What evidence is there around the effectiveness of consuming galactagogues for milk supply? Which, if any, are more effective? How much would one have to consume to really see a difference?—Nursing Parent
“Galactagogues” are drugs or supplements to improve breast milk supply. Before I get into it, I want to say that I hope you — and all the other people who asked a form of this question — can feel comfortable supplementing with formula. Frantically consuming fenugreek and lactation cookies and all the rest isn’t necessarily a recipe for happy parenting. There should be no shame, judgment, or discomfort with the use of formula. (I’ve written about this a lot, but here is a link to the first excerpt from Cribsheet if you need a refresh.)
I know that wasn’t your question!
In terms of what increases milk supply, there is little or no evidence for any of the foods or herbs you commonly hear about. Studies are small or biased, and show mixed results. Certainly there is no magical finding that if you eat the right kind of oatmeal or something, you’ll be producing twice as much milk. If you want to eat a cookie, do so, but pick one because it is tasty, not because of lactation.
There is a bit of evidence for drugs — notably, domperidone and metoclopramide — that increase supply. But the effects aren’t consistent or sizable. And both drugs have side effects. Overall, these are unlikely to be recommended outside of unusual situations.
The only reliable way to increase milk supply is to nurse more and pump more, which indicates to your body that it should ramp up production. But again, please be careful with yourself here. Formula supplementation is not the enemy.