Transcript Herbal Galactogogues - Aspire Communications

Herbs and Foods as
Galactogogues
Introduction
Capsules
Issues
Teas
Methods
Homeopathics
Reference
Selecting
C. Galactogogues
Case Studies
Tinctures
Resources
Lisa Marasco, MA IBCLC
© Copyright Lisa Marasco 2007
Herbs: the original “medicine”
Current day knowledge
• There is little in the American literature regarding the
use of herbs in general, and almost no research on
herbal galactogogues at all
• Our basic knowledge comes from Commission E
(Germany), oral & written tradition, and anecdotes
• Many resources flawed; not all animal studies
can or should be extrapolated to humans, as
plant actions can vary on different animals
• Many report isolated in vitro study results
without consideration of actual in vivo
experience: thus, some herbs experienced as
galactogogues may be “contra-indicated” due
to theoretical concerns not proven in vivo
• Judging an herb by individual constituents does
not take into account the possibly ameliorating
effects of its other constituents
Example: Herb X
ACTIONS
Antidepressant, antihypercholesterolemic, cardiotonic,
demulcent, laxative, nervine, nutritive, thymoleptic, tonic
CHEMICALS & NUTRIENTS
Calcium, Carbohydrates, Chlorine, Choline, Fats, Fiber, Iron,
Magnesium, Manganese, Phosphorus, Potassium, Protein,
Sodium, Starch, Sulfur
PREPARATION & DOSAGES
(3x/day) Liquid extract: 1:1 in 25% alcohol, dose 0.6-2.0 ml
Tincture: 1:5 in 45% alcohol, dose 1-5 ml
CONTRAINDICATIONS: Celiac disease.
herb X
DRUG INTERACTIONS
Due to the cardioactive chemicals in this herb the following drug
interactions are possible: interference and/or antagonism with
antiarrhythmics; antagonism of beta-adrenoceptor blocking
drugs; potentiation of cardiac glycosides and increased risk of
hypokalemia; when combined with depolarizing muscle
relaxants there is a risk of arrhythmia; interference with nitrates
and calcium-channel blockers; may increase the potential
terfenadine has to cause arrhythmias.
SIDE EFFECTS (Possible adverse effects and/or overdose effects)
Allergic reactions.
WARNING Large doses can cause headaches and diarrhea.
REFERENCES
1. Weiss RF. Herbal Medicine. Gothenburg, Sweden: Ab
Arcanum, 1988, 287-8.
OATS!
Understanding the issues
• While there is some regulation of herbs,
quality/potency can still vary, especially with
non-standardized products.
• Standardized vs Non-standardized
• Part of plant used or % of parts in mix used
(Different parts can have different effects)
• Freshness of herb
• Time on shelf (limited life)
• light exposure
• Some brands more reliable than others.
• Potential toxicities are not well understood
• Potential for allergic reactions often
overlooked; ie, chamomile is related to
ragweed, therefore not recommended to
those with ragweed allergies
• Opinions vary between experts
Targeting: the unconsidered problem
• We don’t know a lot about how many of
the galactogogues act
• Little research has been done on reputed
herbal galactogogues to analyze how they
may work (exception: Farnsworth)
• Are they boosting prolactin, or another
part of the equation?
• Inherent difficulties of researching
galactogogues
Underlying problems may vary; does the
herb even affect the problem system…
Or are we simply guessing
our target and hoping to hit
the right one?
Dosing: No such thing as “the right amount”
• Potency varies by
manufacturer
• Potency can vary by
batch
• Experts vary on
recommendations
• Most pkg instructions
based on generic use,
not lactation
• Little info on
therapeutic dosages
for lactation
• Titrate to need
• Teas
• Cover to steep
• Crush seeds
• Can use sweeteners
• Tinctures
• Strengths vary
• Some dosed by weight, others by
standards
• Capsules
• Check capsule size (mg/grams);
many suggested dosages do not
specify mgs.
Best reference aid
Herb ratings:
A- no safety issues identified;
generally considered safe when
used appropriately
B- May not be appropriate for selfuse by some individuals, or may
cause side-effects if misused.
Seek reliable safety and dose info.
