What is a Galactagogue?

The following information has been compiled by Rachel Westfall of Currants and Spice:

Lactation

I have used fenugreek and nettles to enrich my milk. These are two of the many herbs that have been used for centuries by breastfeeding women.

Here is a literature review on five herbs used in lactation. I hope that you will find it helpful. This is part of Rachel Westfall's doctoral thesis. This information and more can be found in a published article, detailed below. If you wish to quote or reprint this material, please credit this webpage.

Westfall RE. Galactagogue herbs: a qualitative study and review. Canadian Journal of Midwifery Research and Practice. 2003, 2(2):22-27.

Fennel

Medicinally, fennel is widely used as a digestive aid and as a treatment for dyspepsia (Blumenthal et al., 2000). It has mild estrogenic properties (Bingel and Farnsworth, 1991). Fennel is also used to counteract infant colic, whether consumed by the mother or given directly to the infant (Weed, 1986; Weizman et al., 1993). The effectiveness of an herbal colic remedy containing fennel, chamomile, vervain, licorice, and lemon balm has been demonstrated in a clinical trial (Weizman et al., 1993). However, this formula was given directly to the babies, so it remains clinically unproven that the beneficial effects of the herbs would reach the infant through the mother’s milk.

The Wise Woman Herbal (Weed, 1986) suggests that breastfeeding women use the seeds of fennel (Foeniculum vulgare Miller [Apiaceae]) or any of its close relatives (anise, cumin, caraway, coriander and dill) to improve their milk supply. Although clinical evidence for its efficacy is lacking, fennel seed has enjoyed centuries of use as a galactagogue. Its mechanism of action is unknown.

In Italy, a galactagogue tea is made from the seeds of fennel and anise (Pimpinella anisum L. [Apiaceae]) (Rosti et al., 1994). Two case reports from that country (Rosti et al., 1994) describe temporary central nervous system depression in infants, 15 and 20 days old, whose mothers were consuming large quantities of fennel and anise tea. All symptoms disappeared once the women stopped drinking the tea. However, these appear to have been isolated cases, so it is possible that a particular batch of the tea was adulterated with another, more toxic herb. In the absence of further evidence, one can assume that this age-old remedy is safe.

There are no known contraindications for use of fennel seed or fennel oil during lactation, but it is not recommended for use for more than a few weeks at a time (Blumenthal, 2000).

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Fenugreek

Another favourite galactagogue seed was widely used by the participants in this study: fenugreek (Trigonella foenum-graecum L. [Fabaceae]). As with fennel and its relatives, there is no clinical evidence to support the use of fenugreek as a galactagogue. However, it has been used for centuries to increase the flow of milk, (Riordan and Auerbach, 1998) and was used historically as such, along with fennel, by wet nurses in the southern United States in days gone by (Duke, 1997). There are also reports of fenugreek’s use as a galactagogue in Sudan, Egypt, other parts of North Africa, Iraq, and Argentina (reviewed in Bingel and Farnsworth, 1991).

Fenugreek is an important medicine in India’s Ayurvedic tradition, where it is used to treat a variety of digestive and mucosal conditions (Passano, 1995; Escot, 1994/5). According to the Ayurvedic tradition, fenugreek, or methi as it is known, is contraindicated in pregnancy as it is believed to cause abortion (Escot, 1994/5; Brinker, 1998). However, this abortive effect was not demonstrated in an experiment involving laboratory animals (Mital and Gopaldas, 1986). And in India, once the child has been born, women are encouraged to eat a sweetened paste or halva made from the seeds to increase the flow of breast milk (Passano, 1995).

Fenugreek is also contraindicated during pregnancy in Western herbalism, as it is a uterine stimulant (Ody, 1999). This action may be the result of a steroidal saponin called neotigogenin, which is contained in the seeds (Escot, 1994/5). It may also make the seeds useful as a childbirth aid, which is one of its traditional uses (Bingel and Farnsworth, 1991). Indeed, the effect of fenugreek upon the uterus may be related to its stimulant effect upon the milk ducts in the breast, for both are effected by the hormone oxytocin and its pharmacological relatives (Bingel and Farnsworth, 1991).

"Alternatively, these plants may not possess oxytocin-like activity, and their reputed galactogenic effect might instead merely be coincidental to their being used in obstetrics" (Bingel and Farnsworth, 1991). Or perhaps fenugreek supports the production of milk because it is a rich source of essential fatty acids (Mowrey, 1986).

