What experts think of breastfeeding supplements — and which ones to use if you need them

May 23, 2019
What experts think of breastfeeding supplements — and which ones to use if you need them

For some lucky women, breastfeeding is a walk in the park. For others, it’s an uphill battle. From plugged milk ducts to low milk supply, nursing moms can face any number of issues — and they’ll do almost anything to turn their breastfeeding journey into one that’s smooth sailing. But should lactation supplements come into play for those experiencing breastfeeding hiccups? According to experts, it all depends on which ones and how you go about using them.

“Generally speaking, breastfeeding supplements are fine,” says Leigh Anne O’Connor, an International Board Certified Lactation Consultant and former president of the New York Lactation Consultant Association. “That said, they should always be taken under the guidance of an IBCLC or doctor if there is an issue with milk supply — and they shouldn’t be your first course of action.”

Thinking of using a lactation supplement to help with breastfeeding ailments? Here’s what the experts have to say about some of the most popular breastfeeding supplements.

Focus on early breastfeeding success

First and foremost, it’s important to know that one of the most impactful things you can do for your breast milk supply is to nurse your baby as soon as possible after giving birth.

“The best way to ensure a bountiful milk supply is to focus on the first hour after delivery, the first three to five days, the first week and the first two weeks,” says Dr. Diane Spatz, professor of perinatal nursing and manager of the lactation program at the Children's Hospital of Philadelphia. “It is essential to turn on all the prolactin receptor sites in the breast to optimize milk production. Research shows that if a mom pumps within one hour of birth versus six hours, she’ll have more milk by the end of the first week and triple the milk three weeks out.”

Before you resort to lactation supplements

Even if you didn’t get off to a good breastfeeding start in the hospital, there are still things you can do to increase supply on your own.

“Before I recommend any supplements, I find the root of the problem — if there is one — with the milk supply,” says O’Connor. “Often moms believe they have a low milk supply when they actually have the right amount of milk. If the milk supply is truly low, we work on increasing it by removing milk from the breast either by more frequent nursing, hand expressing and/or pumping. If someone is going to say the ‘supplement’ word to a new mom, then they need to also say the ‘pump’ word. The best way to increase supply is to nurse and/or pump more often.”

Spatz also recommends new moms breastfeed or pump every one to three hours around the clock, particularly between the hours 10 p.m. and 4 a.m. when prolactin levels peak.

“Breastfeeding moms need to have eight or more nursing or pumping sessions per 24-hour period,” Spatz says. “Moms should also hold their infants skin-to-skin as many hours of the day as possible, as that increases prolactin levels and milk production.”

If you’re nursing or pumping at least eight times per day and still don’t have adequate milk for baby, here are a few lactation supplements to consider.

Fenugreek

Experts say: No, the side effects aren’t worth it, and there’s little evidence it helps.

Historically speaking, the fenugreek breastfeeding supplement has been one of the most popular with nursing moms, but it certainly isn’t without its side effects for both mom and baby.

“Anecdotally, fenugreek has been shown to be helpful in building a supply, but it has also been shown to be equally detrimental to the milk supply,” says O’Connor. “It can also cause stomach upset in mom and/or baby. I rarely recommend it anymore.”

Dr. Donnica Moore, an OB-GYN and host of “In the Ladies’ Room with Dr. Donnica” isn’t a big fan of fenugreek either.

“While fenugreek has been designated GRAS (Generally Recognized as Safe) by the Food and Drug Administration, there are numerous side effects, including nausea, headaches, vomiting, increased gas and diarrhea,” she says. “Some women also report increased breast congestion and a maple-like taste to breast milk. And additionally, there’s a concern that fenugreek may affect thyroid hormone levels in women with thyroid problems.”

Fennel

Experts say: Yes, for its nutritional value more than its effect on milk supply.

Another supplement designated GRAS by the FDA is fennel, which comes in various forms including seeds, teas and capsules. (Many general breastfeeding supplements, such as Motherlove More Milk, contain fennel, as well as fenugreek.)

“Reports about fennel increasing breast milk supply are anecdotal and there is no medical consensus on the amount necessary to eat,” says Moore. “That said, we do know that fennel is a nutritious food rich in vitamin C, potassium, manganese, copper, phosphorus, folate and fiber.” All good things for a nursing mom.

Brewer’s yeast

Experts say: Yes, for its nutritional value more than its effect on milk supply.

According to O’Connor, brewer’s yeast, which can be found in capsule or powder form, is “generally a good nutritional supplement” for nursing moms. And not surprisingly, it’s often an ingredient found in lactation cookies (as well as beer!) Beware, though, hungry moms: If you’re looking for a tasty dessert, you’re probably not going to find it in a batch of brewer’s yeast breastfeeding cookies.