C- Moderate potential for toxicity,
mainly dose related
D- Use only with supervision of
knowledgeable physician
E- Avoid. Toxic plant with no
justifiable medical use.
By Sheila Humphrey RN IBCLC
Better known herbs
reputed to be galactogogues
“Culinary use”
Anise seed (B) Pimpinella anisum
NOT star anise
• Actions: anti-spasmodic,
mildly estrogenic,
expectorant, carminative,
aromatic (Handout:
Indexing Herbs by Action)
• May also be helpful for
MER
• Parts used: seed
• Safety:
USA: GRAS
UK: General sales list
Canada: approved as an OTC drug
France: Traditional Medicine
Germany: Comm E approved as an OTC
• Not for use in pregnancy
• Tea: 1-2 tsp crushed seeds in 1 c
water, cover & steep 10-20min,
3-6x/day.
• Tincture: 3ml 2-3x/day
• Caraway seed (A) Carum carvi
• Actions: appetite stimulant,
anti-spasmodic,
expectorant, carminative,
emmenagogue, astringent
• Parts used: seed
• Has been used for infant
colic
• Safety: considered safe by
FDA
• Often combined with other
herbs
• Tea: 1-2 tsp/5oz water,
steep 10-20 min, 5-6x/day
• Tincture: 3ml TID
culinary use…
CorianderCoriandrum sativum
• Seed of cilantro plant
• Popular galactogogue
among Chinese and
Indian mothers
• Diuretic, nutritive,
anti-flatulent, antidiabetic (mild)
• 1 heaping T seeds to
1 mug of hot water,
steep 10-15 min, take
3-5x per day. Can
sweeten as desired.
Dill (A)- Anethum graveolens
• Actions: anti-spasmodic,
diuretic, carminative,
emmenagogue, antiinflammatory, aromatic
• Parts used: seed
• Used in “gripe water”
• May help with MER
• Contraindicated for low
sodium diets
• Often combined with other
herbs
culinary use…
Dill
• Tea: 2 tsp/8oz
water, steep 1015 min, 2-3x/day
• Decoction: Steep
½ c dill seeds in
water overnight;
boil until very
dark in color,
strain. Drink one
cup of this a day.
• 2 tsp seeds on
meal
culinary use
Fennel Seed (A) Hale L4
culinary use…
Foeniculum vulgare
• Actions: Liver, anti-spasmodic,
diuretic, aromatic, estrogenic
(weak)
• Parts used: seed
• Note: has toxic look-alike
relatives!
• For gastrointestinal disorders
• One source suggests may
promote milk ejection; another
suggest may have bustenhancing properties
• Also studied for anti-hirsutism
properties
culinary use…
• Possible side effects: allergic reactions,
dermatitis.
Fennel oil can be toxic. Avoid.
• Hale: L4 due to concerns regarding
estrogenic property effects on lactation
• Safety: One European case report of 2
infants who reportedly became weak and
lethargic when mom ingested 2 qts of tea
daily made from fennel, licorice, galega.
However, plants never ID’d.
• Not recommended during pregnancy
culinary use
• Tea: 1-3 tsp freshly
crushed seeds per
8oz water, steep 1015 min, 2-6x/day
• Tincture: 3ml X 3
Fenugreek (B) Hale L3
Trigonella foenum-graecum
• Actions: Stimulate breast
growth, digestive aid,
hypoglycemic, expectorant,
emmenagogue, antiinflammatory, hypotensive,
demulcent, diaphoretic
• Parts used: seed
culinary use…
• Source of iron?
• May have hypotensive and thyroid
supporting properties
• Most studied of all lactogenic herbs
• U.S. listed GRAS (generally
regarded as safe) when used in
moderation
• Mother’s sweat and urine usually smell like
maple syrup
• Possible side effects: diarrhea (mother or
baby), stomach upset, hypoglycemia,
allergy. Could worsen asthma.
Contraindicated for pregnancy. May lower
cholesterol.
