Whether you’re a breastfeeding newbie or an old pro, there may come a time when you’re not sure whether you’re producing enough to keep your baby fed and happy. Many nursing moms start to wonder whether there’s something they can do to increase their milk supply. Maybe you’re a new mom with a constantly hungry five-week-old. You’ve heard that your baby is supposed to nurse all the time to stimulate milk production, but what if your baby isn’t getting enough? It’s really hard to tell. Or maybe you’re a pumping-at-work mom, trying to maintain your supply because you can’t nurse on demand 24 hours a day. Could drinking a few cups of lactation tea with fenugreek and blessed thistle at your desk keep your milk from drying up?
If you’re turning to the internet for answers to these questions, you’ve probably found no shortage of web sites, blog posts, and social media ads singing the praises of “natural” remedies like fenugreek and blessed thistle to increase your milk supply. When you’re desperate to breastfeed your baby, you’ll try pretty much anything. But do supplements to increase milk supply actually work? And more importantly, are they safe? Here’s what you need to know.
What is fenugreek?
Fenugreek is an herb that might have a hormonal effect on the body, leading to higher milk production. Both fenugreek and blessed thistle are anecdotally said to be galactagogues, which are any substances that increase milk supply. (You might have heard this about oatmeal and dark beer, too. There are also prescription medications, like domperidone, that are also used to increase milk supply.)
Fenugreek is typically sold in capsule or powder form, though sometimes its seeds and leaves are used in cooking (it’s in the spice blend garam marsala). Its extract is used to flavor maple syrup, so ingesting fenugreek in higher doses can make you smell like maple syrup, too.
As far as milk production goes, paediatrician Jack Newman, chairman of the Canadian Breastfeeding Foundation, and founder of a well-known breastfeeding support centre, notes that when fenugreek works, it works quickly, increasing your supply within 12-24 hours.
What is blessed thistle?
It’s an herbal plant, just like fenugreek, though typically it’s only used medicinally (and not for cooking). It can be taken as a capsule, or sometimes as a tea or tincture.
Fenugreek and blessed thistle can also be found, along with several other ingredients, in lactation teas such as Mother’s Milk, a blend marketed by Traditional Medicinals, a company that sells “wellness teas” in the US and Canada. But the quantities are lower, so you would have to drink a lot of tea to get the same effect as the concentrated capsules. Women drink anywhere from one to five cups per day, and results are pretty mixed. Some moms swear by it, while others report it doesn’t help at all.
Do herbs like fenugreek and blessed thistle really work?
Is domperidone really a magic breastfeeding pill?The short answer: maybe. Plenty of moms have tried them and found their supply increased; plenty others saw no difference whatsoever. Either way, herbal supplements like blessed thistle and fenugreek are not generally recommended by most healthcare professionals, mainly because there’s no real evidence to prove they’re worth taking.
“There are very few researched, robust studies about the effectiveness and safety of long-term use—and what is out there provides inconsistent and inadequate results,” says Rachel Borton, a licensed Family Nurse Practitioner and assistant professor of nursing at Bradley University in Peoria, Illinois. One of Borton’s main research interests is studying breastfeeding duration for first-time mothers, and interventions that could increase how long mothers continue to nurse their babies.
According to the Drugs and Lactation Database (often referred to as LactMed), there have been a handful of studies about the effects of fenugreek on breastfeeding, but no statistically significant data seems to have been found. In most of the studies, no greater volume of breastmilk was noted after the participants took it. And as Borton notes, even the studies that found an increase were insufficient: the sample sizes were small (the majority had less than 50 participants); best practices around breastfeeding were missing (like receiving lactation support and breastfeeding on demand); and basic standards like randomization, blinding, and placebo control were not performed.
The effectiveness of blessed thistle on milk production has not been studied.
There’s also the issue of the lack of regulation surrounding supplements. Because there are no requirements about how concentrated one dose of fenugreek or blessed thistle can be, you could ingest significantly more or less of the substance than you intend to. Medical providers have no way of determining appropriate dosages in the first place, since these substances haven’t been extensively studied in their relationship to breastfeeding—and recommended dosages can be different for different women, explains Anita Arora, a lactation consultant and founder of Happy Baby, a breastfeeding education and support hub for parents and parents-to-be in the greater Toronto area.
Finally, experts don’t know how much of these substances are absorbed into the bloodstream and end up in breastmilk, either. It’s likely not much, but your baby ingests at least a small percentage of mostly everything that you ingest. Right now, no one knows how much fenugreek or blessed thistle gets passed on to your infant through breastfeeding.
Side effects, allergies and interactions
One of the biggest misconceptions about taking fenugreek or blessed thistle is that since these substances are marketed as “natural” options, they’re totally safe. But just because you find them in a health food store doesn’t mean they’re harmless. While fenugreek does appear in the FDA’s database of foods “generally recognized as safe,” that’s not a foolproof designation: Consumer Reports argues the term is misleading, since it doesn’t mean that the FDA has actually evaluated the ingredients, only that its manufacturer has voluntarily reported it to be safe.
