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{{Short description|Substance promoting lactation}}
[[File:galegaofficinalis03.jpg|thumb|220px|Goat's rue (''Galega officinalis'') is one plant that is thought to promote lactation]]

A '''galactagogue''', or '''galactogogue''' (from {{langx|el|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.<ref>{{Cite journal | vauthors = Gabay MP | title = Galactogogues: Medications that induce lactation | journal = Journal of Human Lactation | volume = 18 | issue = 3 | pages = 274–279 | year = 2002 | pmid = 12192964 | doi=10.1177/089033440201800311| s2cid = 29261467 }}</ref><ref>[http://www.merriam-webster.com/medical/galactogogue Merriam-Webster: galactogogue]</ref> It may be [[synthetic compound|synthetic]], [[plant]]-derived, or [[endogenous]]. They may be used to induce lactation and to treat [[low milk supply]].

==Pharmaceutical==
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|D2 receptor]].<ref name="zuppa-2010">{{cite journal |vauthors=Forinash AB, Yancey AM, Barnes KN, Myles TD |title=The use of galactogogues in the breastfeeding mother |journal=Ann Pharmacother |volume=46 |issue=10 |pages=1392–404 |year=2012 |pmid=23012383 |doi=10.1345/aph.1R167 |s2cid=207264697 }}</ref>
There is some evidence to suggest that mothers who are unable to meet their infants' breastfeeding needs may benefit from galactogogues.<ref name="McInnes-2008">{{cite journal |vauthors=McInnes RJ, Chambers J |title=Infants admitted to neonatal units—interventions to improve breastfeeding outcomes: a systematic review 1990-2007 |journal=Matern Child Nutr |volume=4 |issue=4 |pages=235–63 |year=2008 |pmid=18811790 |doi=10.1111/j.1740-8709.2008.00150.x |pmc=6860595 }}</ref><ref name="Osadchy-2012">{{cite journal |vauthors=Osadchy A, Moretti ME, Koren G |title=Effect of domperidone on insufficient lactation in puerperal women: a systematic review and meta-analysis of randomized controlled trials |journal=Obstet Gynecol Int |volume=2012 |article-number=642893 |year=2012 |pmid=22461793 |pmc=3306907 |doi=10.1155/2012/642893 |doi-access=free }}</ref>
A more recent study questions the effectiveness of commercial lactation cookies finding no significant difference.<ref>
{{cite journal |vauthors=Palacios AM, Cardel MI, Parker E, Dickinson S, Houin VR, Young B, Allison DB |title=Effectiveness of lactation cookies on human milk production rates: a randomized controlled trial |journal=The American Journal of Clinical Nutrition |volume=117 |issue=5 |pages=1035–1042 |date=May 2023 |pmid= 36921902|doi=10.1016/j.ajcnut.2023.03.010 |pmc= |doi-access=free }}
</ref>
Galactagogues may be considered when non-pharmacologic interventions are found to be insufficient.<ref name="Amir-2011"/><ref name="Forinash-2012">{{cite journal |vauthors=Forinash AB, Yancey AM, Barnes KN, Myles TD |title=The use of galactogogues in the breastfeeding mother |journal=Ann Pharmacother |volume=46 |issue=10 |pages=1392–404 |date=October 2012 |pmid=23012383 |doi=10.1345/aph.1R167 |s2cid=207264697 }}</ref> 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 [[Breastfeeding#Expressed milk|expressing breast milk]] in sufficient quantity for their child's needs.<ref name="Cochrane-2012">{{cite journal |vauthors=Donovan TJ, Buchanan K |title=Medications for increasing milk supply in mothers expressing breastmilk for their preterm hospitalised infants |journal=Cochrane Database Syst Rev |volume=3 |article-number=CD005544 |year=2012 |issue=3 |pmid=22419310 |doi=10.1002/14651858.CD005544.pub2 |url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0040836/|pmc=11747959 }}{{dead link|date=July 2025|bot=medic}}{{cbignore|bot=medic}}</ref> Lactation induction may also be possible in certain circumstances for women planning to adopt an infant.<ref>{{cite book |last1=Murkoff |first1=Heidi |last2=Murkoff |first2=Sharon |title=What To Expect: The First Year |date=2014 |publisher=Workman Publishing |isbn=978-0-7611-8150-7 |pages=94–95 |edition=3rd}}</ref>