• Research Issues:
• Difficult to create placebo
• Form/brand to test
• Ethics of withholding help
culinary use…
Dosage:
• Capsules: 2-4 540-650mg caps
3-4x day
• Max 6gms/day (Frank Nice) BUT
some people have used up to 4
qid
• Tea: 1 tsp seeds/8oz water,
steep
5-10 min, x2-3. If seeds crushed,
use ¼ tsp
• Tincture: 1-2ml TID
• Often combined with Blessed
Thistle
Shatavari (B)
•
•
•
•
•
Asparagus racemosa
Also known as “hundred
husbands”
Found in Africa, India,
Australia, Asia
Considered “the strongest”
herb for female issues, is
used for infertility, prevent
miscarriage, increase milk
supply, increase breast tissue
Diuretic, nutritive, laxative.
Mucilaginous.
Considered “anti-oxytocic”
for uterine contractions
during pregnancy
H.S. Puri, 2003- Rasayana:
Ayurvedic herbs for Longevity & Rejuvenation
• “Regularizes” menstruation, dysmenorrhea
and fertility
• Pregnancy: “used for proper breast
development, embryonic growth &
to rid genital of diseases.”
• Powder form only first 8 mos
• Oil for vaginal swab 9th mo for
elasticity, “easy and painless delivery”
• 5-10gm asparagus powder with warm milk
recommended for pregnancy/lactation
• 1-2 tsp root powder
stirred into warm
milk 1-2x a day
•
Or one capsule
twice a day
•
Considered safe
for pregnancy and
lactation
Non-culinary herbal galactogogues
Alfalfa (A-plant) Medicago sativa
• Actions: estrogenic (weak),
nutritive, may stimulate
appetite.
• Parts used: leaves
• Nutrition: High in chlorophyll
beta carotene, calcium.
Contains vitamins
A,B1,B6,B12,C,E, K1 along
with •potassium,
phosphorus, iron and zinc.
non-culinary
• Said to increase supply in cows
• Report of presence of “TRH-like material” which
may in turn stimulate prolactin release
• Possible diuretic and pituitary function support
properties
• Possible side effects: allergies, diarrhea. May
lower cholesterol. Avoid with lupus or
rheumatoid arthritis.
•
•
•
•
•
•
Dosages
1-2 tablets or capsules
3-4x/day
Tea: 1-2T dried
leaves/5oz water 24x/day
Tincture: ½- 4ml 4x/day
1T dried juice powder
2x/day
Homeopathic alfalfa: 6
tablets per day (KM)
Can be combined with
homeopathic
Lactuca virosa
Blessed Thistle (B) Hale L3 Cnicus benedictus
• Actions: appetite stimulant
and digestive aid, hormone
balancer, cholagogue
• Parts used: leaf, stem,
flower
• Often used in conjunction
with fenugreek
• Reputed to “increase the
flow of milk”
• Avoid during pregnancy
• Safety: considered nontoxic
non-culinary
Dosage:
• Tea 1-2 tsp crushed seeds
in 5oz water (bitter) 56x/day
• Tincture: 1-3mls 2-4x/day
• 1-3 caps (250-300mg)
3x/day when combined
with fenugreek or up to 6g
total if used alone (per
Commission E)
Borage - Borago officinalis
• Actions: diuretic,
expectorant, antiinflammatory, nervine,
demulcent, diaphoretic,
tonic, mucilaginous
• Parts used: leaf, flower
• Nutrition: potassium,
calcium; oil rich in omega
3 fatty acids
non-culinary
• Oil (A) reputedly
increases creaminess
of milk
• 2-5ml x3 OR
• 1000mg 1-4x/day
• Leaves (C) reputed to
help milk supply, but
must be used
judiciously as large
amounts can cause liver
damage
• 2 tsp dried herb x3
non-culinary
Chasteberry - Vitex agnus castus (B)
• Actions: Hormone balancer,
tonic
• Reputed to “normalize” pituitary
function, used for luteal phase
insufficiency (“shift” in ovarian
hormones in favor of
progesterone), irregular cycles,
PMS. Promotes fertility. May
help MER?
• Parts used: fruit
• Sometimes used for PCOS
• Reputed to “modulate” Prolactin
levels
• 1943 Study found increase in milk
production in 80% of 125 patients.
• 1957 controlled trial of 817
patients claimed that avg milk
production 3X that of controls
Conflicting info:
• “May bring on milk flow
early” if used in pregnancy.
