Milk Production and the Use of Galactogogues

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“A breastfeeding support kit from a formula company is like a vegetarianism support kit from a pig farmer.”
-Annie from PhD in Parenting

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Many new moms will question their milk supply after about the first 12-24 hours of life. If you have been there, you know that once cluster feeding starts, you wonder why your once sweet newborn is now screaming uncontrollably and nursing for hours on end.  Cluster feeding is totally and completely normal and is how your baby tells your body that he or she is on the outside now and needs food out here!

Oftentimes, if there is a marked weight loss or the baby is jaundice, formula may be recommended.  When this occurs, the mother starts to use supplementation of formula for feedings.  Those bottles of formula, although beneficial (but no more beneficial than breast milk) for weight gain and bilirubin, are detrimental to a mother’s milk supply.  We must remember, it is supply and demand at the core.  If it is not on demand, your body will say “hey, she must not need it” and stop production or decrease it dramatically.

We have ways to combat this while in the hospital, and your best bet is to always reach out to a lactation consultant who can guide you through supplementation.  We have special tools and feeding devices that can make formula feeding an option while still breastfeeding.

In other situations, there are some women who physiologically will not produce enough milk.  Whether it be insufficient glandular tissue or a hormonal imbalance, these women will never make enough for their baby.  That is the extreme, but many mothers can increase their milk supply with simple changes to routine in their feeding schedules. 

Below are some changes in routine that may help to increase supply:

For Mom:
Relax between feedings
Spend one on one time with baby for 48 hours only feeding and cuddling
Lots of skin to skin
Deep latch
Galactogogues
Record feeding times and supplementation used
Use a hospital-grade pump for 5-10 minutes after each nursing
Improve diet: more protein, fruits, vegetables
Decrease caffeine
Increase water intake

For Feeding Routines:
Relax during feedings
Put baby skin to skin while nursing
Make sure baby is alert before nursing
Check latch to make sure it is deep
Switch breasts within each feeding
Feed more frequently and try to go longer
Nurse for comfort if the baby is fussy, avoid the pacifier
Continue night time feedings
If giving supplements: use paced bottle feeding

A galactogogue is a food, drink, medication, or herbal supplement that is believed to increase milk production.  Before turning to a galactogogue of any kind, you should first figure out the underlying cause of your low milk supply.  If it is just a supply and demand issue, the techniques above will help to improve milk supply if it is possible.  Some common herbal galactogogues include: fenugreek, blessed thistle, and goat’s rue.  Research is mixed on their effectiveness.

There are prescription medications, but their use is controversial when it comes to breastfeeding and many are not available for such use in the United States.  Medication should not be the first course of treatment for insufficient milk supply and the things mentioned above should be attempted first. 

Any normal mother worries that she is going to do something that harms her baby, especially when it comes to feeding them.  Unfortunately, our breasts are not transparent, and we cannot say “oh good, little Jonny took in 2 ounces at this feeding.”  We can, of course, do pre- and post-feeding weights to see how much milk is transferred, but that won’t help with the day in and day out of feeding. 

Women must trust in themselves, their bodies, and their ability to adequately feed their babies.  When in doubt, reach out! Call a lactation consultant, call the pediatrician, call your obstetrician, or call the hospital where you delivered.  Use the resources available to you.  There is no one right or wrong way to breastfeed, but we can help it become more manageable, as well as give you the courage to continue your breastfeeding journey.
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You got this mama!