Domperidone (like metoclopramide, a D2 receptor antagonist) is not approved for enhanced lactation in the USA.<ref>{{Cite journal | vauthors = Da Silva OP, Knoppert DC | title = Domperidone for lactating women | doi = 10.1503/cmaj.1041054 | journal = Canadian Medical Association Journal | volume = 171 | issue = 7 | pages = 725–726 | year = 2004 | pmid = 15451832 | pmc =517853 }}</ref><ref>{{Cite journal | last1 = The Academy Of Breastfeeding Medici | doi = 10.1089/bfm.2011.9998 | title = ABM Clinical Protocol #9: Use of Galactogogues in Initiating or Augmenting the Rate of Maternal Milk Secretion (First Revision January 2011) | journal = Breastfeeding Medicine | volume = 6 | issue = 1 | pages = 41–49 | year = 2011 | pmid = 21332371}}</ref> By contrast, [[RACGP|Australian guidelines]] consider domperidone to be the preferred galactagogue when non-pharmacological approaches have proved insufficient.<ref name="Amir-2011">{{cite journal |vauthors=Amir LH, Pirotta MV, Raval M |title=Breastfeeding—evidence based guidelines for the use of medicines |journal=Aust Fam Physician |volume=40 |issue=9 |pages=684–90 |year=2011 |pmid=21894275 |url=http://www.racgp.org.au/afp/201109/43841 |access-date=2013-08-18 |archive-date=2018-05-27 |archive-url=https://web.archive.org/web/20180527201749/https://www.racgp.org.au/afp/201109/43841 }}</ref> Unlike metoclopramide, domperidone does not cross the [[blood–brain barrier]] and does not tend to have adverse effects such as drowsiness or depression.<ref name="Amir-2011"/>

Other drugs which may increase lactation include:

* [[Antipsychotics]] such as [[risperidone]], [[chlorpromazine]] and [[sulpiride]], due to their ability to block the D2 receptor<ref name=Zuppa>{{cite journal |last=Zuppa |first=Antonio |first2=Paola |last2=Sindico |first3=Claudia |last3=Orchi |first4=Chiara |last4=Carducci |first5=Valentina |last5=Cardiello |first6=Costantino |last6=Romagnoli |first7=Piero |last7=Catenazzi |title=Safety and Efficacy of Galactogogues: Substances that Induce, Maintain and Increase Breast Milk Production|journal=Journal of Pharmacy & Pharmaceutical Sciences|year=2010|volume=13|issue=2|pages=162–174|url=https://ejournals.library.ualberta.ca/index.php/JPPS/article/view/6663 |doi=10.18433/j3ds3r|pmid=20816003 |doi-access=free}}</ref>
* Certain [[hormone]]s such as [[oxytocin (medication)|oxytocin]], [[growth hormone]] (GH), and [[thyrotropin-releasing hormone]] (TRH).<ref name=Zuppa />

[[Progestogen (medication)|Progestogen]]s like [[progesterone (medication)|progesterone]], [[medroxyprogesterone acetate]], and [[cyproterone acetate]] have been found to produce [[lobuloalveolar development]] of the [[breast]]s, which is important for lactation as milk is produced in the [[mammary lobule]]s.<ref name="pmid18543434">{{cite journal | vauthors = Conneely OM, Mulac-Jericevic B, Arnett-Mansfield R | title = Progesterone signaling in mammary gland development | journal = Ernst Schering Found Symp Proc | series = Ernst Schering Foundation Symposium Proceedings | volume = 2007 | issue = 1 | pages = 45–54 | date = 2007 | pmid = 18543434 | doi = 10.1007/2789_2008_075 | isbn = 978-3-540-73492-5 }}</ref><ref name="pmid25254141">{{cite journal | vauthors = Penagos Tabares F, Bedoya Jaramillo JV, Ruiz-Cortés ZT | title = Pharmacological overview of galactogogues | journal = Vet Med Int | volume = 2014 | issue = | article-number = 602894 | date = 2014 | pmid = 25254141 | pmc = 4165197 | doi = 10.1155/2014/602894 | doi-access = free }}</ref><ref name="pmid10632490">{{cite journal | vauthors = Kanhai RC, Hage JJ, van Diest PJ, Bloemena E, Mulder JW | title = 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 | journal = Am J Surg Pathol | volume = 24 | issue = 1 | pages = 74–80 | date = January 2000 | pmid = 10632490 | doi = 10.1097/00000478-200001000-00009 | doi-access = free }}</ref>

