Herbs, Drugs & Hormones that Promote Lactation 
by DrJim

 

There are many herbs, drugs and hormones that affect lactation positively or negatively. This dissertation gives an overview and is by no means comprehensive. It can be helpful to women to know how some of their medications may affect lactation and what herbs they might choose to achieve such. 

Estrogen

There are many herbs and drugs that have an Estrogen effect. Lactation is promoted by Estrogen primarily when the level goes up and then down because Estrogen withdrawal is what raises Prolactin. The benefit of Estrogen stimulation is also most to women who are still ovulating and thus producing Progesterone. Steady levels of Estrogen such as those used for postmenopausal treatment do not inhibit lactation. Cycling Estrogen alternately with Progesterone is much more effective that Estrogen alone. Fennel, Fenugreek, Soy isoflavones, Black cohosh, blue cohosh, Malted barley and Oats all seem to boost Estrogen some. There are many others. Chaste tree Berry has an anti-estrogen effect and can boost lactation by inhibiting Estrogen in younger women. It should not be used with these other herbs mentioned because it counteracts them. Estradiol cream as a straight Estrogen stimulation is bioidentical (very good) and can be applied to the breasts. It can make the breasts enlarge but it will not induce lactation without Progesterone stimulation as well. Maintenance for post-menopausal women would be better using the weaker Estrogen compound Estriol as it stimulates the breasts less. 

Progesterone

Progesterone cream can be purchased without a prescription. It can promote lactation by stimulating the growth of more alveoli in the breasts and increasing the receptors for Prolactin. Many women lack enough Progesterone. Perimenopausal women ovulate irregularly and generate Progesterone intermittently. Postmenopausal women produce none. Progesterone is the most important hormone in a hormonal regimen to induce lactation. For young and ovulating women Progesterone can help promote a post-partum state with high Prolactin, high milk production and usually light or no menses. Progesterone is in many birth control products and hormonal maintenance products. Wild Yam is a great herb to promote Progesterone effect. Saw Palmetto is a hormonal balancer which overall increases Progesterone effect some and promotes lactation. 

Hormonal Induction of Lactation

 Although women of practically any age have been successful in inducing lactation without the use of hormones, breasts do undergo steady involution with a decrease of alveoli that can be stimulated over time. Peri and Post-menopausal women who induce without hormone supplements will often gain most of the benefits except will have only a small amount of milk. A short course of hormonal induction makes sense for older women who would like to produce more milk. There are several hormonal regimens on the internet, here are some thoughts on them; Taking a course of Yasmin BCP for a month or two is popular. Like most BCPs, it has Estrogen and Progesterone like compounds and stimulates both receptors at the same time. Some Yasmin regimens recommend adding additional Progesterone to the Yasmin. Both Estrogen and Progesterone levels are high during pregnancy so the BCP is thought to mimic a short pregnancy. Yasmin has a Progestin different from most other BCPs that also boosts Prolactin some, so all three hormones are being stimulated at the same time. The breasts are stimulated best however by sequential hormones; Estrogen, Progesterone then Prolactin. This is the normal sequence from month to month between menses. A better BCP regimen I think, is a high Estrogen pill such as 1 month of Ovral (not Lo-Ovral, Aleese, Mircette or other low Estrogen contemporary BCPs) followed by 1 month of Progesterone only minipill like Nordette, Ovrette or Nor-Q follow this with Domeperidome or other Prolactin booster. Two sequential months of these BCPs should cause the breasts to increase in size noticeably unless the breasts are very large with a high percentage of fat to start with in which case there may not be a noticeable increase in size. This two month sequence can be repeated for further alveoli development before proceeding to Prolactin boosting.  

All of the Progesterone only birth control regimens can promote lactation because they induce a post-partum like state with low Estrogen. Minipills: Nordette, Ovrette or Nor-Q, Provera pills or Depo-Provera shot, Nuvaring (the Progesterone ring inserted into the vagina) may do so when combined with nipple stimulation and optionally, Domeperidome. Some young ovulating women may find that stimulation plus Domeperidome do not get them into a Post-partum like state with milk production. Adding Progesterone cream daily can often bring success. Progesterone replaces the effect that Domeperidome has to lower Estrogen levels and increase Prolactin levels so taking Domeperidome sometimes may not be necessary to continue. 

My favorite hormonal regimen is the use of bioidentical hormones (exactly identical to what your ovaries produce, better than synthetics), in the form of a cream applied to the breasts. High levels can be achieved, most concentrated in the breasts. Estradiol cream applied for 1 month followed by Progesterone cream for 1 month. You can also use Estradiol patches. Hormones are not as well absorbed though the skin as when taken by mouth and levels must be higher. Estradiol cream should be in the 4 8mg/d and the Progesterone cream should be in the 40 80mg/d. This is 2 to 4 times the level recommended for maintenance hormone replacement. The type of cream base also makes a lot of difference on the absorption of the hormone. 