In North America, fenugreek seeds are commonly brewed as a tea, and the broth and seeds are both consumed. Alternately, they can be ground and taken in capsule form. According to popular lore, an adequate dose has been consumed when one’s body smells mapley. The German Commission E monograph recommends a daily dose of 6 grams of the seeds (Blumenthal et al., 1998); doses of over 100 grams can cause nausea and an upset stomach (HealthNotes, 2001).

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Raspberry Leaf

Raspberry leaf (Rubus idaeus L. [Rosaceae]) is believed to stimulate lactation and enrich breast milk by restoring the body’s vitamins and minerals (Gladstar, 1993; Weed, 1986; Bartram, 1998; Ipp, 1999). Conversely, due to its astringent qualities, it has the potential to shrink mammary glands and thereby reduce milk flow (Lieberman 1995a; Edmunds, 1995; Weed, 1986).

Indeed, a search of the literature reveals that there is no clinical evidence that raspberry leaf is a galactagogue. Although the herb can be a good source of vitamins A, B complex, C, and E, as well as calcium, iron, phosphorus, and potassium (Weed, 1986; Lipo, 1996), and its effectiveness as a uterine tonic has been clinically demonstrated (Simpsons et al., 2001), there is no proof that it increases the production of breast milk. Nonetheless, one should not underestimate the value of the herb in providing essential nutrients and promoting a sense of self efficacy and relaxation in the breastfeeding mother. There is a recognized need among breastfeeding women for "support, nurturing and replenishment in return for ‘giving out’" (Dykes and Williams, 1999). Raspberry leaf tea, along with other popular herbal preparations, can give women this sense of being supported, nurtured and replenished.

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Stinging Nettle

Stinging nettle leaf (Urtica dioica L. [Urticaceae]) was one of the less-used galactagogue herbs among the participants in this study, though has a long-standing reputation for enriching breast milk (Bartram, 1998; Bombardelli and Marazzoni, 1997; Gladstar, 1993; Weed, 1986; Yarnell, 1998). The herb is believed to be completely non-toxic (Yarnell, 1998). Nettle contains many nutrients, including iron, calcium, and vitamins A, C, and K (Lieberman, 1995), as well as phosphorus, potassium, sulphur, and vitamin D (Weed, 1986). They also contain some B vitamins and appreciable amounts of magnesium (Duke, 1992). They contain up to 20% mineral salts, mainly calcium, potassium, silicon, and nitrates (Blumenthal et al., 2000). Nettle extract has been found to contain all of the essential amino acids (Bombardelli and Morazzoni, 1997).

Nettle is believed to support lactation by providing essential nutrients (Weed, 1986). It has no medicinal action, apart from being mildly diuretic and hemostatic (Bradley, 1992). Dried nettles mixed into cattle fodder are known to boost milk production in cows (Grieve, 1971; Phillips and Foy, 1990). Nonetheless, the herb’s astringent qualities could theoretically reduce milk production (Edmunds, 1995; Weed, 1986). There are no known contraindications to its use during pregnancy or lactation (Blumenthal et al., 2000).

To support lactation, nettle leaves are typically brewed as a tea, often in combination with raspberry leaf.

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Blessed Thistle

Blessed thistle (Cnicus benedictus L. [Asteraceae]) is a Mediterranean weed; it is occasionally found in North America (Hitchcock and Cronquist, 1987). The dried aerial parts are used as a galactagogue; (Gladstar, 1993; Grieve, 1971; Weed, 1986) it is considered to be one of the best galactagogue herbs. It is usually taken in capsules or as a tea. It is said to work by stimulating the flow of blood to the mammary glands, and thereby enriching the milk flow (Gladstar, 1993), but this theory has not been confirmed in a laboratory or clinical setting. There have been no clinical trials of blessed thistle as a galactagogue.

Blessed thistle was historically reputed to be a heal-all, and was even said to heal the plague. (Grieve, 1971) It is recommended for birthing and nursing mothers because of its hemostatic properties, which reduce the likelihood of postpartum hemorrhage (Gladstar, 1993), and because of its antidepressant effects (Weed, 1986).