• hypoprolactinemic agent,
suppressed lactation in rats
• In men, small dose
(120mg/day) increased PRL
while large dose (500mg)
inhibited it.
• May take time for effects
to kick in?
• May interfere with
Reglan
• Tea: 1 tsp ripe
berries infused in 8oz
water 10-15 min;
drink 3x/day (bitter)
• Capsules: 2-“00” per
day or 30-40mg/day
(Humphrey)
• Tincture: 1ml x3 or
up to 5mls daily (1:5
conc)
Goat’s Rue (B) – Galega Officinalis
• Actions: stimulate breast
growth; milk; diuretic;
hypoglycemic;
emmenagogue;
diaphoretic;
• Parts used: dried aerial
parts
• Contains galegin, upon
which phenformin was
based
non-culinary
• Reputation for causing
breast growth
• French dairy farmers
noted 35-50% increase in
output of milk in their
herds
• Popular among French
nursing mothers
• Controversy: toxicity in sheep
• No reports of problems in
human use
• Peripheral Receptor
Sensitizer?
Goat’s Rue
• Dosage: No consensus, but
consider taking with food
• Tea: 1 tsp leaves/5-8oz water,
steep 10-20 min, 3-5x/day
• Tincture:
• 2.5ml X 4 (Wise Woman Herbal)
• 3-4ml x 4 (Mechell Turner)
• 1-2ml x3 (MotherLove)
• 1 tsp in 8oz water TID (LowDog)
• Capsule: 1 cap 4x/day (Motherlove)
Ixbut- Euphorbia lancifolia (C)
non-culinary
• From Ix (woman) and but
(increase in flow or
volume)
• Ancient Mayan
galactogogue used when
milk supply insufficient.
Popular back in the 1940’s, still occasionally used by
rural women in Guatemala. Also found in SE Mexico,
Belice, El Salvador and Honduras.
• “Said to double the quantity of milk given by cows that
eat it.“ High amounts appeared to cause decrease after
several days……. Moderation important?
ixbut
• Claimed “to cause milk to flow after it has ceased
normally, or even in women who have not given birth to
a child……. That aged grandmothers, after taking Ixbut,
have been able to suckle newly born infants through
withered breasts….”
• Aerial parts used– leaves and branchlets
• Typical “dose” tea made from 5 leaves or sections
of stem (~ 5gms) and 1 cup of water, 3x/day
• Dehydrated leaves high in calcium?
• Pozo 1949 study: no changes in breast volume or
milk composition noted, only milk volume.
• Galactagogue properties appear higher in November
before plant blossomed
• Euphorbia family (esp. hirta) has many reputed
galactagogues, but toxicity concerns have
precluded common use
Marshmallow root (A)
Althaea officinalis
• Actions: diuretic; expectorant;
anti-inflammatory; demulcent;
mucilaginous
• Parts used: root and leaf
• Nutrition: calcium
• Galactogogue effect not direct,
perhaps synergistic; one
herbalist uses it “when baby
isn’t gaining weight well”
• May help counteract loose
bowel effects of alfalfa,
fenugreek, blessed th
• Tea: 1T root
powder/ 5oz
water, let stand
30 min; drink
immediately.
• Tincture: 1-4 ml
3x/day
• Capsules: up to
4 caps 3x daily
Milk Thistle (A) Silybum marianum
• Actions: Liver,
demulcent; cholagogue
• Contains silibinin,
silydianin, silychristin
• Parts used: seeds or
leaves
• Mechell Turner says
leaves are used for
milk supply
• Possible side effects:
mild laxative effect,
diarrhea, mild allergen.
Milk thistle
• Tea: 1 tsp
freshly crushed
seeds in 5oz
water, steep 2030 min. 56x/day
• Tincture: 3-5ml
3x/day
• Capsules: two
500mg 3x/day
• Nettle (A)
Urtica dioica, urens
• Actions: astringent,
diuretic, tonic,
hypotensive.
