canada and Italy show that when Domperidone was given to
lactating mothers at a dose of 10 mg three times a day, prolactin
levels and milk production increased. There were no reported side
effects. (
Petraglia, 1985
,
da Silva, 2001
) The FDA recently issued a
warning against the use of Domperidone noting that this drug is not
approved for any use in the United States. In the past, an
intravenous form of Domperidone, which is no longer available, caused
serious side effects including cardiac arrthymias, cardiac arrest, and
sudden death. In some countries where Domperidone is available, it is
labeled with a warning against use by breastfeeding mothers because it
can be found in breast milk and the risk of Domperidone to infants is
unknown (
FDA, 2004
).
|