“I found a recipe online for lactation cookies when I was nursing my daughter,” says Nicole Billows, of Los Angeles. “I was hoping for a sweet treat that would boost my milk supply, because everything is good with chocolate, right? Wrong! I’m not sure if the cookies helped my supply or not. (They didn’t hurt!) But I do know that the cookies were completely disgusting.”

Cod liver oil

Experts say: Yes, for help with sore breasts or inflammatory issues.

For nursing moms who aren’t necessarily concerned with low supply but instead with sore breasts or even too much milk, cod liver oil, which can be taken via liquid or supplement, can be a good option.

“Cod liver oil is a good anti-inflammatory and good supplement in general,” says O’Connor. “If a breastfeeding mom has inflammatory issues, it can make for an oversupply or general poor feeling, which cod liver oil can help with.”

Lecithin

Experts say: Yes, to help reduce plugged milk ducts, but only after any actual milk duct issues are assessed by a doctor.

Another breastfeeding supplement for moms who aren’t worried about supply is lecithin, which comes in soft gels or powder. Taking lecithin while nursing can help reduce the viscosity of milk, allowing it to flow more easily and reduce the likelihood of plugged milk ducts or even help loosen up ones that already exist.

“While lecithin has helped many moms break up clogged ducts, it is important to address the issues that caused the clogs in the first place,” says O’Connor. “They could be oversupply, too tight bras, sleeping with bras, nursing on a rigid schedule or a baby with a poor latch or weak suck.”

Breastfeeding tea

Experts say: Yes, but mostly just for the self-care benefits that come from sitting, relaxing and sipping tea.

When it comes to breastfeeding teas, there are a number of different types available. Some, like fennel tea, include only one ingredient, but others, like Milkmaid Tea and Mother’s Milk tea, include a number of herbs, such as fenugreek, fennel and blessed thistle. Whether or not a breastfeeding tea is going to help with supply is up for debate (and it certainly depends on the ingredients), but for nursing moms, the mere act of having a cup of tea can be soothing and stress-reducing, which, of course, is good for overall health and well-being.

“There are various teas marketed for breastfeeding and lactation,” O’Connor says. “If nursing moms enjoy tea, then I find them to be fine, and some — though not many — reportedly help with milk supply. I believe the ritual of sitting and drinking tea is valuable in that mom is taking time to treat herself, and self-care is so important to new parents.”

Blessed thistle

Experts say: The jury’s still out, as it’s said to work best alongside fenugreek, which has fallen out of recommendation.

According to the American Pregnancy Association (APA), blessed thistle, which comes in capsule or tea form, can help boost a nursing mother’s milk supply. That said, it reportedly works best when taken in conjunction with fenugreek, which doesn’t agree with everyone. The APA advises taking it three times per day.

Moringa

Experts say: It’s too soon to tell, but one small study shows some benefits to milk supply.

An herb gaining increasing popularity among breastfeeding mothers is moringa, which is usually taken in capsule form. In a small study, moringa was found to increase milk supply in nursing mothers — and for some women, the side effects are almost undetectable.

“I stopped using fenugreek within a week of taking it with my first son, so I knew I didn’t want to try it with my second,” says Ashley Grossman, of Vernon, New Jersey. “I felt bloated all the time, and my baby seemed to be more cranky when I was taking it. After seeing a lactation consultant for my second, she recommended moringa, and I swear I noticed an increase in my supply without the side effects.”

Prenatal and multivitamins

Experts say: Yes, for their nutritional value more than their effect on milk supply.

Is a multivitamin going to boost your breast milk supply? Probably not. But should you take one, or better yet, continue with your prenatal vitamin? Yes.

“For overall health and nutritional benefits (to mom and baby), most physicians recommend that nursing moms continue to take their prenatal vitamins while breastfeeding,” says Moore. “While it hasn’t been shown to have any impact on milk supply, it does affect breast milk nutritional content.”

Water

Experts say: Yes, a resounding yes.

Technically speaking, it’s not a supplement, but one of the things every nursing mother needs is water and lots of it.

“The most important ‘supplement’ to take to increase breast milk production is water,” says Moore. “One of the biggest factors in not producing enough breast milk is not consuming enough fluids. Drinking milk, juices and teas can also help, though it should be noted that most physicians recommend limiting caffeine to two cups per day or less and limiting sugary beverages when nursing and in general.”

Are breastfeeding supplements worth it?

Ultimately, you’re the only person, along with the help of your health care practitioner, who can decide if lactation supplements are right for you. However, according to experts, they probably shouldn’t be your first line of defense against what you presume to be a low milk supply.

“Taking herbs and supplements should never be used without the approval of your physician and a thorough evaluation for the most common causes of low supply, which are often related to the frequency and completeness of breast emptying,” says Dr. Katherine Hoops, a pediatric critical care physician at Johns Hopkins. “In other words, the best way to increase supply is to nurse frequently, and consider pumping if your baby does not completely empty your breasts during a nursing session.”

Tips and stories from parents and caregivers who’ve been there.

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