What is a Galactagogue? Can Galactagogues Fix Low-Milk Supply?
A galactagogue is a food, drug, or supplement that works to stimulate or increase lactation. In pharmaceutical form, galactagogue medications function by interacting with the dopamine system to increase prolactin. Prolactin is a pituitary hormone which, once activated, stimulates milk secretion.
Galactagogue drugs are often used by individuals who, after consulting with a doctor and lactation consultant, have determined that the breastfeeding problems presented are due to low-milk supply and that the patient requires medication to increase milk supply. This is usually concluded after numerous options have been exhausted, such as lip and tongue tie revisions, various breastfeeding positions, and other potentially beneficial methods that could aid in breastfeeding success.
Other instances in which lactation medications may be used include cases of adoption and LGBTQ families. These individuals may seek out breastfeeding drugs to induce lactation without pregnancy, such as prescription drugs Risperidone and Metoclopramide.
Metaclopramide for Breastfeeding Success
Metoclopramide, also known by its name brand Reglan, is a nausea and GI medication shown to improve lactation in mothers with low-milk supply, as well as stimulate lactation without pregnancy.
It is considered one of the safer galactagogue medications on the market, due to its minimal transference from mother to child.
Although it is considered one of the best galactagogue drugs available, Metoclopramide cannot be taken for more than 12 weeks, due to the lack of long term test results on the drug.
Some of the Metoclopramide side effects include: restlessness, fatigue, nausea, diarrhea, anxiety, and severe depression. Anyone taking Metoclopramide who begins experiencing any of these symptoms should consult with their health care provider immediately.
Additionally, Metoclopramide should not be taken by anyone with a history of seizures, bleeding ulcers, Parkinson’s, high blood pressure, asthma, and liver or kidney failure. Metoclopramide has been noted to cause adverse reactions to people with these specific health concerns.
Domperidone Induced Lactation Aids Those Without Pregnancy
Another GI and nausea drug that is commonly used as a medication to increase milk supply is Domperidone. Also known by its brand name, Motilium, Domperidone is generally considered safe to use as a galactagogue medication. Despite many countries labeling it as a safe drug to use, it is not approved by the United States FDA due to the limited studies conducted on it.
The few studies performed have found that, while Domperidone does pass through the blood brain barrier, it does so to a lesser extent than Metoclopramide, making it an appealing medication choice for some patients. With that said, Domperidone has been found to be less effective than Metoclopramide in raising prolactin levels in individuals who are attempting to induce lactation without pregnancy.
The side effects recorded with Domperidone use include: nausea, dry mouth, abnormal heartbeat, headache, and dizziness. A healthcare professional should be consulted if any of these symptoms are experienced after beginning Domperidone.
Domperidone has been found to cause complications in individuals with a prior history of liver disease, tumors, and stomach bleeding. An alternative medication should be considered if any of these health issues are present or previously experienced.
Risperidone for Lactation Induction
Risperidone, or brand name Risperdal, is an antipsychotic medication that is occasionally prescribed for lactation problems.
The studies performed on infants whose mothers took Risperidone have shown no adverse developmental or physical reactions, despite small traces of the medication excreating into the breast milk. Additionally, this medication has shown some promise in inducing lactation in biological male.
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The side effects for Risperidone are quite vast, making it a lactation medication that should only be prescribed if necessary. Some of the side effects include: tremors, uncontrolled movements, spasms, fatigue, insomnia, sun sensitivity, anxiety, agitation, and headache. It should be avoided by people with heart disease, as it is noted for causing abnormal heart rhythm.
Sulpiride and Breastfeeding
Another galactagogue medication not approved within the United States is Sulpiride, also known by brand names Dolmatil and Sulpor.
It is not a commonly prescribed breastfeeding medication because, while studies have shown it does stimulate prolactin, those studies have also indicated that it does little to actually increase milk supply. Most studies have shown that patients still had to supplement milk while taking Sulpiride.
Sulpiride is not approved by the United States FDA because, while it hasn’t shown to cause any adverse effects in infants, it does pass through breast milk in substantially higher levels than what is generally considered safe.
Some documented side effects with Sulpiride include: fatigue, headaches, and depression. It should be avoided by anyone who is high risk for postpartum depression.
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Chlorpromazine for Lactation Use
Commonly used an an antipsychotic medication, Chlorpromazine, or brand name Thorazine, is rarely prescribed for its galactagogue properties. It has been noted to cause drowsiness and lethargy in infants whose mother were on it, which are both problems that can cause further breastfeeding issues. Additionally, it is a medication that has shown to cause some individuals to experience psychotic symptoms and paranoid reactions.
While it may Chlorpromazine may induce lactation, it should likely not be prescribed for use as a galactagogue except for extreme circumstances. Healthcare providers well versed in lactation should be heavily consulted before beginning a course of Chlorpromazine for breastfeeding.
How to Obtain Breastfeeding Medication
Lactation medications for low supply should only be used after numerous other options have been exhausted. The side effects found in some lactation drugs may cause more complications for some individuals than what would make the increased milk production beneficial.
Always consult with an international board certified lactation consultant (IBCLC) whenever a breastfeeding complication is encountered. An IBCLC is a well-trained medical professional with a specialized education in lactation. They are trained to help solve numerous breastfeeding issues, including low-milk supply and inducing lactation without pregnancy. An IBCLC can also refer patients to a different healthcare professional if the breastfeeding issue requires specialized attention.
As with all medications, a healthcare professional should be consulted before beginning a medication for lactation. The patient should be thoroughly evaluated in order to ensure that a medication is even needed and that the proper one is prescribed.
This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.
Grettas on April 12, 2019:
Thanks for this article. I've been on domperidone for about 10 days now. And started and still am taking 3 10mg pills 3 times a day. I was lucky and my milk went up with in the first 24 hours and has slowly kept going up since. But it can take longer to see a full effect. I started with getting about 6oz a day and now am about 12oz and going up every day. And that's with only pumping three times a day. I get Dom from "GETDOMBF", but If you were lucky enough to get a script for Dom, you should count yourself fortunate and keep going with it!
sandra228 on December 31, 2017:
I had to pump w/ both my kids. I used the Medela both times. The best thing to do to build your milk supply is to try to pump as often as you can - every 2 hrs for 20 mins at first, then when you start to get your milk going (more coming in), you can pump every 3 hrs for 15 mins. Drink "Healthy Nursing Tea" three times daily. It also helps to boost your supply.