Famed for its ability to increase milk supply, Cnicus benedictus is best used as a tincture; up to 20 drops, two to four times daily is the usual dose. It is said to remove suicidal feelings and lift depression as well. -Weed, 1986: 85

Blessed thistle is approved by the German Commission E for loss of appetite and dyspepsia (Blumenthal et al., 2000). It is rich in a sesquiterpene lactone called cnicin (Blumenthal et al., 2000), which stimulates digestive enzymes and bile secretions (Blumenthal et al., 2000; Gladstar, 1993). The Commission E does not recommended blessed thistle for use during pregnancy and lactation, and its popularity as a galactagogue is not mentioned in their monograph (Blumenthal, 2000). The plant is strongly emetic in large doses (Grieve, 1971), so it should not be overused. It is reputedly an effective emmenagogue and thus should be avoided by pregnant women (Bartram, 1998).

References

Bingel AS, Farnsworth NR. Higher plants as potential sources of galactagogues. Econ Med Plant Res 1991;6: 1-54.

Blumenthal M, Busse WR, Goldberg A, Gruenwald J, Hall T, Riggins CW, Rister RS (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998.

Blumenthal M Goldberg A Brinckmann J, eds. Herbnl Medicine: Expanded Commission E Monographs. Austin, Tex: American Botanical Council; 2000.

Bradley PR. Editor. British Herbal Compendium, Volume 1. Bournemouth: British Herbal Medicine Association; 1992.

Brinker F. Herb Contradictions and Drug Interactions. Sandy, OR: Eclectic Medical Publications, 1998, 70–1.

Duke JA. Handbook of Phytochemical Constituents of GRAS Herbs and Other Economic Plants. Florida: CRC Press, 1992.

Duke JA. The Green Pharmacy. Emmaus, Pa: Rodale; 1997.

Escot N. Fenugreek. Atoms 1994/95; summer: 7-12

Edmunds J. Remedies. Birthkit 1995 (Autumn):7.

Gladstar R. Herbal Healing for Women. New York, NY: Simon & Schuster 1993.

Grieve M, ed. A Modern Herbal [reproduction of the 1931 original]. New York, NY: Dover; 1971.

HealthNotes. Herbal Remedies: Fenugreek. 2001 [cited 2002 Jun 5]. Available from: URL: http://www.healthnotes.com.

Hitchcock CL, Cronquist A. Flora of the Pacific Northwest: An Illustrated Manual. Seattle, London: University of Washington Press; 1987.

Ipp, Moshe. “Treatment for poor milk production.” Patient Care: The Practical Journal for Canadian Primary Care Physicians 1999; Volume 10, April 1.

Kopec K. Herbal medications and breastfeeding. J Human Lactation, 1999; 15 (2): 157-161.

Lieberman L. Remedies...to file for future reference. Birthkit. 1995;5(Spring):1.

Lipo A. A holistic approach to 'loose cervix.' Birthkit. 1996;10(Summer):3-5.

Mital N, Gopaldas T. Effect of fenugreek (Trigonella foenum-graecum) seed based diets on the lactational performance in albino rats. Nutrition Reports International 1986;33(3):477-484.

Mowrey DB. The Scientific Validation of Herbal Medicine. New Canaan, CT: Keats, 1986.

Ody P Herbs for a Healthy Pregnancy. Los Angeles, Calif: Keats; 1999.

Passano P. The many uses of methi. Manushi; november 1 1995: 31-34.

Phillips R, Foy N. The Random House Book of Herbs. New York, NY: Random House; 1990.

Riordan J, Auerbach K. Human Lactation and Breastfeeding. 2nd edition. Boston, MA: Jones & Bartlett, 1998.

Rosti L, Nardini A, Bettinelli M, Rosti D. Toxic effects of a herbal tea mixture in two newborns. Acta Pediatr 1994;83:683.

Scarpa A. “Various uses of the castor oil plant (Ricinus communis L.): a review.” Journal of Ethnopharmacology 1982; 5: 117-137.

Simpson M, Parsons M, Greenwood J, Wade K. Raspberry leaf in pregnancy: its safety and efficacy in labor. J Midwif Women’s Health 2001; 46 (2):51-59.

Weizman Z, Alkrinawi S, Goldfarb D, Bitran C. Effects of herbal tea preparation in infantile colic. J Pediatr 1993; 122: 650-652.

Weed S. Wise Woman Herbal for the Childbearing Year. New York, NY: Ash Tree; 1986.

Yarnell E. Stinging nettle: a modern view of an ancient healing plant. Alternative Compl Ther. 1998;4(June):180-186.

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