“You really need to let your healthcare provider know if you’re trying any new [herbs and supplements],” says Borton. “They shouldn’t be taken lightly or independently.”
Arora agrees: “A lot of women think ‘Oh, it’s an herb, so it’s no big deal,’ but these herbs can interact with certain conditions, like diabetes and allergies, or even medications, like ones for thyroid function.”
It’s also worth noting that some of these substances can cause unpleasant side effects. Arora says that in addition to fenugreek’s maple syrup smell (which can be so strong it becomes offensive), it can also upset your stomach—a side effect that Hannah Grieco, a mother of three from Arlington, Virginia, experienced firsthand when she took it while breastfeeding her one-month-old.
“I don’t know for a fact that the fenugreek worked, but it seemed to. I was exploding with milk!” she remembers. “But I also had horrific gas that was so painful, and my son, who was also gassy, screamed endlessly.”
After two weeks, Grieco was so distraught that she discontinued the fenugreek. Within 48 hours, both she and her son felt better. She went on to breastfeed without problems after that, suspecting that her difficult labor and subsequent C-section inhibited her milk production in the first several weeks post-birth.
Arora acknowledges there’s no way to know for sure that the fenugreek itself caused the gas issues Grieco’s son experienced. (It could have been that the increase in milk caused an oversupply, making it difficult for the infant to drink without gulping air.) But, she notes, it’s not the first time she’s heard about fenugreek-induced gassiness for both mom and baby.
What is the right dosage of herbs to increase milk supply?
Because these substances haven’t been carefully studied, there’s no consensus on what the right dosage is for actually increasing your supply. Each bottle of fenugreek or blessed thistle will come with its own recommendations for dosing, because the concentration of the substance in each capsule will vary across brands.
According to Dr. Newman’s site, the typical dosage for both fenugreek and blessed thistle is somewhere in the neighborhood of three capsules, three times per day, but it depends on the actual capsules you’ve purchased.
Because of the confusing dosage recommendations, many women end up turning to the internet for advice, or taking more than what’s on the label, even if their doctor or lactation consultant has cautioned against taking a supplement to begin with.
“The social media influence is huge,” says Arora. “Women Google ‘ways to increase milk supply’ and several sites come up telling them what and how much to take, or they go to a mommy group on Facebook saying they have low supply and other moms share what worked for them.”
That’s exactly how Danielle Armstrong,* a mother of two from Chicago, Illinois, went about troubleshooting her low supply issues after her labour and delivery resulted in a C-section, despite her original plan for an at-home water birth. “I consulted with an IBCLC [an International Board certified lactation consultant] in the beginning, but most of the things I tried were based on asking around in mom Facebook groups and researching online,” she says.
Armstrong experimented with nearly everything: taking fenugreek, drinking 100 ounces of water per day, and waking up in the middle of the night to pump. But when nothing increased her supply, she ended up supplementing with a small amount of formula. After that, she was able to continue breastfeeding until her baby was 14 months old.
Armstrong says she put immense pressure on herself to solve her low supply issues on her own, especially because her birth experience, and her first few weeks as a mom, were not at all what she’d envisioned. “Breastfeeding felt like something I was supposed to be able to do. I think I was clinging to the last ‘natural’ part of being a new mom.”
What you need to know about low supply
Before you buy a bottle of fenugreek and start swallowing handful of capsules daily, it’s important to remember that there’s usually an underlying reason or something causing low milk supply, most of which can be resolved with the right breastfeeding support.
“If you think you have low supply, the first thing I would recommend is working with a lactation consultant to make sure supply is truly an issue,” says Arora. “A lot of moms think they don’t have enough milk, but there could be other things going on.”
A lactation consultant can help you figure out whether or not your supply is truly low, and if so, what’s behind it. Latch problems, nipple pain, breast engorgement, or infrequent or restricted breastfeeding sessions are just a few possibilities. If you don’t have access to an LC, many midwives have the know-how to troubleshoot breastfeeding issues, too. (You should also talk to your OBGYN about breastfeeding concerns, but remember that an OBGYN’s specialty is pregnancy, and many don’t have the experience or education to fully support all the issues a breastfeeding mom may encounter.)
Bottom line: if you’re struggling with low supply, that’s a problem best addressed with a professional—not your local vitamin shop employee, or with your mom friends on Instagram. While drinking a cup of lactation tea probably won’t hurt you, it may not do much to really help you in the long run, either.
“A mother’s gut instinct about her supply is usually right, but herbs and supplements are a Band-aid,” says Arora. “They’re not a solution that really gets to the root of the problem.”
* Name has been changed.