This is a guest post from Stephanie Canale, M.D., a family physician at UCLA and co-founder of Lactation Lab. Canale is a mom of two young kids and currently resides in Los Angeles, where her practice focuses on young families.
It’s very common for nursing moms, even those who make plenty of breastmilk, to worry about their supply. I get it — as a mom you want to do everything you can to ensure you’re taking care of your baby. So what can you do if you aren’t able to, or are struggling to, keep up with your baby’s appetite?
First: I always ask my patients if they’re drinking enough water. Consuming enough fluids is really important and, if dehydration is the cause of a dip in supply, a very easy fix. If that doesn’t solve it, the next step is to contact a lactation consultant for a consultation. She will observe a feed and be able to evaluate factors that impact supply, including latch, tongue or lip ties, frequency of feeding or pumping and thoroughness of breast emptying.
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If you’re hydrating and a lactation consultant has ruled out a physical cause, you may want to try a supplement. My patients often ask me about the efficacy and safety of supplements that claim to increase your milk supply. Do they really work?
The answer is … maybe. “Galactagogue” or “lactagogue”, which means a food or supplement that can increase a woman’s milk supply should be used with caution, and women should be aware of potential side effects as well as the minimal data available showing their effectiveness. While there are only two common herbal supplements that are designated by the FDA as safe for increasing milk supply — fenugreek and fennel — there are several other supplements that you may see marketed towards breastfeeding moms.
Here are the three supplements I think are worth considering. But before taking any supplement, I recommend checking with your doctor first, to make sure it’s appropriate for you.
#1: Fenugreek (Trigonella foenum-graecum L.)
What it is: Fenugreek is a member of the pea family sometimes used in artificial maple flavoring. Fenugreek has been used for many years to promote wellness, increase milk supply and to help with urethritis (urethral inflammation) and arthritis (joint inflammation). It has been used for many years in Indian and Chinese cooking. A meta-analysis (which is a study that looks at all of the studies together to draw a conclusion) showed that it was superior to placebo and can help increase a woman’s milk supply.
How to take it: There are many different forms of fenugreek: teas, capsules, liquid, seeds and powders. The recommended dose of fenugreek is 2-3 capsules (580-610 mg per capsule) 3-4 times per day, and it may be discontinued once milk supply has increased to the desired level. Many women have reported results within 24-72 hours. It’s not clear exactly how fenugreek works, but some have proposed that it increases sweating and the breast is essentially a large sweat gland. Others have proposed that it increases certain naturally-occurring hormones that stimulate milk production.
Side effects: The side effects of fenugreek have been poorly studied. However, some generalized side effects that have been reported include nausea, headaches, vomiting, increased gas and gastrointestinal motility with loose stools. Some women have reported a maple-like taste to breast milk. It is important for mothers to be aware of side effects and to monitor themselves and their infants. They should discuss supplements that they are taking with their primary care providers and lactation consultants.
Bottom Line: Fenugreek is listed as generally recognized as safe (GRAS) by the FDA and as long as mothers are aware of the side effects, this is a good option to try to increase supply.
#2: Fennel (Foeniculum vulgare):
What it is: Fennel is a licorice-flavored herb native to the Mediterranean and is best known for treating colic. Some anecdotal reports have found an increase in milk production.
How to take it: There is no consensus on the amount, formulation or frequency of consumption. It should be noted that fennel is also rich in vitamin C, potassium, manganese, copper, phosphorus and folate. It is also a great source of fiber and in moderation is a nutritious food to support a breastfeeding mother.
Bottom Line: Fennel is recognized as safe (GRAS) by the FDA and given the other health benefits of consuming it, this is a good option to try.
#3: Palm dates
What it is: Palm dates are one of the oldest galactagogues. Dates are low in fat and protein and rich in sugars. It is estimated that 100g of dates can provide upwards of 300 kcal and contain over 10 different essential minerals such as selenium, zinc, copper, potassium and magnesium. They contain B-complex vitamins, vitamin C and are high in fiber. Palm dates also have antioxidant properties.
How to take it: One study looked at 25 women who ate the flesh of 10 grade A palm dates 3 times a day and were found to have increased breast milk production. This was most noticeable in the first two-weeks postpartum. Breast milk volume almost doubled in the date-eating group as compared to the control group.
Side effects: Palm dates as supplements do not carry the GRAS rating by the FDA.
Bottom Line: Given the other benefits of palm dates, I don’t see a problem in trying them, despite the lack of firm evidence.
Stephanie Canale, M.D., is the co-founder of Lactation Lab, which was born out of a personal need to understand what was in her breast milk, and in turn, wanting to help mothers optimize their milk and their baby’s nutrition.
Canale is from Montreal, Canada and earned her undergraduate and medical degrees from McGill University. She completed her residency training in family medicine at UCLA. After medical residency, she joined the teaching faculty at the UCLA Family Health Center, before joining the Santa Monica Parkside office. She enjoys seeing patients of all ages, especially families with young babies and young adults. Canale is a Member of the American Board of Family Medicine. She is married with two young children and despite loving the weather in Southern California, still enjoys winter sports such as skiing and playing ice hockey.
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