Galactagogue Herbs: A Qualitative Study and Review
After a woman gives birth, the establishment of a mature milk supply is dependent upon the presence of mammary tissue, regular removal of milk from the breast, and a set of maternal hormones, prolactin and oxytocin.1 Prolactin is involved in the initiation and stimulation of lactation in mammals. It is associated with numerous physiological processes in addition to lactation.1 Oxytocin triggers milk secretion, or 'let-down'. These two hormones must be present (and in the case of prolactin, at above- baseline levels) for lactation to become established.1 Neither hormone determines the volume of milk produced in a lactating breast; rather, this is a feedback mechanism dependent upon the amount of milk removed from the breast and the frequency of milk removal.
Though galactagogue herb use has been reviewed on a global scale, the role of herbal galactagogues among Canadian women today is heretofore unstudied in an academic context.5 Identified here are five galactagogue herbs that were in use among a small, purposeful sample of women in Western Canada. The main objectives of this paper are to (a) discuss the potential value of these herbs, including the participant's observations, historical use, safety and efficacy, and (b) provide direction for future clinical research.
METHODOLOGY & SAMPLE
This paper draws upon a data set gathered in 2002, for an interview-based study of women's perspectives on self-care and health care in pregnancy, childbirth and lactation. The data used here consisted of transcripts from interviews with 23 women, all of whom were one to four months postpartum at the time of the interview.
Of the 23 women who participated in this portion of the study, nine lived in the metropolitan Vancouver area, and the remainder lived on Vancouver Island, mostly in the capital city of Victoria. They ranged in age from 19 to 43, and parity ranged from one to four. A range of birthplace, socio-economic backgrounds and racial backgrounds were represented in this group of women. Seventy-eight percent were Canadian-born; others were born in the United States, Germany or Asia. Seventy percent were Caucasian, though a few were Métis, Asian, or had mixed genetic heritage. All the participants had completed high school, and 78% had some post-secondary education; 10 women held undergraduate and/or graduate degrees.
The perception of insufficient milk supply is a relatively common problem for breast-feeding mothers. While it is often explainable by physical problems caused by breast surgery, or milk withdrawal problems such as a poor latch, it is sometimes not so easily explained, and may even be imagined.4 As demonstrated here, women may choose to use galactagogues to enhance their milk supply, whether or not they experience supply problems. From a purposive sample of 23 childbearing women, interviewed in the postpartum period, 14 were using galactagogues, which included herbal remedies, food items, and prescription drugs. Herbal remedies were most widely used; 11 women used five reputed galactagogue herbs.