Herbs for Stimulating Lactation, and Stopping It When It’s Time for Weaning from Breastfeeding

When nursing mothers can't produce enough breast milk to feed their baby, their doctors can't do a lot to help. A drug that works reliably, domperidone (which is not to be confused with Dom Pérignon champagne), is illegal in the US, strictly regulated in Australia and Canada, and available over the counter in much of the rest of the world. Domperidone is more often used to treat vomiting, and it has relatively few side effects in adults. In infants, it can in rare instances cause neuroleptic malignant syndrome, a potentially fatal problem causing fever, stiffness, and nervous system dysregulation. A drug that can kill your baby is not a good choice to help you feed your baby.

It's safe for women who are pregnant or breasfeeding. It has a relatively good success rate for treating morning sickness, and a condition of "slow stomach" called gastroparesis. It can be used to treat migraines. But five out of six clinical trials of its use as a galactogogue, a stimulant to lactation, failed.

Milk thistle is an herb nowadays more often associated with diabetes and liver health, but its original use was for increasing breast milk production. Clinical trials have found that it can be very helpful for women whose problem is "borderline" milk production. In a group of women who were able to produce a minimal amount of breast milk each day, using the herb for a month increased breast milk production on average 64 percent, and using the herb for two months increased breast milk production on average 85 percent. In women who already have some breast milk production, milk thistle can help them produce adequate amounts for their baby.

An effective dose of milk thistle is standardized to 420 mg (usually three capsules) silymarin per day. Women who have a problem with diarrhea may have worse diarrhea for a few days when they start using the herb. Paradoxically, the herb can cause constipation in women who have had their gallbladders removed.

Malunggay leaf is a popular remedy for inadequate milk production in the Philippines, although the plant from which the leaf is harvested, the moringa or drumstick tree, is used in herbal medicine all over the world. The leaf relieves pain from a variety of conditions, including mastitis. Sometimes the problem is not so much that a woman can't produce enough breast milk as it is that breastfeeding is painful. Relieving inflammation helps. Malunggay leaf is mildly antiviral.

Exactly how malunggay stimulates lactation is not know, but two clinical trials in the Philippines found that it more than doubled milk production in 10 days of use. It is a safe herb, and in the Philippines, it literally grows on trees. It is also a good source of vitamins A, B, C, and K, as well as magnesium, manganese, and potassium.

Three More Herbs for Lactation That Work

Milk thistle and malunggay are not the herbs most commonly used to stimulate lactation. These three herbs are fenugreek, shatavari, and fennel. There are some other herbs that will be mentioned later.

• Fenugreek is most often taken as a tea. The milk ducts of the breast are modified sweat glands. There is something about hot fenugreek tea that makes them "sweat" milk. Tea is made with seed powder, not whole seeds. It's best to use water that is piping hot, but not boiling, to make the tea, so that essential oils are not evaporated from the tea. Brew in a closed container such as a teapot. Clinical trials find that it is the tea, not powdered fenugreek in capsules, that makes a difference in milk production. Fenugreek can impart a maple syrup odor to the baby's sweat and urine. There has been a case in which an infant was diagnosed with maple syrup disease (a metabolic condition) when the unusual odor was actually due to the fenugreek the mother was taking.
• Shatavari is the root of Asparagus racemosus, which has many uses in several traditions of Asian herbal medicine. The thing to remember about shatavari is that it adds to the effects of other galactogogues. It does not stimulate milk production when it is used by itself. Drinking a shatavari tea the same day you drink fenugreek tea is helpful, but just drinking shatavari tea or taking shatavari capsules is not.
• The culinary herb and vegetable fennel both increases milk production and settles digestion. It is best used when both issues are problems. Fennel, chamomile, and lemon balm also help soothe tummy troubles in colicky infants. It doesn't make any substantial difference whether the mother consumes them as a hot tea or the infant is given tiny sips of them as warm tea. Either way, the herbs relieve colic, and make it easier for the baby to feed.

There are of course many herbs that increase breast milk production, but not with their limitations:

• Hops and beer are used to increase breast milk production in Central Europe. There is even a German expression about "beer babies" who are well fed. Not just any beer, however, stimulates breast milk production. It's only the darker beers that have enough hops in them to make a difference. The hops will also make baby sleepy, but getting enough hops into the breast milk to make the infant more ready to take naps also requires that the mother get a little tipsy from drinking, which is not always a good thing for the caretaker of a child. Also, babies who get too relaxed can't generate enough suction to get adequate milk from the nipple.
• Goat's rue (Galega officinalis) is a traditional galactogogue. It works best, however, when silymarin (milk thistle) is also taken. Combinations of goat's rue and licorice can cause disturbances in potassium in both mother and infant. Don't take any herbal formula containing and amount of licorice for more than two weeks at a time unless you are under a doctor's supervision.
• Vitex is used to stop lactation when it's time to stop breastfeeding, but it can actually increase milk production. It can also restart the menstrual cycle in women who are still breastfeeding. Stinging nettle and blessed thistle also regulate milk production in two ways, increasing deficient milk production and stopping galactorrhea, leakage of breast milk.