Updated: Dec 4, 2019
Welcome to the series: Review of Natural Galactagogues on TheLactationNutritionist.com!
Here, we will review the evidence behind some commonly used galactagogues - substances which are often used while breastfeeding because they supposedly increase milk supply.
Why? Because I know you guys want to know whether they actually work or if you're just wasting your money! Most importantly, you want to know if they are safe to use while breastfeeding!
The first substance I will review for you is Fenugreek because I've come across tons and tons of blog posts promoting Fenugreek as a natural way to boost milk supply without even citing a single research paper.
Most of these articles have affiliate links to fenugreek supplements throughout the article. Be wary, because such blog posts may be biased. The writer gets a commission every time the product is purchased through their link so, obviously, they will make it sound as if it was the most amazing product out there - sometimes without considering whether it's actually safe while breastfeeding!
Here, you will have an evidence-based review of Fenugreek which is based on facts - the available research to date, as well as safety aspects. My primary goal as I am writing this is not to sell you a product - it is to equip you with knowledge so you can make the best decisions for you and your baby's health!
Fenugreek - a safe and effective way to boost milk supply?
1. Nutritional Information
Common Name: Fenugreek
Also known as: Bockshornklee, Bird's Foot, Greek Clover
Botanical Name: Trigonella foenum-graecum
Botanical Family: Fabaceae
Active Ingredients: trigonelline, 4-hydroxyisoleucine, sotolon
(per tablespoon Fenugreek Seed, using USDA Nutrient Database)
Protein: 2.55 grams
Fat: 0.71 grams
Carbohydrate 6.48 grams
Fiber 2.7 grams
Iron: 3.72 milligrams (41% of RDA*)
Magnesium: 21 milligrams (7% of RDA*)
Potassium: 85 milligrams (2% of RDA*)
Calcium: 20 milligrams (2% of RDA*)
(*Recommended Daily Intake while Breastfeeding)
The review of Fenugreek's nutritional profile shows us:
Fenugreek is a significant source of Iron. Almost 4 milligrams of iron per tablespoon fenugreek seed - that is pretty amazing for a herb! A 3 ounce beef steak has a little over 2 milligrams, so fenugreek has more iron than beef!
Aside from that, fenugreek has some fiber and a little bit of magnesium, potassium and calcium. That's it, however. It isn't a significant source of vitamins or other minerals, especially since it is usually consumed in only in small amounts, as a supplement or as a spice.
2. Fenugreek has many traditional uses aside from Lactation
Fenugreek is native to India, China ,and North Africa. The seeds were traditionally used to make yellow dyes for coloring wool; and in folk medicine to treat digestive issues, diabetes, cellulitis, tuberculosis and more.
In northern Africa it was consumed in combination with sugar and olive oil to gain weight.
Due to its sweet (maple syrup-like) but somewhat bitter flavor, it was commonly used as a spice in various dishes, such Indian Curries, and to flavor wine.
Proposed Health Benefits
In folk medicine, fenugreek is thought to have antiatherogenic, antidiabetic, antianorexic, antioxidant, anticarcinogenic, antihyperlipidemic, galactogogue and anti-inflammatory activity, although not all of these health benefits have been proven to be true in clinical trials.
Its most thoroughly studied health benefits are those of being able to lower blood sugars, improve glycemic control in diabetics, as well as improve blood lipid levels. It is currently being looked at as a potential new candidate in the treatment of type 2 diabetics, and for those suffering from dyslipidemia (abnormal blood lipids) (1).
Various Fenugreek teas, capsules and powders are on the market with claims such as 'Stimulates and supports lactation' or 'Designed to promote natural milk production'. In fact, many women do report an increase in milk production: In a 2015 study, most of women who used fenugreek felt it increased their milk supply (2).
3. Scientific evidence on the Effect on Breast Milk Supply is inconclusive
Few studies are out there looking at the effect of Fenugreek on breast milk production or infant weight gain.
Study 1 - no effect
A 2013 study on 26 mothers of preterm infants found no effect (4). The researchers gave each breastfeeding mother 3 capsules of fenugreek, 3 times daily or a placebo. Neither the pumped milk volume, nor the serum prolactin levels was statistically significant between the two groups at the end of the study period (21 days later).
Study 2 - increase, but several herbs were tested at once
In another study (5), 66 mothers received a herbal tea (Still Tee) containing fenugreek, among other things, a 'placebo' tea with no active ingredients or no tea at all. The amount of breast milk they were able to express vial an electric pump was assessed on the third day postpartum.
Mothers who drank the Still Tee were able to express more milk and their infants regained their birth weight earlier than those who received the placebo or the control group.
It is important to note, however, this tea did not only contain Fenugreek, but hibiscus, fennel extract and fennel oil, rooibos, verbena, raspberry leaves, goat's rue and Vitamin C as well, so this increase in milk volume was may not be due to the effect of Fenugreek alone.