==Herbal==
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.<ref name="Mortel-2013">{{cite journal |vauthors=Mortel M, Mehta SD |title=Systematic review of the efficacy of herbal galactogogues |journal=J Hum Lact |volume=29 |issue=2 |pages=154–62 |date=May 2013 |pmid=23468043 |doi=10.1177/0890334413477243 |s2cid=38727190 |url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0057268/}}{{dead link|date=July 2025|bot=medic}}{{cbignore|bot=medic}}</ref>
The herbals most commonly cited as galactagogues are:<ref name="Mortel-2013"/>

* Shatavari (''[[Asparagus racemosus]]'')<ref name="Mortel-2013"/><ref name=Newman/>
* Fenugreek ([[Trigonella foenum-graecum|''Trigonella foenumgraecum'']])<ref name="Mortel-2013"/><ref name=Newman/><ref>{{Cite web |first1=Caroline J. |last1=Chantry |first2=Cynthia R |last2=Howard |first3=Anne |last3=Montgomery |first4=Nancy |last4=Wight |title=Use of galactogogues in initiating or augmenting maternal milk supply |series=ABM protocols, Protocol#9 |year=2004 |website=The Academy Of Breastfeeding Medicine |url=http://www.bfmed.org/ace-files/protocol/prot9galactogoguesEnglish.pdf |archive-url=https://web.archive.org/web/20070628052457/http://www.bfmed.org/ace-files/protocol/prot9galactogoguesEnglish.pdf |archive-date=28 June 2007 }}</ref>
* Torbangun (''[[Coleus amboinicus]]''), which has been used by the [[Batak (Indonesia)|Batak]] people of [[Indonesia]] as a galactogogue for hundreds of years.<ref name="Mortel-2013"/><ref name="Damanik-2006">{{cite journal |vauthors=Damanik R, Wahlqvist ML, Wattanapenpaiboon N |title=Lactagogue effects of Torbangun, a Bataknese traditional cuisine |journal=Asia Pac J Clin Nutr |volume=15 |issue=2 |pages=267–74 |year=2006 |pmid=16672214 }}</ref>
* Fennel (''[[Foeniculum vulgare]]'')<ref name="Mortel-2013"/><ref name=Newman/>
* Milk thistle (''[[Silybum marianum]]'');<ref name="Mortel-2013"/> 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|date=May 2017}}
* Chasteberry (''[[Vitex agnus-castus]]'')<ref name="Mortel-2013"/>
* Goat's rue (''[[Galega officinalis]]'')<ref name="Mortel-2013"/><ref name=Newman/>

Other herbals that have been claimed to be galactagogues include:

* [[Cnicus|Blessed thistle]]<ref name=Newman>{{Cite web|url=http://canadianbreastfeedingfoundation.org/induced/herbs.shtml|title = Herbs for Increasing Milk Supply |publisher=Canadian Breastfeeding Foundation . Fondation canadienne de l'allaitement |author1=Jack Newman |author2=Edith Kernerman |date=2009 |access-date=2023-12-13}}</ref><ref name="Nice-11" />
* [[Alfalfa]]<ref name=Newman/><ref name="Nice-11">{{cite journal|vauthors=Nice FJ |title=Common Herbs and Foods Used as Galactogogues |journal=[[ICAN: Infant, Child, & Adolescent Nutrition]]|date=19 May 2011|volume=3|issue=3|pages=129–132 |doi=10.1177/1941406411406118}}</ref>
* [[Anise]]<ref name="Nice-11" />
* [[Urtica|Nettle]]<ref name="Nice-11" />
* [[Oatmeal]]<ref name=Newman/><ref name="Nice-11" />
* [[Vervain]]<ref name="Nice-11" />
* [[Red raspberry leaf]]<ref name=Newman/><ref name="Nice-11" />
* [[Althaea (genus)|Marshmallow]] (althaea) root<ref name="Nice-11" />
* [[Moringa (genus)|Moringa]]<ref>{{Cite web |url=https://www.drugs.com/breastfeeding/moringa.html |title=Moringa use while Breastfeeding |date=May 4, 2023 |website=Drugs.com |access-date=2023-12-13}}</ref>

==See also==
* [[Galactorrhea]]
* [[Herbalism]]
* [[Hypothalamic–pituitary–prolactin axis]]

==References==
{{Reflist}}

{{Galactagogues|state=expanded}}
{{Prolactin receptor modulators}}

[[Category:Galactagogues| ]]
[[Category:Biologically based therapies]]
[[Category:Breastfeeding]]
[[Category:Systemic hormonal preparations]]

Galactagogue - Revision history

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