• Parts used: aerial parts
• For gastrointestinal
disorders
• High in chlorophyll; also
Vit C, iron
• Possible side or
overdose effects:
gastritis, edema, burning
sensation of skin
• Tea: 2-3 tsp herb
in 1c water;
steep 10 min,
2-3x/day
• Leaf Tincture
2.5-5ml 3x/day
• Capsules: 1-2
300mg 3x/day
• Red Clover (B)
Trifolium pratense
• Actions: anti-spasmodic;
expectorant; estrogenic
(weak) stomachic;
cholagogue
• Parts used: flower head
• Use in pregnancy
considered controversial
• Use non-fermented only
non-culinary
Dosage
• Tea: 1-3 tsp herb
in 5oz water;
3x/day
• Tincture: 2-6 ml
3x/day
• Red Raspberry (A) Rubus idaeus
• Astringent, tonic, parturient
• Parts used: leaves, fruit
• Nutrition: vitamin A, B complex,
C, E, calcium and iron,
phosphorous, potassium.
• Galactogogue effect uncertain;
one source says it is believed to
lower supply long term, but may
help if used short term (<1wk)
• Other sources say it “increases
the flow” and “enriches” the milk,
use tea to aid milk ejection
non-culinary
• Tea: 1 tsp leaves/5oz water, steep 5-10 min, 2-4x/day
• Tincture: 3-4mls 3x/day
• Capsules: 3-300mg caps 3x/day
Saw Palmetto (A) Serenoa repens
• Historical use includes for
treatment of “underdeveloped
breasts,” “a galactia;” “increased
lactation;” “breast enlargement.”
• Parts used: fruit
• Nutrition: The leaves have a very
high content of vitamin A as well
as moderate amounts of vitamin
D, vitamin C, various B vitamins,
iron, silicon, magnesium, zinc,
and manganese.
• Dosage (general)
• 320mg daily
• tinc: 1-2ml 3x/day
• tea: ½-1 tsp berries in
1c water, simmer 5 min,
drink 3x/day
• Vervain: Verbena officinalis (B)
• Actions: nervine, anti-spasmodic,
diaphoretic, hypotensive, hepatic
• Reputedly oxytocic and uterotonic
• Parts used: aerial parts
• More often found in combinations
• Dosage:
• Considered safe in appropriate
dosages; not for pregnancy
• Tea: 1 tsp per 5oz water steep 510 min, drink 3x/day
• European Infusion: 30-60g herb in
1 qt boiling water; steep 10-15 min
• Tincture: 2-4ml 3x/day
non-culinary
Others on the horizon
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•
•
Ashwagandha (C)
Black Cohosh (B) hypotensive
Chickweed (A) thyroid, ovarian cysts
Dandelion (A) diuretic
Hops (A) diuretic; bust enhancement?
Licorice (B) another aromatic herb
Oat Straw (A) iron; diuretic; pituitary
Handouts: Herbs by family, Herbs by similar action
Commercially available herbal galactogogue
tinctures
• More Milk, More Milk Plus
(Motherlove Herbal): Blessed
Thistle, Nettle, Fennel; plus adds
Fenugreek. MM+ now 1:3,
or also in glycerin form.
• More Milk Special Blend
(Motherlove Herbal): adds goat’s
rue to More Milk Plus (1:5)
• More Milk Two (Motherlove
Herbal) : Raspberry leaf, Nettle,
Alfalfa. Considered safe for use
during pregnancy.
other combinations…
Mother’s Lactaflow (Wise Woman Herbals)
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•
•
•
Fennel
Blessed thistle
Fenugreek
Goat’s rue
Suggested dosage
30-40 drops 3-4x
per day
Commercial Tinctures….
• Make Milk
(Laura Nevada Lactation):
Fenugreek, Blessed Thistle,
Borage, Goat’s Rue
• M&B-A: (Pure Herbs)
Marshmallow root,
Fenugreek, Blessed Thistle,
Universal ER, Plaintain,
Fennel
Nursing Mother’s
Abundant Milk Tincture
Blend (Kerry’s Herbals) (Growing Life)
•
•
•
•
•
Fenugreek
Blessed Thistle
Goat's Rue
Alfalfa
Anise
•Blessed thistle
•Fennel
•Fenugreek
•Peppermint
•Lemon grass
Commercial tinctures
• Ancient One’s formula (B&BR): Anise, Dill,
Fennel, Fenugreek. Made of kitchen-familiar
herbs only, for those not comfortable with the
unknown.
