Why To Be Wary of Lactation Supplements To Increase Breast Milk Supply

If you’re breastfeeding (chestfeeding) and concerned about low milk supply, you probably already know that there’s a lot of advice out there. From social media to your sister-in-law, everyone has an opinion about what you should do to make more milk.

It can be a vulnerable time for you. You have a new baby. You want to make sure they’re getting what they need to be healthy. And of course, you’re inclined to listen when you hear about breastfeeding pills, lactation supplements and galactagogues that promise to ramp up your milk supply. You’re trying to do the right thing here.

The thing is, not everyone who’s breastfeeding needs to make more milk. And most of the foods, teas, supplements and pills that claim to increase your milk supply aren’t backed up by research.

“There are a lot of different products out there that are advertised to increase milk supply because they’re moneymakers,” says breastfeeding physician Kam Lam, MD. “But nothing replaces the hard work of emptying and stimulating the breasts. There’s no magic lactation supplement that we know of that can completely replace the normal physiology of how milk is made.”

What are the risks of using galactagogues? And how can you safely and effectively increase your supply? Dr. Lam shares advice.

What are galactagogues?

Galactagogues are supplements that are believed to increase milk supply in people who are breastfeeding. But the key word here is “believed.”

Some galactagogues have been used for generations as home remedies for increasing milk supply. Hippocrates even suggested, “If the milk should dry up … give her to drink the fruit and roots of fennel.”

Some supplements that have been used historically in the hopes of increasing supply include:

• Brewer’s yeast.
• Herbal teas.
• Lactation cookies.
• Fenugreek.
• Blessed thistle.
• Milk thistle.
• Anise.
• Nettle leaf.
• Marshmallow root.

But there’s a big difference between the anecdotal evidence of traditional practices and the scientifically sound results of randomized controlled clinical trials. And as far as scientifically valid evidence is concerned, the safety and effectiveness of most galactagogues are unknown.

“The studies on most galactagogues have been fraught with a lot of limitations,” Dr. Lam says. “It’s really hard to say that any particular lactation supplement can help you make more milk.”

Should you try lactation supplements?

There may be some cases when certain breastfeeding supplements may be helpful for some people in some scenarios. Like if you have insulin resistance or low levels of prolactin. And if your milk supply truly is low.

Dr. Lam recommends trying out lactation supplements only as advised by a healthcare provider, like a breastfeeding medicine physician.

“I recommend a shared decision-making process between the person who’s breastfeeding and a qualified healthcare provider who can check for contraindications and monitor for side effects,” Dr. Lam suggests.

Contraindications are reasons that you wouldn’t want to take a supplement based on things like your medical history, allergies, medical conditions or medications.

It can be easy to assume that lactation supplements are safe and no big deal. After all, they’re not really medicine, right? What’s the harm in some herbal tea? Or a little vitamin-looking pill?

Dr. Lam shares the concerns.

You may not need to make more milk

It’s easy to have a skewed perception of reality when it comes to how much milk you’re making and how much you really need.

“There’s a lot of pressure on people who are breastfeeding to keep up their supply, especially if you’re going back to work and feel like you need a big freezer stash,” Dr. Lam acknowledges. “But if the baby is gaining weight appropriately and you’re emptying your breasts enough, you probably don’t really need to make more milk.”

Lactation supplements should really only be considered if you truly have low milk supply.

Because if the supplements do work, you risk overproducing. That can leave you at risk for breast engorgement, which can be uncomfortable and make it harder for your baby to eat. Prolonged engorgement can even lead to problems like clogged ducts and mastitis.

Effects on certain medical conditions

Just because a product is labeled as “natural” or “herbal” doesn’t mean it’s good for you. (Think about it: Poison ivy is natural ... but that doesn’t make it safe.)

And especially if you’re living with certain health conditions or taking other medications, you risk harmful effects and bad interactions.

“Some galactagogues shouldn’t be used if you have a clotting disorder or thyroid disease or any other number of conditions,” Dr. Lam notes. “It’s not just that they won’t help; they could wind up being dangerous.”

Lack of regulation

One of the biggest concerns about breastmilk supplements, Dr. Lam says, is that you don’t necessarily know what’s in them. That’s because supplements, unlike medication, aren’t rigorously tested. Companies don’t have to prove they’re safe or effective before putting them on the shelves.

“Over-the-counter supplements aren’t regulated by the FDA,” Dr. Lam warns. “Companies can put whatever they want in those bottles. What you get can vary greatly, regardless of what it says on the box.”

When it comes to purchasing breastmilk supplements (or any supplements for that matter), buyer beware.

Unneeded expense

Without scientific evidence to show their effectiveness, how your milk will respond to breastfeeding supplements is a big question mark.

“In some people, certain supplements could increase supply, but in others, it could decrease supply. And we don’t have enough evidence to know which camp you’ll fall into,” Dr. Lam emphasizes.

And even when lactation supplements do appear to improve supply, that may not be the whole story.

“Often, when people worry about their supply, they take many different steps at once to improve it,” Dr. Lam clarifies. “They eat the cookies and drink the teas and nurse more often and pump more often. And then, when their supply improves, they give credit to the tea without considering that that was just one of several variables.”

So, you continue to buy the supplements, teas, pills and cookies because you think they work. You don’t give yourself credit for the extra time spent removing milk from your breasts. And the cost adds up.

“Some brands of breastfeeding supplements are multi-dose pills that you take multiple times a day. That can get pretty expensive out of pocket,” Dr. Lam says. “It can be a real investment in something that may not do anything.”

Better ways to increase your milk supply

But rest assured that even if breastfeeding supplements aren’t the answer, there are ways to help stimulate your body to make more milk.

“Breastfeeding is a matter of supply and demand,” Dr. Lam explains. “The more milk you remove from your breasts by nursing or pumping, the more it will trigger your body to make milk. That’s the best method of establishing and maintaining a healthy supply. Even when medications or supplements are appropriate, they only work in conjunction with breastfeeding or pumping.”

Most people will make plenty of milk to keep their baby healthy and fed by:

• Eating a healthy diet.
• Drinking plenty of fluids.
• Practicing skin-to-skin care.
• Feeding your baby on demand and ensuring a proper latch.
• Pumping between feedings.
• Managing anxiety.
• Getting enough sleep.
• Taking care of your own mental and physical well-being.
• Continuing to take your prenatal vitamins.

Low supply can be a real problem for some people, but rushing to load up on lactation supplements isn’t the best answer for most people. Talk with a healthcare provider about your concerns. They can help you identify any issues and help you find solutions.