My patients often ask me about the efficacy and safety of the supplements that claim to increase your milk supply. Do they really work?

If you’re struggling with milk supply issues, the first step is to evaluate simple factors including latch evaluation, oral examination of the infant, frequency of feeding or pumping and thoroughness of breast emptying. I always ask my patients if they’re drinking enough water – consuming enough fluids is more important than any supplement. A lactation consultant, often available at your local hospital or breastfeeding support store, can be invaluable in identifying if there are underlying issues contributing to milk supply.

I always ask my patients if they’re drinking enough water… Consuming enough fluids is more important for milk supply than any supplement.

Time to Take a Galactagogue

If those issues have been ruled out, then a “galactagogue” or “lactagogue” – which means a food or supplement that can increase a woman’s milk supply – can be considered. They should be used with caution, and mothers should be aware of potential side effects and minimal data as to 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 others that have produced success for some women, so here is an overview.

1. Fenugreek

Fenugreek (Trigonella foenum-graecum L.) 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 placebos and can help increase a woman’s milk supply.

There are many different forms: 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 occuring hormones that stimulate milk production.

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 increased breast congestion and 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

Fennel (Foeniculum vulgare) 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. 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

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. 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. 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.

4. Coleus Amboinicus

Coleus Amboinicus is a perennial succulent plant and has been used for centuries in Chinese cooking to treat a myriad of health conditions including chest pain, asthma, epilepsy, rashes, and insomnia. It has also been suggested that Coleus species can increase a woman’s’ milk supply. In my literature search, I could not find any evidence that was not anecdotal, and I could not find any recommendations of dosage, formulation, and frequency.

Bottom Line: I would proceed with caution, try a small amount to begin with.

Want to read more from Dr. Stephanie Canale?

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