New Galactotogue Protocol: What this means

Last month, a new protocol was published by the Academy of Breastfeeding Medicine on the suggestion of galactogogues by health care professionals to nursing mothers.  A galactogogue is any medication or substance (i.e. herb) that has been known to have the effect of increasing milk supply.  Some common examples are fenugreek, domperidone, and goat's rue, to name a few.  Many mothers have used some of these as a way to increase their milk supply when everything else they've tried hasn't led to their expected results.

The new protocol does not warn against the use of these substances, but what it does is emphasizes other, primary sources of increasing milk production in an attempt to only use a galactogogue as a last resort.  For those of us working in lactation, this means that we will be focusing on all of the other, proven ways to help you increase your supply before recommending a substance.  Those methods are:

• Increase skin-to-skin contact with baby.  This is one of the most effective ways of increasing your supply for many reasons.  First, it puts you in close proximity to the baby so that you can pick up on early feeding cues.  Second, skin-to-skin increases oxytocin, which is the hormone that causes your milk to let down.  The more milk you are able to remove, the more milk you are able to make.  Third, the increase in oxytocin will help facilitate a calming state between mother and baby, helping you to bond and helping feedings to start out more smoothly.
• Assess the latch.  No medication should ever be a substitute for making sure that you have a good latch.  Not just to increase milk transfer, but to avoid cracked or sore nipples, plugged ducts, or mastitis.
• Making sure that you are as comfortable as possible.  Many mothers I meet with are used to leaning forward off the edge of the couch because it's the only way that they feel that they can get a good view of their baby latching on.  But this will cause you to have a sore back, making feedings less comfortable and possibly more rushed.  Let someone help you find a better position so that you are comfortable sitting or laying for a long period of time, if necessary.  You don't need to jeopardize your comfort to make sure that your baby is latched as long as you find the right position that works best for you.
• Evaluating your labor, birth, and medical history to see if there is anything that could possibly be contributing to a low milk supply.  Before jumping to take more milk plus, check with your OB or a Lactation Consultant to see if there might be something in your medical history worth taking a look at so that we can find a plan that works best for you.

What I love about this new protocol is that it really promotes the idea that nursing mothers, above all else, need lots and lots of support.  If you are experiencing any kind of discomfort, pain, or feelings of low milk supply, first and foremost get help!!  Take care of yourself and your baby and get some good information and support!