Study 3 - improved the signs of making enough milk, but did not test milk volume
In a third study from 2015 (6), 78 exclusively breastfeeding mothers were randomly assigned to receive a black tea containing 7.5 grams of fenugreek seed. The control group received the black tea containing no fenugreek seed. After 4 weeks, they found the weight of the infants, their head circumference, the number of wet diapers, the number of stools and (!) the number of breastfeeding times were higher in the group which received the fenugreek tea. They concluded, the fenugreek tea improved the signs of making enough milk.
Study 4 - increase, but not as much as palm dates
A fourth study (7) gave 75 breastfeeding mothers either a herbal tea with fenugreek, palm dates or no galactagogue for two weeks. They found both fenugreek and dates increased the amount of expressed breast milk, but only the newborns in the date group had an increase in weight, while those in the fenugreek or control groups were still below their birth weight on the seventh day postpartum.
All in all, I'm a bit wary on the results of these studies, especially since we do also have some studies which point to possible risks.
4. There may be some risk to taking Fenugreek while Pregnant or Breastfeeding
Hale, in his online publication Medications and Mother's Milk (8), considers Fenugreek at a Level 3, meaning it is moderately safe. The US Food and Drug Administration (FDA) considers Fenugreek (as a spice) to be 'generally recognized as safe' (9) (GRAS), although this does not apply to supplements and limited scientific data exists on the safety for nursing mothers and infants.
There are some side effects which have been reported, such as diarrhea, gassiness in baby, breast milk oversupply and a maple syrup smell emitted from mom's body.
Fenugreek has the potential to lower blood glucose levels. While this is a generally favorable effect in those who struggle with high blood sugars, people on insulin, as well as pregnant or breastfeeding moms may run the risk of blood sugars going too low.
The question is also: If Fenugreek transfers into breast milk, could it potentially lower baby's blood sugars as well? This could be very dangerous, especially for a newborn baby who would run the risk of going into a coma or even suffering brain damage from low blood sugars in the first days of life. Unfortunately, no data exists on the transfer of Fenugreek into breast milk, or its effects on baby's blood sugars so far.
Another safety aspect of Fenugreek is its uterine stimulating effect: Fenugreek has traditionally be used to induce childbirth because it promotes uterine contractions. In their publication, Toxicological properties of Fenugreek (Trigonella foenum graecum), Ouzir and colleagues (10) discussed the potential toxic effects of Fenugreek (if taken in too high of amounts). They report possible teratogenic effects (may cause birth defects), anti-fertility effects in males, as well as anti-fertility, antiimplantation and abortifacient (may cause miscarriage) activity in females related to Fenugreek's saponin compound. It should therefore be avoided during pregnancy, and especially prior to term since it may lead to miscarriages or early delivery.
A 2013 study (11)on mice found Fenugreek may be dangerous and lead to some congenital deformations if taken during pregnancy.
Fenugreek should also be avoided by people who have peanut or chickpeas allergies, or moms who breastfeed babies with such allergies, due to possible cross-reactivity, since Fenugreek is in the same 'family' in regards to these allergies.
Fenugreek is one of the most popular herbs today which many breastfeeding moms consume in an effort to increase their milk supply. Unfortunately, evidence on its effect on milk supply is scarce and inconclusive.
Fenugreek has some significant side effects relevant to us women in our reproductive years, which should not be overlooked.
It can lower blood glucose, which could become dangerous for some pregnant or breastfeeding women with delicate blood glucose control, or those on insulin. So far, it is unknown if Fenugreek tranfers into breast milk, but if it does, it could potentially lower baby's blood sugars as well, which is a significant risk, especially in newborn babies.
Furthermore, due to its uterine stimulating ability, Fenugreek is a potential teratogenic agent, which means it may cause birth defects, lead to infertility, and could potentially prevent implantation, thus making it harder to get pregnant.
After looking at the evidence, potential side effects and toxicology, I would therefore NOT recommend Fenugreek while Breastfeeding, and especially not to those who are pregnant or trying to conceive.
If you are trying to increase your milk supply, I recommend this informational read from La Leche League International which summarizes the best techniques to increase milk supply through correct and adequate lactation and otherwise focus on wholesome and balanced nutrition.
Why do so many women still report an increase in milk milk supply after taking Fenugreek?
I can only speculate on this one. Obviously, the possibility of a placebo effect (I think it helps because I want and expect it to help) is there. But there may be more to it:
Fenugreek has the ability to make our body odors (urine, sweat etc.) sweeter. A common side effect of ingesting a lot of Fenugreek is often a maple-syrup like body odor.
It could simply be that babies nurse longer and seem more content because mom's milk tastes sweeter. Consequently, a more content baby who nurses longer gives mom the impression of making more milk.
Please share if you found this article useful and evidence-based!