Here is my belief.   The study that was reported on fenugreek was using prolactin levels as a measure of increasing milk volume.  Of course, anecdotal info means nothing, but here is what I and my colleagues have noticed.  The dose has to be taken 4 x a day.  If the mother does not smell like maple syrup, it doesn't work.   In the creamatocrits I've done, I've seen the fat levels increase as the milk volumes increase.  It takes 3-4 weeks for full effect.  It doesn't work unless the mom is also getting the milk out.   Moms should establish efficient milk removal first before adding herbs.  
I would like to know what other pathways besides prolactin affect milk supply.  We have recently been told that serotonin is the feedback inhibitor of lactation.  What role do prostaglandins play?  Anecdotally, have heard mothers say NSAID's can reduce milk supply.  Is this by inhibiting prostaglandins?  WE know prostaglandins play a part in labor initiation, what about lactation?   I think before we go writing off traditional herbs and remedies, we might look at what other role they play in lactation.  

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Janet Business
Sent: Thursday, December 25, 2014 12:28 PM
Subject: Re: Academy of BrFdg Medicine/galactogogues

I lump it with most of Western Medicine not recognizing role of herbs in healing. I'm not advocating for or against galactagogues per se, just a general observation that extends to lactation as well.

Janet Dombro, IBCLC 


> On Dec 25, 2014, at 9:06 AM, [log in to unmask] <[log in to unmask]> wrote:
> 
> Was just reading on the Academy of Breastfeeding Medicine protocol for 
> galactogogue use and it was mostly not favorable for them. It 
> basically said there are no good studies on reglan or fenugreek so do 
> other measures such as improve latch and pumping. I meet many mothers 
> who are doing lots of feedings and lots of pumping ~ lots of work ~ 
> and I often think it is time to make it a little easier and suggest 
> they contact their Dr and request a prescription for reglan, or 
> possibly explore getting domperidone. Other thoughts on this? Susan in 
> Minnesota, USArn ibclc 
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