Galactagogue
A galactagogue, or galactogogue (from Greek: γάλα [γαλακτ-], milk, + ἀγωγός, leading), also known as a lactation inducer or milk booster, is a substance that promotes lactation in humans and other animals.[1][2] It may be synthetic, plant-derived, or endogenous. They may be used to induce lactation and to treat low milk supply.
Pharmaceutical
[edit]Synthetic galactagogues such as domperidone and metoclopramide interact with the dopamine system in such a way to increase the production of prolactin; specifically, by blocking the D2 receptor.[3] There is some evidence to suggest that mothers who are unable to meet their infants' breastfeeding needs may benefit from galactogogues.[4][5] A more recent study questions the effectiveness of commercial lactation cookies finding no significant difference.[6] Galactagogues may be considered when non-pharmacologic interventions are found to be insufficient.[7][8] For example, domperidone may be an option for mothers of preterm babies who at over 14 days from delivery and after full lactation support still have difficulty expressing breast milk in sufficient quantity for their child's needs.[9] Lactation induction may also be possible in certain circumstances for women planning to adopt an infant.[10]
Domperidone (like metoclopramide, a D2 receptor antagonist) is not approved for enhanced lactation in the USA.[11][12] By contrast, Australian guidelines consider domperidone to be the preferred galactagogue when non-pharmacological approaches have proved insufficient.[7] Unlike metoclopramide, domperidone does not cross the blood–brain barrier and does not tend to have adverse effects such as drowsiness or depression.[7]
Other drugs which may increase lactation include:
- Antipsychotics such as risperidone, chlorpromazine and sulpiride, due to their ability to block the D2 receptor[13]
- Certain hormones such as oxytocin, growth hormone (GH), and thyrotropin-releasing hormone (TRH).[13]
Progestogens like progesterone, medroxyprogesterone acetate, and cyproterone acetate have been found to produce lobuloalveolar development of the breasts, which is important for lactation as milk is produced in the mammary lobules.[14][15][16]
Herbal
[edit]Herbals and foods used as galactagogues have little or no scientific evidence of efficacy, and the identity and purity of herbals are concerns because of inadequate testing requirements.[17] The herbals most commonly cited as galactagogues are:[17]
- Shatavari (Asparagus racemosus)[17][18]
- Fenugreek (Trigonella foenumgraecum)[17][18][19]
- Torbangun (Coleus amboinicus), which has been used by the Batak people of Indonesia as a galactogogue for hundreds of years.[17][20]
- Fennel (Foeniculum vulgare)[17][18]
- Milk thistle (Silybum marianum);[17] in 2010 the European Food Safety Authority considered and rejected a claim for silybum as a galactagogue because the evidence was deemed insufficient.[citation needed]
- Chasteberry (Vitex agnus-castus)[17]
- Goat's rue (Galega officinalis)[17][18]
Other herbals that have been claimed to be galactagogues include:
- Blessed thistle[18][21]
- Alfalfa[18][21]
- Anise[21]
- Nettle[21]
- Oatmeal[18][21]
- Vervain[21]
- Red raspberry leaf[18][21]
- Marshmallow (althaea) root[21]
- Moringa[22]
See also
[edit]References
[edit]- ^ Gabay MP (2002). "Galactogogues: Medications that induce lactation". Journal of Human Lactation. 18 (3): 274–279. doi:10.1177/089033440201800311. PMID 12192964. S2CID 29261467.
- ^ Merriam-Webster: galactogogue
- ^ Forinash AB, Yancey AM, Barnes KN, Myles TD (2012). "The use of galactogogues in the breastfeeding mother". Ann Pharmacother. 46 (10): 1392–404. doi:10.1345/aph.1R167. PMID 23012383. S2CID 207264697.
- ^ McInnes RJ, Chambers J (2008). "Infants admitted to neonatal units—interventions to improve breastfeeding outcomes: a systematic review 1990-2007". Matern Child Nutr. 4 (4): 235–63. doi:10.1111/j.1740-8709.2008.00150.x. PMC 6860595. PMID 18811790.
- ^ Osadchy A, Moretti ME, Koren G (2012). "Effect of domperidone on insufficient lactation in puerperal women: a systematic review and meta-analysis of randomized controlled trials". Obstet Gynecol Int. 2012: 642893. doi:10.1155/2012/642893. PMC 3306907. PMID 22461793.
- ^ Palacios AM, Cardel MI, Parker E, Dickinson S, Houin VR, Young B, Allison DB (May 2023). "Effectiveness of lactation cookies on human milk production rates: a randomized controlled trial". The American Journal of Clinical Nutrition. 117 (5): 1035–1042. doi:10.1016/j.ajcnut.2023.03.010. PMID 36921902.
