Galactogogues are synthetic or herbal-based molecules that are able to induce, maintain and increase a woman's milk production. Frequently-used natural galactogogue herbal extracts include galega (Galega officinalis) and milk thistle or silymarin (Silybum marianum) (Wilinska et al, 2015). Compared to other natural solutions, this composition is absorbed more easily by the body and thus increases its effectiveness in promoting lactation.
Other natural substances and herbal extracts, such as fennel, fenugreek, and malt beer, generally have the power to increase breast milk production, too. Compared to medical drugs without natural ingredients, they are safer and have less negative side-effects. However, their effectiveness is questionable because of the extremely large quantities necessary to provoke the desired galactogenic effect.
Herbal extracts are a safe and natural solution to problems with breast milk production such as hypogalactia (common in preterm mothers). However, the validity of many of these treatment options must firstly be clinically tested. Also, herbal extracts tend to have low bioavailability (i.e. low solubility and low rates of absorption). This reduces their efficacy and necessitates having to take abnormally large quantities of the extracts. An alternative approach is to combine several milk promoting ingredients, like Castoldi et al. (2014) was able to show. They evaluated a combination of silymarin and galega with vitamins and carotenoids, during a 56 days period. Although the results were positive, the sample groups were small and the results showed some improvement opportunities.
Over the years, formulation techniques have been developed in order to overcome this problem. One approach is the use of phospholipids as a delivery system for herbal-based molecules. Recently, for example, a silymarin-phytosome complex was combined with phosphatidylserine, which increased the bioavailability of the herbal extract while maintaining its natural safety-advantage.
Another new galactogogue formulation – combining the silymarin-phytosome complex with galega (a synergic galactogogue) – is introduced in a clinical trial developed by the group of Professor C. Romagnoli. The use of this galactogogue formulation results in increased breast milk production in the first month after delivery in mothers of preterm infants, without presenting any side-effects (Zecca et al, 2016). A follow-up study concludes that mothers who are given this formulation present improved lactation for the first 3-6 months of the baby’s life after discharge when compared with mothers who are administered lactose (Serrao et al, 2017).
This novel approach is an example of how the effectiveness of an inherently safe natural remedy has been enhanced with the aid of science. Suitable herbal extracts with improved bioavailability have become an optimal solution for lactation insufficiency (or Hypogalactia).back
Other natural substances that serve as galactogogues include herbal and homeopathic substances. They are mainly available in the form of teas, other drinks, and extracts, or globules in the case of homeopathic substances. Along with galega and silymarin, frequently mentioned herbal supporters of lactation are: fenugreek (Trigonella foenum-graecum), shatavari (Asparagus racemosus), torbangun (Coleus amboinicus Lour), fennel (Foeniculum vulgare), chaste berry (Vitex agnus-castus), anise (Pimpinella anisum), blackseed (Nigella sativa), caraway (Carum carvi), coriander (Coriandrum sativum), dill (Anethum graveolens), basil (Ocimum basilicum), alfalfa (Medicago sativa), blessed thistle (Centaurea benedicta), nettle (Urtica dioica), red clover (Trifolium pratense), mauve (Malva), verbena (Verbena officinalis), cumin (Cuminum cyminum), and malunggay (Moringa oleifera) (Bazzano et al, 2016; Espinosa-Kuo, 2005; Mortel and Mehta, 2013; Zuppa et al, 2010). Also, grains such as barley, oat, and malt, as well as related products such as malt beer, are linked with galactogenic effects.
Fenugreek in particular has been widely researched with regard to its power to increase breast milk production. However, similar to other herbal galactogogues, the results show some discrepancy with regard to its effectiveness. While some studies show it supports lactation, other studies do not report a significant effect. Similar results exist for other herbal substances – for example shatavari, torbungun, and malunggay – where the effectiveness cannot be clearly confirmed (Bazzano et al, 2016; Mortel and Mehta, 2013). A possible reason for these inconsistent results is that effectiveness greatly depends on the concentration of the respective herb. Due to the low bioavailability (or bodily absorption) of herbal extracts, the required dosage of the herbal compound leading to a clear increase in breast milk production is extremely high and might not be met. The high quantities in turn may lead to side-effects. Large amounts of fenugreek, for example, may provoke nausea and vomiting, as well as the maple-like smell of urine, breast milk, and perspiration in the mother, and the child may experience diarrhoea (Bazzano et al, 2016; Zuppa et al, 2010).back