We often hear from moms that are worried about their milk supply. Usually their concerns are that their baby seems fussier, is wanting to nurse more often (especially at night), or their breasts no longer leak or feel full.
Many times these moms report that they’ve tried remedies suggested by friends, Facebook pages, and mommy boards. “Lactation cookies”, Gatorade (usually a specific color is considered imperative), drinking gallons of water, Plexus, Advocare……you name it, they’ve been told it, and have tried it.
So what are the real evidence-based galactogogues? And what is, well….hooey?
First of all, it’s important to understand how milk supply is regulated. It’s an entirely supply and demand driven business, meaning that an empty breast will make milk and a full breast will slow production.
Early in lactation, something called prolactin receptors are laid down on the walls of the lactocytes. If the breast is full, these receptors get bent out of shape and prolactin cannot land there…..thereby decreasing your prolactin level. For the entire duration of this lactation. (This is why it’s important to nurse *on demand* instead of by watching a clock!) Another feature of early lactation is that milk contains a substance (a whey protein) that will slow production. If the breast is full, this particular protein’s presence will minimize milk production. If the breast is empty, there is no substance (we call it the “feedback inhibitor of lactation”, or FIL) present, and the milk production ramps up.
The full breast/empty breast is what drives milk production. Emptying your breast can be from direct breastfeeding or from pumping or from a combination of the two.
Knowing this, you can probably guess what the first line treatment is for a lowered milk supply.
Empty your breasts more often!
This can mean waking baby to feed before you go to bed, or even waking baby in the middle of the night for a quick feeding. It can mean pumping after your first morning feeding, or taking a babymoon and just spending the weekend in bed with your baby, doing nothing but nursing and resting.
Many moms are disheartened to learn that they must wake their just-started-sleeping-through-the-night baby to nurse. However, babies sleeping through the night is never conducive to a robust milk supply.
There is no magic pill or herb or drink to boost supply. Taking a galactogogue without increasing the emptying of your breasts is futile.
There are galactogogues in nature that other cultures use in foods and drinks to enhance milk production. Many cultures add fennel, fenugreek, malunggay, flaxseed, brewer’s yeast, and oats to mother’s diet. These are all amazing, healthy additions to any diet — and they do have the added bonus of being a naturally occurring galactogogue. I encourage all new moms to eat oatmeal or granola every day (make your own with oats, flaxseed, wheat germ, slivered almonds, dried fruit, honey, and a bit of olive oil!) You can add brewer’s yeast and flaxseed to a bowl of oatmeal every morning. Very healthy, good for your heart AND your milk!
There is no need to drink water until you’re floating away. Simply drink to thirst. That’s it. Staying hydrated is important, but frankly has nothing to do with your milk supply. Honest. I’m speaking scientifically, as far as the whole how-milk-is-produced science.
There is plenty of anecdotal evidence out there making the rounds. Anecdotal, meaning that it just so happened that when I slept on my right side and ate 1/4 of a cantaloupe with toast I always notice I have more milk. I could tell this information to 59 people, and some will claim that it helped them too. But without measuring breastmilk output and comparing it to a baseline, it’s simply anecdotal.
Let me put to rest the idea that Gatorade increases your milk supply.
Did you read the ingredients? Not one of them is scientifically a galactogogue. Truly. Water, dextrose, sugar, citric acid…..not.a.galactogogue!
While we’re on the topic of drinks, let’s look at Plexus and Advocare. These rumors are incredibly worrisome, considering that the list of ingredients is sketchy and no formal studies have been done on the effects of these ingredients on breastfeeding infants. IBCLCs the world over rely on Tom Hale’s opinion when it comes to the safety of medications and herbs in breastfeeding children. Dr. Hale is a researcher and the author of “Medications and Mother’s Milk”, which he revises every couple of years. On Dr. Hale’s InfantRisk website, Dr. James Abbey addresses Plexus and Advocare:
“ Breastfeeding babies are a metabolically vulnerable population and it just makes sense not to expose them to substances for which the risks are poorly defined. Lactation is a time for simplicity and letting your body do what it does best. We are unable to make recommendations based on marketing materials or product testimonials. It is our well- considered position that breastfeeding women should limit their use of ALL herbs and medications to only those situations where the benefit to the family clearly exceeds the risk to the infant. Think carefully whether or not this is one of those circumstances.”
Now….what about those “lactation cookies”?
Simply put, if the ingredients are oats, flaxseed, and brewer’s yeast, then they will indeed boost your supply a bit. Not dramatically perhaps, but most women who eat a bowl of oats in the morning report they do feel fuller and notice increased pump output. But…..as we all know, there is more to a cookie than oats, flaxseed, and brewer’s yeast. There is also flour, butter, and sugar.And while those are super-tasty, they aren’t kind to your waistline, especially when you would have to eat quite a few to get the punch that you can get from whipping up a simple bowl of oats or mixing up some granola.
Milkmakers is a company that has hit the jackpot on the low milk supply market. Selling 10 cookies for $21.99, the owners of this company are making quite a killing marketing their cookies to busy moms that don’t want to bake. 1 Milkmakers chocolate chip cookie has a whopping 220 calories, and their website recommends 1-2 cookies per day. So to get the full benefit, you would need to spend $131.94/month and ingest 13,200 cookie-calories each month.
For many moms, that’s just way too much money AND calories to consider.
And what about Fenugreek? It seems that every new mother I meet already knows about this ancient herb and many are already taking it by the time they talk to me.
Fenugreek is generally regarded as safe, but should not be used until you’ve been seen by an IBCLC. The reason being, in the case of a “true” low milk supply, we want to address the cause of the low supply. Not every mom needs fenugreek, and it’s troubling to see so many women take it, thinking it’s a quick fix.
Some common causes of low milk supply include:
- tongue tie or other oral restriction
- scheduling feedings
- restricting baby’s time at the breast
- nursing only on one side
- using a pacifier
- hormonal birth control (even the mini-pill and Mirena)
- maternal health (hypothyroid, PCOS, smoking, breast surgeries)
Low milk supply should not be self-diagnosed. Some signs that you may have a low supply are:
- your baby does not seem satisfied or content after nursing
- when nursing, your baby pulls/tugs at the breast in an attempt to get more milk
- baby’s diaper output has diminished, urine is concentrated, stools are scanty and less than the size of a quarter.
- your baby is losing weight or gaining very slowly
- your baby has a worried look on his face (a “furrowed brow”)
If you are experiencing any of these signs, definitely reach out to your local IBCLC.
The bottom line is nurse more to make more. There is simply no magic cure. God made us this way for a reason. To spend our nights alone with our nurslings, watching them feed sleepily with the peace of the angels, to force us to sit down often throughout the day to nurse, to lay down at naptime and bedtime and 196 times in between for nursies.
In the great pie chart of life, this is but a very tiny wedge.
And don’t eat too many cookies.
This article was originally published at: http://www.emeraldcoastlactation.com/blog/cookies-gatorade-and-fenugreekoh-my