• LC’s proprietary blend (B&BR): Blessed
Thistle, Fenugreek. Most commonly
demanded herbs.
• Milk In Formula (B&BR): Blessed Thistle,
Borage, Fenugreek, Goat’s Rue, Red
Raspberry. When nothing else seems to be
working.
Commercial tinctures
• Mega Milk Formula (B&BR): Blessed
Thistle, Borage, Red Raspberry. For those
who don’t want fenugreek.
• Anti-Puffy Formula (B&BR): Dandelion,
Cornsilk. For postpartum edema.
• Let-down Formula (B&BR): Black Cohosh,
Motherwort, Schizandra berries. Can also
get with added fenugreek. When MER
seems to be the problem, not available milk
Combination Galactogogues in
Capsules
More Milk Plus
• Fenugreek, blessed
thistle, nettle, fennel
• Dosage:
1 capsule QID or 2
caps TID if >175lbs
or not working well
after 48 hrs
“Lactation Blend” (Vitanica**)
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•
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•
•
•
•
•
•
•
•
•
•
Fennel Seed -------------------------100 mg
Nettles Leaf -------------------------- 70 mg
Blessed Thistle---------------------- 70 mg
Vervain---------------------------------- 70 mg
Hops------------------------------------- 45 mg
Oat Straw------------------------------ 45 mg
Raspberry Leaf----------------------- 40 mg
Goat's Rue aerial parts------------ 40 mg
Chaste tree berry-------------------- 35 mg
Fenugreek Seed--------------------- 25 mg
Milk Thistle Seed-------------------- 20 mg
Borage Seed Oil--------------------- 20 mg
Borage Flower & Top-------------- 10 mg
TOTAL mg per capsule
590 mg
*Recommended dosage 1-2 caps per day
**formulated by Dr. Tori Hudson, Naturopath
capsules…
Baby Me Now
Lactation Ease
(Solaray)
• Fenugreek,
fennel, nettle
• Mfr
reputation?????
Nonichai
•
•
•
•
•
Noni (leaves)
Cardamom (seed)
Marshmallow herb (root)
Fennel (seed)
Fenugreek (seed)
Dosage: 2 capsules per
day
??????
Gactogogue Teas
Mother’s Milk Tea
(Traditional Medicinals):
Fennel, Anise, Coriander,
Spearmint, Lemongrass, Lemon
verbena, Althea root, Blessed
thistle, Fenugreek.
–Milder than tinctures, usually taken as 1-4 cups a day.
Katherine Shealy finds 8 cups a day very effective.
–Tasty iced tea version: 6 bags MMT + 4 bags
Celestial Seasonings Wild Berry Zinger to make 3 qts
tea; place in water bottles and sip throughout day.
Weleda Nursing Tea (Swiss)
• Swiss Formula: Nettle, Aniseed,
Caraway and Fennel
• U.S. Formula: Fenugreek Seed,
Anise Seed, Fennel Seed,
Caraway Seed, Lemon Verbena
Leaves.
• Directions 1: Combine one level
5ml teaspoon to 1 cup of cold
water and bring to the boil.
Simmer for one minute, steep 5
minutes.
• Directions 2: 1 tea bag to a cup
of boiling water, cover and
steep 5 minutes.
• Drink 3 cups a day or as
directed by your naturopath.
swiss
U.S.
Yogi Tea – Woman’s Nursing Mom
• Fennel, fenugreek,
anise, chamomile,
lavendar
• Directions: pour 8 oz
boiling water over one
tea bag and steep for 5
to 10 minutes. Gently
squeeze each tea bag
to fully release the
active ingredients. Drink
2 cups daily to maintain
milk production or 1 cup
every 3 hours to
stimulate milk flow.
other combinations….
• Abundant Milk
Tea (Growing Life)
Blessed thistle, fennel,
fenugreek, peppermint,
lemon grass
• “Lactare” from India
• Asparagus Racemosus
(Shatavari) 200mg
• Withania Somnifera
(Ashwagandha) 100mg
• Glycyrrhiza glabra
(European Licorice) 50mg
• Fenugreek 50mg
• Allium sativum (garlic) 20
mg
• Directions: 2 caps TID for first 14
days after delivery or as needed
• Studies cited showing Lactare
increases prolactin, milk
production, creaminess of milk
Homeopathics
• Based on the Law of Similars, or “like treats
like.” Counter-intuitive to western thought.
