Fenugreek And Other Herbs To Boost Lactation

If you are struggling with low milk supply as a feeding mother, you are not alone. There is a range of lactational supplements in the market that are composed of herbs, to support mothers struggling with this issue. Fenugreek, Fennel and Blessed thistle are some of the herbs that have gained a reputation over the years for lactational benefit with some scientific research evidence.¹

The subject of lactational supplements is actually a medically studied topic. Substances that increase milk supply are called galactagogues. These can be medications like Domeridone for example^2,3 or herbal supplements. 

Some mothers prefer herbal remedies as opposed to medication because they are worried about side effects from the latter. The little research done on herbal supplements is either neutral or slightly positive regarding their benefit.¹

These herbs have been household items for many years and continue to be used in cooking throughout the world. Their effectiveness in lactation have been mostly anecdotal yet persistent over the years and hence they are now available as commercial supplements. Certain theories explain why some herbs work, such as their ability to increase the effects of hormones like Oestrogen. 

Some herbs like Fenugreek are more studied than others and their side effect profiles have emerged including some beneficial effects on the body.⁴ These include their ability to lower blood sugar and blood pressure. But they are also known to interfere with medications like Warfarin.⁴

The herbs that are used for lactational benefits include the following:⁵

1. Fenugreek
2. Fennel
3. 3Blessed Thistle
4. Nettle
5. Goat’s Rue
6. Milk thistle

Challenges in breastfeeding 

Establishing a good breastfeeding practice has many challenges. There are many causes for poor feeding and lack of weight gain of the baby and low supply of milk is only one of them. Most other reasons include poor feeding techniques, latching problems and breast pain, sore nipples etc. In some countries, an observed feeding takes place before diagnosing low supply as the cause of poor feeding. 

Once low milk supply is established as the cause of poor feeding of babies, there are substances, both medications and herbs that are used to increase production. Of these herbal remedies are quite popular and available as commercial supplements.

Role of herbs in supporting lactation

Herbs are substances that are used for various therapeutic and nutritional uses. They are not new to consumption in small doses as they are often used in cooking.

Of the herbs that act as galactogogues, Fenugreek is at the top of the popularity list followed by Fennel, milk thistle and others.

What is Fenugreek and how is it supposed to increase milk production?

Fenugreek is a household herb with the scientific name Trigonella foenum-graecum.¹ Studies done on animals show that Fenugreek increases the effect of Oestrogen. Some other studies claim that Fenugreek enhances sweat production and because the breast is considered as a type of a modified sweat gland, the mechanism operates in the same way.⁴ Analysis of a collection of research studies called meta analysis has found that Fenugreek has a mild ability to increase milk production.¹ Other studies claim that the benefit is actually more in the first two weeks after delivering the baby and not so much after.¹

Fenugreek is available as commercial supplements. Sometimes it is available in combination with other substances like Fennel.

What is the recommended dose for use and guidelines?

The dose for Fenugreek for breastfeeding is recommended at 1 to 6 grams daily.

Is Fenugreek safe to be used during feeding?

Yes. It is on the ‘generally recognized as safe’ list of FDA, the American authority for safety of food and medicine.¹

What are the potential side effects of Fenugreek?

Fenugreek is reported to have other side effects which can affect people who consume it, especially those with some medical conditions. In addition it is said to cause some interactions with certain medications.

Some of the suggested beneficial side effects of Fenugreek is its lipid lowering ability and protection against cancer.¹

Drug interactions means, having Fenugreek at the same time as some other medications could cause these medications to work at a higher or lower therapeutic level than you would normally expect. In which case the drug dose will not be right for you and potentially cause harm.

 Some of the well known interactions include those with blood thinning drugs like Warfarin.⁷

 There are also some reports of Fenugreek worsening asthma in patients.⁷ Fenugreek is also reported to reduce blood pressure and potassium levels of the blood.⁷ It can also cause mild adverse side effects in the gut, such as nausea and diarrhoea^1,4 and is said to impart a maple syrup-like aroma to urine and other body fluids. 

It is important that Fenugreek is not used during pregnancy as it can stimulate the uterus and can affect the progression of pregnancy.⁷

One study analysed the benefits and adverse effects of Fenugreek and recommended all these need to be discussed with patients who are prescribed the supplements to let them make an informed choice.⁴

Any serious side effects of the breast fed infants while their mothers were on Fenugreek supplements are not reported.¹

What is Fennel and how is it assumed to work in increasing milk production?

The scientific name of Fennel is Foeniculum vulgare and it is also said to be used as a galactogogue.⁵ The mechanism is also supposed to be its ability to increase the action of Oestrogen. 

What is Blessed thistle and how is it presumed to work on increasing milk supply?

Blessed thistle is also a herb called Cnicus benedictus, that is a rather bitter herb ⁵ sometimes used in combination with Fenugreek in herbal teas to increase lactation.⁶ Sometimes they are also available in capsules.⁶ Both these herbs are reported to work better in the early days after delivery than later. 

What are the other herbs and dietary additions that are known to increase lactation?

There are other herbs such as Anise (Pimpinella anisum) and Alfalfa (Medicago sativaso) that are presumed to have some lactational benefit but they are also lacking in adequate research on their benefit or safety profiles.⁶

Additionally Oats as well as garlic and ginger in moderation is considered to be beneficial to be included in the diet of breastfeeding women to improve lactation.⁶

Why is it important to consult a healthcare worker when having low milk supply?

Low milk supply can be due to a variety of causes.¹⁰ Sometimes poor feeding of the infant and lack of weight gain can be due to faulty techniques. In some countries a mother’s feeding is observed and techniques and practises corrected before concluding on low supply. A health care worker can assess all this. All treatable causes should have been treated before resorting to supplements.

Are herbs considered safe in nursing?

Most studies have concluded that there are no serious adverse effects with the herbs¹ but there are side effects that can affect you if you have other medical conditions or if you are on other medications. Therefore the general recommendation is to discuss with your healthcare worker before starting on herbs for lactation benefit.

Summary

Low supply of milk production is one of the many challenges breastfeeding mothers face. Herbal supplements play a big role as they are quite popular without a history of causing any serious adverse effects on the mother or baby. These herbs include Fengureek, Fennel, Blessed thistle, Nettle and a few others. More data and research is needed on the benefits of these herbs and also their side effect profiles.

However the currently available studies do not show serious adverse effects. Analysis of major research studies show a mild benefit in using Fenugreek. Some of these herbs are available either alone or in combination with others as supplements or as herbal teas. Fenugreek and Fennel are on the list of generally recognized as safe to be used during feeding by the FDA.

The herbs are not without mild side effects. An example is Fenugreek causing some disturbance in the stomach as well as worsening asthma and lowering blood pressure and blood sugar levels etc. Perhaps the most significant is its interaction with the blood thinning medication Warfarin. No major adverse effects on the infants fed by mothers on these supplements have been reported. 

Before starting any supplement to increase lactation, it is important to rule out other common causes for poor feeding in infants such as wrong attachment and latching techniques, pain in the breast of the mother etc. Also it is important to consult a healthcare worker before starting on herbal supplements, especially if you are suffering from another medical condition and/ or on another medication as there can be interactions.