title: The use of galactogogues in the breastfeeding mother.
abstract: OBJECTIVE
  To review data regarding the efficacy of galactogogues available in the US to increase breast milk production in postpartum mothers.
  
  
  METHODS
  Literature was sought using PubMed (1966-June 2012) and EMBASE (1973-June 2012). Search terms included breastfeeding, breast milk, lactation, galactogogue, metoclopramide, oxytocin, fenugreek, milk thistle, silymarin, growth hormone, thyroid releasing hormone, medroxyprogesterone, domperidone, goat's rue, beer, Asparagus racemosus, shatavari, Medicago sativa, alfalfa, Onicus benedictus, blessed thistle, Galega officinalis, brewer's yeast, and herbals.
  
  
  METHODS
  All studies including humans and published in English with data assessing the efficacy of galactogogues for increasing breast milk production were evaluated.
  
  
  RESULTS
  Breast milk is considered the optimal food source for newborns through 1 year of age. Many factors influence overall maternal production, including maternal pain, illness, balance of time when returning to work, anxiety, or emotional stress. Although a variety of herbal and pharmaceutical options have anecdotal evidence of their ability to improve breast milk production, peer-reviewed studies proving their efficacy are lacking. Metoclopramide, oxytocin, fenugreek, and milk thistle have shown mixed results in improving milk production; however, the trials were small and had a variety of limitations.
  
  
  CONCLUSIONS
  Nonpharmacologic recommendations should be exhausted before adding therapy. Although anecdotal evidence encourages the use of metoclopramide, fenugreek, asparagus, and milk thistle for their galactogogue properties, efficacy and safety data in the literature are lacking. Oxytocin and domperidone are potentially available for compounding purposes, but safety data are limited. More studies are needed to evaluate the effects of available galactogogues on breast milk production.
authors.affiliation: Department of Pharmacy Practice, St. Louis College of Pharmacy, MO, USA. aforinash@stlcop.edu
authors.forename: Alicia B
authors.initials: AB
authors.lastname: Forinash
authors.forename: Abigail M
authors.initials: AM
authors.lastname: Yancey
authors.forename: Kylie N
authors.initials: KN
authors.lastname: Barnes
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Myles
mesh_terms: D001942:Breast Feeding; D005260:Female; D056669:Galactogogues / Q000627:therapeutic use*; D006801:Humans; D007774:Lactation / Q000187:drug effects; D009035:Mothers; D008517:Phytotherapy
chemical_list: D056669:Galactogogues