Here is my problem with placenta encapsulation and galactagogues in general, I feel like often these things just contribute to the false ideas that many pregnant women have that milk production is going to be unduly difficult or that they need to do all of these special things in order to make enough milk for their babies. They are often excessively worried about the possibility that they will not make enough milk. Unless she has some risk factor such as a history of breast surgery or breast hypoplasia I would never recommend that they use these products prophylactically to increase milk production. I feel like many, many women have this terrible fear that they will be one of the women who just can't physically produce enough milk, which almost never true. I think we should be recommending that they focus on getting breastfeeding off to a good start and teach them how milk production works. How many times have we seen women taking fenugreek right away and then ignoring feeding cues, not feeding frequently enough and over using the pacifier in the hospital? Most of the time, we need to focus on the basics and make sure that they understand that milk is produced by emptying the breast, good latch, good drainage of the breast, supply and demand, etc. There is usually nothing "special"they need to do to make enough milk for the baby. Some other factors that contribute to this problem, I think, are formula commercials that say things like, "breastfeeding is best, but for those women who are unable to breastfeed..." Or hearing from friends or family that they weren't able to make enough milk... Then they worry that they too won't be able to make enough milk. To me, this seems to be really a case of a lack of information about how milk production works. And unknowingly some LC's may be contributing to this lack of knowledge and unfounded fear that these women have by recommending mother's milk teas or encapsulating placentas, etc. Another thing that I tell these women is that they want to make enough milk for one baby. Has anyone else noticed a problem with women beginning excessively pumping right away due to fears about low milk supply and then having a problem with overproduction of milk? I had a call from a mother with a 2 month old with a pumping after every feeding, as she had been doing since birth and she was complaining about oversupply issues. It turned out that she just began pumping frequently not because she was going back to work, but because she "just wanted to be sure she made enough milk." Now she had overly full breasts, a baby that was choking/sputtering during feeds, and a freezer full of milk that she was donating to a milk bank. Not to mention side effects like fenugreek potentially lowering platelet counts. Placenta encapsulation just contributes to the myth that women need to be doing something "special" to make enough milk for their babies.That being said, it is traditional in chinese medicine. However, there are many cultural practices regarding lactation that we are not going to encourage. It is also traditional in this culture that there is a belief that women need to only eat hot foods, not get out of bed for 30 days, can't shower, and be wrapped in warm blankets to make enough milk. Too often cultural practices such as these become a barrier to the mother successfully breastfeeding her baby. 95% of the time this is a very simple process - supply and demand - and mothers tend to overcomplicate the very simple. 
Tricia Shamblin, RN, IBCLC


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