I find that sage is the best anti-galactogogue.  I recommend 1/4 teaspoon 
of ground sage 3 times a day until the supply is acceptable. The mother can 
sprinkle it onto the tiny corner of a sandwich that she can swallow without 
chewing and follow it with some juice.  A few of my clients find that sage 
sprinkled on a hummus sandwich tastes fine without disguising it. Others 
have bought empty gelatin capsules to put the sage into.  It has worked in 
some of the toughest cases at newborn or later, including when a mother 
needs/wants to wean.

The cabbage leaf treatment offers relief for engorgement but I have not 
seen it to reduce a milk supply.  It is my opinion, after using it widely 
in my practice, that it draws out edema from tissue but neither milk from 
ducts nor blood from veins in a swollen ankle. Mismanagement of 
engorgement/milk stasis however can surely reduce a milk supply. Many of my 
clients are warned in the hospital to not use cabbage leaves for 
engorgement because it will diminish the milk supply.  This warning is 
given along with "Don't ever wake a sleeping baby" and "A bottle of formula 
will be fine at night so that you can get some sleep" and other such common 
discharge teachings.

As soon as there was question by LCs about cabbage leaf treatment and 
supply the word spread quickly in hospitals in my area.  Too bad other 
breastfeeding management  protocols were not embraced as rapidly.

Patricia Gima, IBCLC

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