• Classical approach takes in-depth
consititutional history and chooses one
remedy only
• Remedies are diluted until no measurable
amount of source remains; can be found in
6x, 12x, 6c, 12c, 30c, 200c, L and M dilution/
potencies; typically used short term, ~ 3 days
• The greater the dilution, the more potent it is
considered
• Best results when prescribed by practitioner
rather than self-diagnosis
Advice from herbalist Mechell Turner, IBCLC:
• Do not touch the pills or tablets (remedy is on the
outside of the pellet)
• Put the dose—usually 1 tablet or drop—into the
lid of the bottle, or even a clean paper cup. (Often
placed under tongue for quick absorption)
• Take the remedy only for the symptoms.
• If symptoms get worse, stop the dosage.
• Administer less frequently as symptoms improve.
• Usually do not take medicine for longer than 3
days.
• For emergencies use the 30C every 30 minutes to
1 hour for up to 10 doses. Then see above rule.
• Take the smallest dose for the shortest period of
time.
Homeopathics more commonly
used for low milk supply…..
*Urtica urens
• Considered a good galactogogue for general
use. May be useful when there is a total
absence of milk or when milk supply is slow to
establish without an obvious cause. May be
appropriate when hemorrhage or anemia
precede low milk supply.
*Lactuca virosa
• Considered a strong galactogogue overall,
good for general use
• Suggested dosage 4 (30c) pellets QID
or 2 (30c or 200c) BID
• *Ignatia
• Often used for sudden loss of milk related
to shock and grief.
“I haven't seen this do much on it's own.
However, when it's combined with a mild
galactagogue like nettle I've seen amazing
results.”
-Jay Gordon’s website
• Suggested dosage: 2 (6x) tablets TID (KM)
• Ricinus communis
• Hemorrhage or anemia preceding low milk
supply
• Galega
• When anemia or poor nutrition are also
variables
• Helonias (False Unicorn)
• When caused by extreme maternal
exhaustion (super mom syndrome)
• Dulcamara
• Traditionally used when sudden loss of milk
occurs after exposure to cold and damp; may
be helpful when low milk supply follows milk
stasis (ie, engorgement).
• Agnus Castus
• When low milk supply is accompanied by
depression. (Note: Patricia Hatherly believes this
depression could possibly be related to hormones
from retained placental products, the latter of which
suppress lactation.)
• Causticum
• Short-term exhaustion leading to drop in
milk supply, ie mother up all night with
baby. Most appropriate with personality
that resists rather than “rolls with the
punches.”
• Calcarea carbonica
• May be useful when breasts are engorged
and milk is not flowing, or when low supply
occurs with breast infection that is
associated with engorgement. May
possibly have application for milk supply
when thyroid function is low.
• Silicea
• Low milk supply related to poor maternal
diet/extreme dieting. May also be appropriate
when supply problems preceded by boggy
uterus after childbirth, possible retained
placental products, or inflamed breast infection
• Rescue Remedy
• When the milk is present but not flowing and
mother is stressed from pain, fear of pain, etc.
• Use 4 drops sublingually before nursing
or pumping to facilitate milk ejection .
• Rescue Remedy can have a slight
sedative effect, so use caution.
Selecting galactogogues
• A good maternal health history is
important, including any medical
conditions, allergies, history of
depression, current medications
• What is the root of the problem? Is there a
lactogenic medication or herb that seems
to target this issue?
For example: (not exhaustive)
• Thyroid support: dandelion, chickweed,
nettle, vervain
• High Iron: alfalfa, dandelion, fenugreek,
nettle, red raspberry leaf,
• Pituitary support: alfalfa, chasteberry,
• Diuretic properties: alfalfa, blessed thistle,
borage, coriander, dandelion, dill, fennel
seed, goat’s rue, marshmallow, nettle,
• Milk ejection: anise?, chasteberry?, dill,
fennel seed?, red raspberry leaf?
