It is not true that there is "no evidence." What is true is that the quality of the evidence overall is not strong, for a variety of reasons. Women have used galactagogues for millenia because they have found them helpful. The problem we face is when galactagogues are employed prior to addressing the underlying causes by those who do not understand how milk is made or who are looking for a quick fix. But they do have a role to play and for some mothers, they can make a pivotal difference when the "gold standard" falls short.
There are many things that we do that are not supported by high quality evidence; the question really is more of risks versus benefits. I have had the opportunity to work on a new Cochrane review on galactagogues; the protocol can be found at http://www.cochrane.org/CD011505/PREG_oral-galactagogues-for-increasing-breast-milk-production-in-mothers-of-non-hospitalised-term-infants and the review is currently under editorial review; we hope that it will be finalized soon.
Lisa Marasco, MA, IBCLC, FILCA
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