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Low supply

Galactagogues- What are they and who needs them?

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Galactagogues- What are they and who needs them?

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Galactagogues- What are they and who needs them?

By Jenna Forster, IBCLC, RN

Galactagogues are foods and herbs that are known for their milk increasing properties.  Many of these come from traditional diets of many different cultures around the world. There are also several prescription medications that are known galactagogues, but neither are currently approved by the FDA for that purpose.   

Here is a list of a few common ones that you have likely heard of, and a few you may not!

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Who needs galactagogues?

Low milk supply, whether perceived or actual, is the most likely cause that will contribute to parents seeking out galactagogues.  Thanks to the internet, you can find tons and tons of info on various things that help increase milk supply. So how do you know what works and what doesn’t?

The first thing to consider if you feel as though you have low milk supply, would be an evaluation by a skilled International Board Certified Lactation Consultant, or IBCLC.  An experienced IBCLC has the ability to gather a full health history, and perform a full assessment on both you and your baby to determine if there is, in fact, low supply and what factors may be contributing or causing the low supply.

The second thing to consider is how milk is made.  Milk production works on supply and demand. Increasing the demand, is one of the biggest factors in increasing supply.  Often galactagogues can be used in conjunction with increased breast stimulation, such as more frequent feeding, or pumping.



There are many different causes for low milk supply, and different galactagogues have different actions and purposes.  For example, someone who has had a breast reduction would consider (under the guidance of their physician or midwife) to take goat’s rue to increase their milk making tissue.  It’s important to have a full assessment of the problem, before starting any herbal supplement. While many herbal galactagogues can be found over the counter, this certainly doesn’t mean they are without risk.   Fenugreek, for example, should not be taken by breastfeeding or chestfeeding parents with a history of thyroid disorder, yet fenugreek is in many lactation boosting products.



Bottom line:

Breastfeeding is so much more than milk; it’s a relationship, and many parents can have a beautiful breastfeeding relationship, regardless of how much milk their breasts make. If you are struggling with low milk supply, reach out for an evaluation by an IBCLC, and work together with your IBCLC and physician/midwife team to decide what route would be the most effective in helping you reach your breastfeeding/chestfeeding goals!  Happy nursing! 

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Jenna Forester has been an International Board Certified Lactation Consultant (IBCLC) for 5 years, and a Registered Nurse with a focus on Women’s Health for 10 years. She started my career as a Labor and Delivery Nurse, and then worked in an OB/GYN office for several years before moving her focus to lactation after having her older daughter and realizing how much support breastfeeding/chestfeeding families really need! She was fortunate to have a friend who was very supportive in my breastfeeding journey and that sparked her desire to go through the training to become an IBCLC.  She loves helping families reach their breastfeeding/chestfeeding goals and She loves talking and educating on breastfeeding/chestfeeding. Low milk supply is one of the many challenges that faces breastfeeding/chestfeeding families and one of the most common questions she gets is ‘What can I do to increase my milk supply?!?!?’



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Let's Tell your Story!  BFAR and Increasing Low Milk Supply Part I

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Let's Tell your Story! BFAR and Increasing Low Milk Supply Part I

During World Breastfeeding Awareness month Doulas of Capitol Hill owner and founder, Emily Smith, will share her story and journey of her fourth breastfeeding experience as a BFAR mom (breastfeeding after breast reduction).  She will be documenting her experience of trying to increase milk supply by utilizing herbs and supplements, known as galactogogues, as well as lactogenic (breast milk producing) food and drinks, to combat her history of low supply caused by a previous breast reduction surgery.  

Doulas of Capitol Hill believes that sharing one’s story, while unique unto itself, can help to encourage, to strength, and to inform the experiences of others.  That’s why our slogan is “Let’s Tell Your Story.” We have found that in the sharing of our stories, owning them, and allowing them to be lived in the context of community, we are all stronger for it.  

We acknowledge the causes of Low Supply in breastfeeding moms can be multidimensional.  

This blog and the information shared is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or IBCLC (International Board Certified Lactation Consultant) with any questions regarding low supply, any medical condition, or treatment.

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Hi everyone,

I’m writing this two-part blog series to share my experience using galactagogues to help increase my breast milk supply with my fourth baby.  Today I’ll share a quick run-down of my history and what brought me to this point in the story. Then, I’ll lay out the game-plan for the next 4 weeks.  And finally, at the end of World Breastfeeding Awareness month I’ll come back with part II and report on my experience. Thanks for joining me on this journey!  

How did I get here?

  • When I was 17 years old, I had a breast reduction surgery.  It was medically necessary for my health. I remember asking the surgeon what my chances to breastfeed would be and he said 50/50.  Many years later I’ve hears doctors saying the same thing to other mothers.. Now I know that MOST people who have breast reduction surgery are able to lactate to some degree.  For many this may be just drops (milliliters, not ounces). However, the odds of having a full milk supply and being able to exclusively breastfeed, are more unknown, and depend on many factors such as the type of surgery, how much tissue was removed, and the amount of time between the surgery and having a baby.  

  • Ten years later I gave birth to my first child.  After birth, by day 3, she was dehydrated and had lost greater than 10% of her birth weight (7-10% is the range of normal newborn weight loss).  We began supplementing with formula from bottles and an attempt at the SNS (supplemental nursing system which attaches a thin tube to the nipple and the baby can get formula/pumped milk at the same time as being latched onto the breast). I saw IBCLCs. Went to support groups. We battled painful vasospasms. At 3 months she had a tongue tie clipped. That helped some with the painful latching and we went on to breastfeed until around 15 months. However, I supplemented around 90-100% of her nutritional needs. We mostly nursed for comfort and bonding.  I was a warm pacifier.

