Health provider experiences with galactagogues to support breastfeeding: a cross-sectional survey

Abstract

BackgroundExclusive breastfeeding for infants up to 6 months is widely recommended, yet breastfeeding rates are relatively low in the US. The most common reason women stop breastfeeding early is a perceived insufficiency of milk. Galactagogues are herbal and pharmaceutical products that can help increase milk supply; however, data on their efficacy and safety is limited. Lactation consultants, obstetricians, and other health providers are an important point of contact for breastfeeding women experiencing challenges with lactation. This study explored providers’ perceptions, experiences, and practices in relation to galactagogue recommendation.MethodA cross-sectional survey was conducted among a convenience sample of English-speaking health providers in the US who counsel breastfeeding women and their infants.ResultsMore than 70% of respondents reported to recommend galactagogues. The most frequently recommended galactagogue was fenugreek with respondents indicating that they recommend it either ‘always’ (8.5%) or ‘most of the time’ (14.9%) and ‘sometimes’ (46.8%). More than 80% of the respondents indicated that galactagogues were useful for their clients and only one-third reported side effects. Reasons for refraining from recommending galactagogues were insufficient evidence of its efficacy and safety. Respondents reported a wide variety of sources of information used for their own education about galactagogues.DiscussionDespite little evidence regarding safety and efficacy, some galactagogues are widely recommended and often perceived to be useful. However, concerns about their efficacy and safety remain. In order to assure both providers and users about safety and efficacy, more robust studies as well as better pharmacovigilance systems are needed.

Which Benefits and Harms of Using Fenugreek as a Galactogogue Need to Be Discussed during Clinical Consultations? A Delphi Study among Breastfeeding Women, Gynecologists, Pediatricians, Family Physicians, Lactation Consultants, and Pharmacists

“…Similarly, about 70% of the healthcare providers reported that they recommend quiet often herbal galactogogues for breastfeeding women seeking recommendations to increase their human milk supply. Our findings were consistent with those previously reported by Bazzano et al in the US, in which 70% of the healthcare providers surveyed indicated that they often recommend galactogogues [ 52 ]. Similarly, fenugreek was the most frequently recommended herbal galactogogue in Bazzano's study.…”

“…The panel of healthcare providers was composed of gynecologists/obstetricians, pediatricians, family physicians, lactation consultants, and pharmacists. Those healthcare professionals would normally be consulted by breastfeeding women seeking recommendations to increase their human milk supply [ 17 , 52 ]. Women who were recruited for the panel of women experienced inadequate human milk supply sought recommendations from healthcare providers and used herbal galactogogues.…”

Ethnobotanical Survey of Natural Galactagogues Prescribed in Traditional Chinese Medicine Pharmacies in Taiwan

“…In various regions of the world, several herbs are used to promote lactation, with T. foenum-graecum L. and F. vulgare Mill being the most common ( Forinash et al, 2012 ; Mortel and Mehta, 2013 ; Sim et al, 2013 ; Sim et al, 2014 ; Sim et al, 2015 ; Bazzano et al, 2016 ; Javan et al, 2017 ; Zheng et al, 2020 ). The origin of the two herbs resembles those indicated in the present study.…”

Clinical Study on Plant Galactagogue Worldwide in Promoting Women’s Lactation: a Scoping Review

“…There is generally a high-level of market acceptance in the use of galactagogue to increase milk production, as reported in several publications. In general, the topic of research on galactagogue can be categorised into plant only [55][56][57], plant and food [58][59][60], and plant and pharmacological galactagogue [61][62][63]. Although these articles were excluded in our study, the studies have highlighted that many mothers have shown interest and optimism regarding consumption of galactagogue to improve milk production [56].…”