• Anti-hypertensive: fenugreek, nettle, vervain
• Nervine: anise, borage, fennel seed, vervain
• What is mother’s comfort and
philosophy regarding medications or
herbs?
• Are there institutional or HCP
restrictions on what can be used? Must
work carefully within framework of
mother’s HCPs
• Look for reputable manufacturers or
herbalists
• Rotating herbs may work better for longterm dependence
Case Studies
Case 1: Two babies, two different results
• Primary supply failure (but >50%) with baby #1
• Did research, then used herbs for #2:
• During pregnancy: drank mix of
• Handfuls of Red Raspberry Leaf & Nettle
• Slightly less Alfalfa and Red Clover Blossom
• Heaping handful of the mixture to 1qt of boiling
water steeped overnight (drank iced)
• Postpartum Adjustments:
• Added hops, blessed thistle, marshmallow root,
fenugreek and goat’s rue powder (1 tsp ea/qt)
• Drank 1qt per day
~anecdotal~
Case 2: Break through experience
• Primigravida age 33 presented at 8 days pp.
due to no BMs in 72 hrs, “brick dust” urine
• Baby born at home, 8#2, now 7#00.5.
• Mother feeding almost constantly.
• Family staunch vegans, opposed to
commercial formulas
• Mildly hypoplastic type 2 breasts spaced 11.5” apart
•
•
•
•
•
mild pregnancy changes only.
More palpable gland in L vs R
Veining moderate
Areolae very large
Milk in day 4 ( by color change)
• Additional maternal hx:
• erratic cycles from age 13 with menorrhagia;
placed on BCPs during 20’s. Cycles improved 2
yrs ago after starting vegan diet
• Infant Assessment: good suck, tone, alertness
• Feeding observation: latched fairly well
• Intake 8ccs L and 2ccs R
• Post pumping yielded 20ccs total; good MER
• Initial lactation dx: infant lack of weight gain
secondary to poor supply due to inadequate
glandular tissue.
• F/U 2 (1 wk, age 19 days)
• Baby 7#12.5, up 7oz/7days
• Baby taking about 2oz suppl. per feed for
14oz AIM + 7oz EBM per day
• Test intake 8ccs R 9ccs L; switched to
football, got 28ccs more = 45ccs total
• Mom reports taking both herbs 8-10x/day
• Baby breastfeeds 30 min total
• Pumping 6-7x/day, 20-35ccs ea
• Continue plan
• F/U 4 (2 wks, age 6 wks)
• Baby wt 8#15.9 up 13oz/14 days
• Test feed: 24ccs R and 80ccs L =
104ccs!
• AIM down
• Mom taking herbs 10-12x/day + MM tea
• Mom also reported some vaginal
bleeding
• Baby eventually rejected
supplements; gain average .5oz/day.
Solids started late due to paternal
preference.
• New pregnancy @ 7 mos; baby #1
breastfed 6 mos into new pregnancy
At 5 mos: transferred 100ccs, but wt gain not quite .5oz/day
• Interesting stuff
• Mom got tired of doing herbs all the time, so
decided to try domperidone instead.
• At first this seemed to work, but then supply
dropped and breasts “deflated,” so she
added Goat’s Rue back and took them
concurrently.
• Later on, she ran out of the Goat’s Rue for a
few days and found that her breast seem to
“deflate” again. She quickly got more and
things returned to normal
• Supply was ~95% overall
• Baby #3……..
Web Resources
• KellyMom.comhttp://www.kellymom.com/herbal/milksupply/herbal_galactagogue.ht
ml
• LowMilkSupply.org http://lowmilksupply.org/increasingmilkgalactagogues.shtml
• Birth and Breastfeeding: http://www.birthandbreastfeeding.com/
• Mongraphs by D. Hoffman, Herbal Materia Medica:
http://www.healthy.net/clinic/therapy/herbal/herbic/herbs/
• Longwood herbal task force: http://www.longwoodherbal.org/
• Saw palmetto: http://www.sawpalmetto.com/history.html
• Napralert: http://www.napralert.org/
MOBI: http://www.mobimotherhood.org/MM/article-diet.aspx
Breastfeeding & herbs discussion group:
http://health.groups.yahoo.com/group/Bfg-HerbsDiscussion/