  • My next baby was born two years after my first child.  At this point I was a birth doula, had read the BFAR “bible” Defining Your Own Success: Breastfeeding After Breast Reduction by Diana West, and had a new plan for what “successful” breastfeeding could mean.  I saw the director of the Breastfeeding Center for Greater Washington during my pregnancy.  We collected donor milk found from local moms on Human Milk for Human Babies and stored it in a deep freezer during my pregnancy.  I began hand-expressing colostrum at 36 weeks to give my baby right after birth, so we wouldn’t go through the scary experience of a dehydrated baby.  And this time some of my milk ducts recanalized (reconnected) and I was able to make more milk. I estimate around 30-40% of his nutritional needs. I pumped some but focused on the bonding and good latching. The rest we supplemented with a bottle.  We nursed until 13 months.

  • Our third (and what we thought final) baby came along 4.5 years later.  This time my approach to breastfeeding was to throw “everything and the kitchen sink” at the problem of low milk supply.   I took every herb you have ever heard of and even one pharmacological medicine called Domperidone. I drank every tea. I encapsulated my placenta and took those capsules.  I made a jar of tincture with galactagogues made with the most enormous bottle of Gray Goose vodka that has ever been created. I pumped. I collected donor milk.  And this time I was able to make about 50-60% of my baby’s milk. He and I went on to nurse until he was 2.5. I made peace with what breastfeeding was for me; success wasn’t a full milk supply but that it could still be a happy ending.  

  • And now, our surprise baby #4, who came 5 years after a failed vasectomy.  Just like my breast tissue which recanalized more over time, so did my husband’s vas-deferens.  This time, armed with over a decade of research and experience, I’ve decided to meet this breastfeeding journey with a more systematic approach than in the past.  

The Plan-

I’m very excited to partner with some fantastic companies who make products for breastfeeding moms to have a different experience this time.  Some of these companies have offered sample products for me to try. Others have gone a step above and sent along samples for our doula clients to try also.  Many of them have given us a special discount code for our clients to use. And lastly a few companies have offered to do special giveaways for World Breastfeeding Week to celebrate together!  

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Who?

Earth Mama Organics

Gray’s Cowbell Lactation Treats

Legendairy

Majka

Motherlove

Traditional Medicinal

Upspring

Uplifties

How/What?

I will be adding in a new galactogogue twice a week over the first four weeks from birth and recording the impact of the added galactogogue by measuring my milk production 2 days after the introduction of the new product by doing a weighed feeding (which is when the baby is weighed with a precision scale, like those used by our IBCLCs, before a feeding, then fed at the breast, and finally weighed again after to see how much they consumed) AND pumping with a quality breast pump.  If the galactogogue seems to have a positive or neutral impact I’ll continue it throughout the duration of the 4 week time. However, if it seems to have a negative impact I’ll stop immediately. At the end of World Breastfeeding Awareness month I’ll report on my experience.

Baseline variables:

  • Under the guidance of my midwife I started taking goats rue glycerine tincture during pregnancy. This herb is one of the few which is considered safe for pregnancy.  It is known to help grow breast tissue and for this is often recommended to people who have a diagnosed low supply from prior breast surgery or IGT (insufficient glandular tissue.) Another which is safe for pregnancy is alfalfa and I also started during pregnancy.  Some of the products I’ll be sampling have goats rue and alfalfa as ingredients. I plan to continue the doses of goats rue (alcohol-based tincture) and alfalfa which I consumed during pregnancy throughout my postpartum period. I’ll also be drinking loads of water and eating lactogenic foods as often as possible. Most well-known is oatmeal, healthy fats like salmon, avocado, and coconut oil, and maybe an occasional beer, as hops, barley, and malt are all lactogenic. My favorite book in my personal library for lactogenic (and anti-lactogenic) foods is Mother Food by Hilary Jacobson.  

  • Every baby is different!  While I have a history of low supply on the maternal side of the relationship, the baby is the other half of the equation.  Unknown variables like mode of delivery (vaginal or cesarean), feeding impediments like tongue or lip tie or high pallet, gestational age at the time of birth, and illness or infection (like thrush or mastitis) can all impact how breastfeeding gets established.  While I certainly hope and plan for a smooth, uneventful birth experience and no ties or infections, it’s important to mention these as variables to my ability to see results from the product testing. Put another way, if things are off to a rocky start for any unknown variables, it may not be a reflection of the effectiveness of the products and more a consequence of the challenges faced.  

Emily Smith is owner of Doulas of Capitol Hill and co-owner of sister agency, Doulas of Prince George’s County, which provides professional, non-judgemental birth doula, postpartum doula, newborn care, breastfeeding (and bottle-feeding) support throughout the DC, Virginia, and Maryland region.

Emily Smith is owner of Doulas of Capitol Hill and co-owner of sister agency, Doulas of Prince George’s County, which provides professional, non-judgemental birth doula, postpartum doula, newborn care, breastfeeding (and bottle-feeding) support throughout the DC, Virginia, and Maryland region.

Stay plugged into Doulas of Capitol Hill on Facebook and Instagram throughout the month of August to get in on the giveaways and discounts we share.  You can also swing by our Community page and check out our Affiliates. Then, be sure to be back again on the blog at the end of the month to hear the part II of my BFAR story!

Warmly,

Emily



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