There is medicines that contribute to increase the available supply of milk, increasing production, but it is important to note that they must be prescribed by a specialist and taken temporarily and at the indicated doses.
They are usually used to induce breastfeeding in cases of adoption and are also useful for moms who have the child hospitalized or suffer a sharp drop in production due to the baby's rejection of breastfeeding. Of course, as I said, we should see a doctor to indicate them and adjust the dose, so it is not appropriate to take them without the advice of the specialist.
It is essential to know that any herbal or medical product that produces a galactogogue effect will not be effective if it is not combined with an effective extraction or suction. If that mechanism, which is the one that produces milk, is not properly established, no product will improve the situation.
Natural galactogogues
Herbs that have traditionally been considered good for breastfeeding are recommended as natural galactogogues: Alfalfa, fennel, nettle, milk thistle, alcarabea, fenugreek, raspberries, dill or coriander are some of them. Its true effect could only be ascertained through serious medical studies and they are not as effective as domperidone.
There are other products that are marketed with promises about increased production or milk quality, some recommended in the consultations. However, they can confuse mothers, whether their breastfeeding is correct or not. If you send them to us because the child is going just in weight or to improve the quality of the milk, we distrust, because breast milk does not improve its quality with any medicine and to increase the intake of breast milk what works is a correct placement, a review of possible suction problems and increase the intake so that production increases.
Promil
The idea that these preparations, like one called Promil, which we can read widely in the SINA Association blog, will avoid supposed deficiencies in milk quality.
However, I have not found clear data or recommendations from official bodies that consider the effectiveness of the Promil and what we know scientifically about the mechanism of breast milk production makes us recommend not to use it until these are considered true by medical authorities and never if there are no real problems. No woman needs preparations to increase her milk production or quality without a very clear reason and once all the factors have been studied.
When is the galactogogue needed?
Only if the mother is really in a special situation that causes a low production what she needs is help to recover the correct suction, maintenance of the production with extraction and, ultimately, a demonstrably effective galactogogue; Domperidone usually. A relacctation or induced breastfeeding may make the use of a galactogogue advisable, but it will always be under strict optional supervision.
Before using any substance to increase milk supply, a thorough evaluation of the current breast milk supply and the effectiveness of milk transfer is required. Only adoptive mothers should take them and, once the possible convenience of the medication has been evaluated, use it.
The cases in which the use of a galactogogue should be evaluated are, in addition to the induced breastfeeding for adoptions, the case of a relationship once it is decided to relate an already weaned child or a medical problem that has meant the separation of mother and baby . The doctor would have the obligation to inform thoroughly the effectiveness of the prescribed galactogogue and also its effects and safety, as indicated by the Spanish Association of Pediatrics.
Several medications act by stimulating milk production, they are called galactogogues. The most used are: Sulpiride, Metoclopramide and Domperidone. Anyone is effective, but they should not be used except when the physiological methods have been exhausted: frequent chestings, with a child well held in a correct posture, ensuring a proper rest of the mother as well as the absence of some diseases of the mother ( like anemia or thyroid disorders), and who drinks what thirst asks. They should also not be used for too long or without medical supervision because they have side effects, although used judiciously there is ample and good experience with any of them. If you think you may need them, you should consult your pediatrician or a doctor and a breastfeeding expert for advice.
Once the contraindications have been explained, the doctor should follow up on the mother and the infant because although in the short term if the effects are known, in the medium and long term there are no studies on their effect on women and children.
Effective galactogogue medications
These medications are used as it has been recognized that increase prolactin. Those known and recognized for their effects are domperidone and metoclopramide, in addition to some hormones, whose use, in principle, is usually ruled out for their contraindications.
The Metoclopramide (Reglan) is used in the United States, where the most complete data on its efficacy and adverse effects come from. In therapeutic doses it does not yield indices that exceed those considered therapeutic for infants nor have there been any adverse effects observed in them. However, in mothers there may be insomnia, headache, confusion, discomfort, depression or feelings of anxiety or agitation.
The Domperidone (Motilium) is used more frequently, because, having the same effect, it does not cross the blood-brain barrier, causing fewer side effects in the mother and, although prolactin increases, it does not reach breast milk as much. It is the only galactagogue evaluated in a randomized controlled trial that has proven to be safe and effective in increasing breast milk production. Obviously, people who are sensitive to their active substance and those who should not take medications that stimulate gastrointestinal function are not advised.
Their results are quickly ascertained in some cases, being necessary in others a use of two or three weeks to perceive an obvious effect.
Thyroid and growth hormones are practically not used and are generally not advised except in very specific cases.
Conclusion
The use of galatogogues, when the baby rejects the breast, should be carried out under strict medical supervision and only when they are indispensable.