- ^ a b c Amir LH, Pirotta MV, Raval M (2011). "Breastfeeding—evidence based guidelines for the use of medicines". Aust Fam Physician. 40 (9): 684–90. PMID 21894275. Archived from the original on 2018-05-27. Retrieved 2013-08-18.
- ^ Forinash AB, Yancey AM, Barnes KN, Myles TD (October 2012). "The use of galactogogues in the breastfeeding mother". Ann Pharmacother. 46 (10): 1392–404. doi:10.1345/aph.1R167. PMID 23012383. S2CID 207264697.
- ^ Donovan TJ, Buchanan K (2012). "Medications for increasing milk supply in mothers expressing breastmilk for their preterm hospitalised infants". Cochrane Database Syst Rev. 3 (3): CD005544. doi:10.1002/14651858.CD005544.pub2. PMID 22419310.
- ^ Murkoff, Heidi; Murkoff, Sharon (2014). What To Expect: The First Year (3rd ed.). Workman Publishing. pp. 94–95. ISBN 978-0-7611-8150-7.
- ^ Da Silva OP, Knoppert DC (2004). "Domperidone for lactating women". Canadian Medical Association Journal. 171 (7): 725–726. doi:10.1503/cmaj.1041054. PMC 517853. PMID 15451832.
- ^ The Academy Of Breastfeeding Medici (2011). "ABM Clinical Protocol #9: Use of Galactogogues in Initiating or Augmenting the Rate of Maternal Milk Secretion (First Revision January 2011)". Breastfeeding Medicine. 6 (1): 41–49. doi:10.1089/bfm.2011.9998. PMID 21332371.
- ^ a b Zuppa, Antonio; Sindico, Paola; Orchi, Claudia; Carducci, Chiara; Cardiello, Valentina; Romagnoli, Costantino; Catenazzi, Piero (2010). "Safety and Efficacy of Galactogogues: Substances that Induce, Maintain and Increase Breast Milk Production". Journal of Pharmacy & Pharmaceutical Sciences. 13 (2): 162–174. doi:10.18433/j3ds3r. PMID 20816003.
- ^ Conneely OM, Mulac-Jericevic B, Arnett-Mansfield R (2007). "Progesterone signaling in mammary gland development". Ernst Schering Found Symp Proc. Ernst Schering Foundation Symposium Proceedings. 2007 (1): 45–54. doi:10.1007/2789_2008_075. ISBN 978-3-540-73492-5. PMID 18543434.
- ^ Penagos Tabares F, Bedoya Jaramillo JV, Ruiz-Cortés ZT (2014). "Pharmacological overview of galactogogues". Vet Med Int. 2014: 602894. doi:10.1155/2014/602894. PMC 4165197. PMID 25254141.
- ^ Kanhai RC, Hage JJ, van Diest PJ, Bloemena E, Mulder JW (January 2000). "Short-term and long-term histologic effects of castration and estrogen treatment on breast tissue of 14 male-to-female transsexuals in comparison with two chemically castrated men". Am J Surg Pathol. 24 (1): 74–80. doi:10.1097/00000478-200001000-00009. PMID 10632490.
- ^ a b c d e f g h i Mortel M, Mehta SD (May 2013). "Systematic review of the efficacy of herbal galactogogues". J Hum Lact. 29 (2): 154–62. doi:10.1177/0890334413477243. PMID 23468043. S2CID 38727190.
- ^ a b c d e f g h Jack Newman; Edith Kernerman (2009). "Herbs for Increasing Milk Supply". Canadian Breastfeeding Foundation . Fondation canadienne de l'allaitement. Retrieved 2023-12-13.
- ^ Chantry, Caroline J.; Howard, Cynthia R; Montgomery, Anne; Wight, Nancy (2004). "Use of galactogogues in initiating or augmenting maternal milk supply" (PDF). The Academy Of Breastfeeding Medicine. ABM protocols, Protocol#9. Archived from the original (PDF) on 28 June 2007.
- ^ Damanik R, Wahlqvist ML, Wattanapenpaiboon N (2006). "Lactagogue effects of Torbangun, a Bataknese traditional cuisine". Asia Pac J Clin Nutr. 15 (2): 267–74. PMID 16672214.
- ^ a b c d e f g h Nice FJ (19 May 2011). "Common Herbs and Foods Used as Galactogogues". ICAN: Infant, Child, & Adolescent Nutrition. 3 (3): 129–132. doi:10.1177/1941406411406118.
- ^ "Moringa use while Breastfeeding". Drugs.com. May 4, 2023. Retrieved 2023-12-13.