Galactagogue
A galactagogue, or galactogogue (from Template:Langx [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>Template:Cite journal</ref><ref>Merriam-Webster: galactogogue</ref> It may be synthetic, plant-derived, or endogenous. They may be used to induce lactation and to treat low milk supply.
PharmaceuticalEdit
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.<ref name="zuppa-2010">Template:Cite journal</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">Template:Cite journal</ref><ref name="Osadchy-2012">Template:Cite journal</ref> A more recent study questions the effectiveness of commercial lactation cookies finding no significant difference.<ref> Template:Cite journal </ref> Galactagogues may be considered when non-pharmacologic interventions are found to be insufficient.<ref name="Amir-2011"/><ref name="Forinash-2012">Template:Cite journal</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 expressing breast milk in sufficient quantity for their child's needs.<ref name="Cochrane-2012">Template:Cite journal</ref> Lactation induction may also be possible in certain circumstances for women planning to adopt an infant.<ref>Template:Cite book</ref>
Domperidone (like metoclopramide, a D2 receptor antagonist) is not approved for enhanced lactation in the USA.<ref>Template:Cite journal</ref><ref>Template:Cite journal</ref> By contrast, Australian guidelines consider domperidone to be the preferred galactagogue when non-pharmacological approaches have proved insufficient.<ref name="Amir-2011">Template:Cite journal</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>Template:Cite journal</ref>
- Certain hormones such as oxytocin, growth hormone (GH), and thyrotropin-releasing hormone (TRH).<ref name=Zuppa />
Progestogens like progesterone, medroxyprogesterone acetate, and cyproterone acetate have been found to produce lobuloalveolar development of the breasts, which is important for lactation as milk is produced in the mammary lobules.<ref name="pmid18543434">Template:Cite journal</ref><ref name="pmid25254141">Template:Cite journal</ref><ref name="pmid10632490">Template:Cite journal</ref>
HerbalEdit
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">Template:Cite journal</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 foenumgraecum)<ref name="Mortel-2013"/><ref name=Newman/><ref>{{#invoke:citation/CS1|citation
|CitationClass=web }}</ref>
- Torbangun (Coleus amboinicus), which has been used by the Batak people of Indonesia as a galactogogue for hundreds of years.<ref name="Mortel-2013"/><ref name="Damanik-2006">Template:Cite journal</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.Template:Citation needed
- 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:
- Blessed thistle<ref name=Newman>{{#invoke:citation/CS1|citation
|CitationClass=web }}</ref><ref name="Nice-11" />
- Alfalfa<ref name=Newman/><ref name="Nice-11">Template:Cite journal</ref>
- Anise<ref name="Nice-11" />
- 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" />
- Marshmallow (althaea) root<ref name="Nice-11" />
- Moringa<ref>{{#invoke:citation/CS1|citation
|CitationClass=web }}</ref>
See alsoEdit
ReferencesEdit
Template:Galactagogues
Template:Prolactin receptor modulators