>> Prof Hartmann has suggested that before we give galactagogues we
should check serum prolactin levels and if they are normal then giving
galactagogues is useless  ie. their reason for working, when they do, is
by boosting a too-low level of prolactin (serum), so that milk prolactin
may be normal and hence milk production occur.  His point being that to
increase prolactin levels in a woman with normal levels will not
influence her to make more milk. That's my understanding to date<<

Denise, I have a slightly different take on the question. While reglan
and domperidone apparently affect prolactin levels, I'm not sure that we
can assume this about all the other reputed galactogogues, most
especially herbal. Why does goat's rue, for example, have a reputation
for causing breast growth when I don't hear this much about fenugreek,
blessed thistle, nettle, etc? What is different about it? There is so
much that we *don't* know about reputed galactogogues, most especially
their specific actions.

I agree with Prof. Hartmann that to give prolactin-boosting agents to a
lactating mother with normal prolactin levels may not be very effective,
though I think there still may be a "turbo-charging" effect in some.
However, poor milk production may possibly be caused by things such as
prolactin resistance (recently theorized by one author), and anything
that would address that might be effective. Since we don't know all the
actions of reputed galactogogues, I'm not ready to dismiss them in the
face of normal prolactin levels. What I do wish for is research to be
conducted to try to narrow down the specific actions that they may have
on milk production.

~Lisa Marasco MA IBCLC

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