Domeperidome

This drug works to promote lactation by inhibiting Dopamine, which inhibits Prolactin. More women seem to use this drug than any other. Adding Progesterone in any form (I prefer cream) will increase the effect of Domeperidome. This drug is used to increase gut motility and promote more rapid gastric emptying. Reglan and Propulsid are other drugs in this class that would have similar effects. All of the major tranquilizers including Thorazine, Zyprexa, Haldol and many others lower Dopamine and thus promote lactation. These drugs are generally all sedating and in general, many other sedating drugs and herbs may promote lactation. Beer is known to promote lactation, it contains malted barley and hops. Malted barley can be eaten as a food supplement and promotes lactation. Hops is a sedating herb which also promotes lactation. Blessed Thistle also promotes lactation.

Sedation and Anxiety

In order to produce milk a mother needs to be content, calm, serene and very much enjoying her lactating state. Stress, anxiety and being uncomfortable inhibit the process. Along this line husband support is important and benzodiazepines may promote lactation including Xanax, Valium and others (I am not in favor of taking these for this purpose). These work at the GABA receptor in the brain. Taking GABA supplements may promote lactation. GABA is a food supplement and a neurotransmitter, which promotes quality sleep and boosts Growth Hormone. They are usually taken at bedtime (about 5 caps) to promote sleep but can be taken several times a day (2-3 4x/d). Stimulants on the other hand may inhibit lactation. These include caffeine, Adderall and others.           Some antidepressants with pure Serotonin boosting such as Prozac may promote lactation. On the other hand, many antidepressants used today such as Effexor and Wellbutrin also boost Dopamine, which inhibits lactation.

5-HTP (5 Hydroxytryptophan) and L-Tryptophan boost Serotonin because they are precursors. They can be purchased without prescription. One cap of 5-HTP 100mg can be taken with each Domeperidome dose to enhance its effect. Alternately L-Tryptophan about 400mg cap can be taken several times daily. Straight Tryptophan can also be taken at double the mg. Dose of L-Tryptophan. It is likely to be very inexpensive but may not be as effective as 5-HTP. 

Antihistamines are sedating but they inhibit lactation. Histamine in the body causes increased tissue fluid as in the form of hives or wheals from a mosquito bite. When women are inducing, their breasts swell some and retain fluid with a mechanism that is similar to the swelling that Histamine promotes. Antihistamines inhibit fluid transfer into the alveoli and promote drying up of the breasts. Benadryl, Claritin, Zyrtec and any medication with an antihistamine effect will inhibit lactation. Some drugs have pro-histamine effects such as Risperdol and will promote lactation. Pro-histamine drugs also tend to increase the appetite and promote weight gain. Risperdol is an antidepressant that is used to also promote weight gain and increased sleep. 

Other Medications

Diuretics in general inhibit lactation somewhat by drying out the body and inhibiting the fluid transfer into the alveoli. This of course includes Lasix, Bumex, Hydrochlorothiazide and others. An old blood pressure medication called Aldomet worked by inhibiting Dopamine and has been long known to promote lactation. Aldactone has an anti-Testosterone effect and may promote lactation. 

Other Things

Exercise boosts Thyroid function and Prolactin (and promotes lactation). Hypothyroid condition tends to promote lactation because the brain puts out more TRH to increase Thyroid function, which also increases Prolactin. Proper thyroid function is very necessary for lactation. Thyroid supplements are not likely to inhibit lactation. Any medication, food, herb or drug that increases Growth Hormone will increase lactation because Growth Hormone is also necessary for successful lactation and Growth Hormone is paired with Prolactin at night. It is particularly necessary to accomplish the changes in the breasts on the cellular level as the breast tissue remodels into the active lactating state. There are Growth Hormone boosters on the internet including Symbiotropin, ProArgi and many others. The amino acid L-Arginine is the basis of  ProArgi, Tyrosine may also boost Growth Hormone. Calcium supplements before bed are apparently helpful. Virtually any vitamin and amino-acid supplement combination that you can get at the health food store to boost Growth Hormone could also potentially assist in the induction of lactation. 

An interesting and very effective regimen to promote lactation has been used with Proterelin or TRH (Thyrotropin Releasing Hormone). TRH stimulates the release of Prolactin. A nasal spray of 1mg. of TRH can cause the release of Prolactin similar to probably 15 minutes of nipple stimulation. A small bottle carried in the pocket and sprayed in the nose 5 or 6 times a day can induce lactation similar to a regular schedule of pumping. This regimen has been prescribed and used successfully for women wanting to induce for adopted babies but it is uncommon. It is felt to be completely safe.

 

DrJim

 



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