Disclaimer regarding supply: True low milk supply is rare. Perceived low milk supply, however, is one of the leading reasons women cite for giving up breastfeeding.
Genuine low milk supply is often the result of a medical condition: hypoplastic tubular breasts, sometimes in women with polycystic ovarian syndrome, sometimes in women who have had breast surgery, and sometimes in women with thyroid disorders. If you don't fall into one of these categories, it is worth considering whether your milk supply issues might be either perceived, or real but fixable!
In this series on milk supply, I'm going to offer tips for moms whose supply issues are in the "real but fixable" category.
There are a number of herbs historically used to increase milk supply, and anecdotal evidence to back up their efficacy. It is unfortunate that there have been few, if any, clinical studies done to clarify whether these herbal
galactogogues actually work. However, fortunately, most of the herbs said to increase milk supply fall into the category of medications that are "Generally Regarded as Safe" for breastfeeding mothers. That means you can feel confident testing them out on your own personal body and seeing if they have an effect on your own personal milk supply.
The most commonly recommended herb for low milk supply is Fenugreek. Fenugreek can be obtained from health food stores, breastfeeding and baby boutiques, and online. Dosing instructions and number of milligrams per capsule vary from brand to brand, however a universal bit of advice is to start with a lower than recommended dosage and ramp up if and until an increase in milk supply is noticed. Once milk supply has increased and stayed at a higher level for a few days, one can try weaning off of the Fenugreek. In most instances, milk supply will remain at the new, higher volume level. If not, there are no risks associated with long term use of Fenugreek.
A few warnings: Fenugreek is a member of the peanut and pea family and, as such, if you have a history of peanut allergies it is best avoided. Fenugreek can make your (and your baby's) sweat and urine smell like maple syrup. Fenugreek is, in fact, an ingredient in many artificial syrups. There is a rare metabolic disorder called "Maple Syrup Urine Disease" (I could not make this stuff up) and it is important to make sure your Fenugreek use is not mistaken for this disease. Fenugreek also has an effect on blood sugar, so diabetics should avoid its use. As always, check with your baby's pediatrician and with your own doctor or OB before beginning any herbal remedy.
As noted above, there are few if any studies done on the effectiveness of herbal galactogogues. The Academy of Breastfeeding Medicine, however, has published a thorough and helpful protocol for the use of galactogogues, which contains information on and recommendations for the use of Fenugreek.
It is worth noting that any measures to increase milk supply will be most effective if combined with an increase in nursing and/or pumping. Getting the milk out is the key to teaching your body to make more.