Wednesday, December 11, 2013

Battlestar Galactagogue: On Fenugreek and Other Products for Perfect Production

Pop Quiz: Assuming physiological normalcy for both mother and infant, a healthy milk supply depends on:
a) Making sure mom goes through a batch of lactation cookies at least once a week.
b) Getting the best tincture from a health food store.
c) Drinking 4 cups of breastfeeding tea blends every day.
d) Obtaining a prescription for Domperidone.
e) None of the fracking above.
Following on my recent theme of nursing support in the age of social media, breastfeeding support products are more easily available than ever before. How is this going for us?  Have we, with all our good intentions in making galactagogue products more widely available, contributed to the (apparently growing) perception that mothers can't have a normal milk supply without teas, tinctures, cookies, and pills?

First off, what is a galactagogue?

Defined: Ga·lac·ta·gogue: gəˈlaktəˌgäg/ noun. 1.a food or drug that promotes or increases the flow of a mother's milk.  Common and popular herbal  options include blessed thistle, fennel, and the most famous reindeer of all: Fenugreek.  Drop into any mom's forum, and you'll see that every thread discussing supply will inevitably include recommendations for various galactagogues, in drug (i.e. Reglan or Domperidone), food (oatmeal for all), and herbal forms, fenugreek being by far the most well-known.

A brief stroll down the aisle at New Seasons, a local Whole Foods-like company in the Portland area, revealed these options:

So, here I go with another post in which I preface with a disclaimer and close with a hedging qualification. Let me be clear: There is nothing at all wrong with galactagogue use when needed! I cannot stress this enough. Part of the very reason we have such a diverse array of options for galactagogues in the first place is because women in vastly different cultures in a variety of ecosystems all over the world have sought them out and passed them down through generations.

The world is very different now - so many undeniable improvements, and yet the matter of marketing as a major force in our collective psyches is a critical one. Let's think about this: how does formula marketing actually function? The most effective formula marketing depends on insidiously undermining women's confidence (I discussed this here and then illustrated it here, a la Mad Men). Is the promotion of galactagogues as something lots and lots of women are likely to need really that different, purely psychologically speaking?

It IS different in some crucial ways because it's not artificial infant milk, of course, and ever moreso because it's not as though well-intentioned companies like Motherlove are engaging in underhanded tactics like slipping samples into gift bags of hospitals. And they possess nowhere near the financial oomph that massive corporations like Abbott wield. My point is not their intention, but the effects on us as a community of mothers. What overall effect does the promotion of galactagogues (whether from professionals, peers, or by the company itself) have on attitudes toward breastfeeding? We collectively need to ask ourselves if this is helpful.

Boiling it down, is it helpful for us to have so many mothers believing that A) they cannot produce a normal supply without purchasing and consuming a product or products, even really high-quality ones? Again, taking a peek into any peer support forum is guaranteed to provide multiple examples of galactagogue recommendations flowing as freely as an uninhibited milk ejection reflex. And possibly even more damaging, is it B) helpful for mothers with genuine low supply to be taking them (haphazardly in many instances, i.e. all-fenugreek-all-the-time) without addressing or even identifying the underlying issues?

And as one learns more about herbal galactagogues in particular, you can't help but notice that most herbs function by supporting the health of the mother, working with whatever underlying condition may have caused or contributed to her low supply in the first place (many of the most effective galactagogues work primarily on the digestive system, for example, the very core of maternal health). Low supply doesn't just happen randomly to moms who are unlucky; there is always a reason. But just as with the matter of breastfeeding advice in general, the most critical point is to tailor the plan to each dyad, and to use when NEEDED.

Again I find myself on the horns of a dilemma. I am truly glad and grateful that a variety of galactagogues are so readily available when mothers need them, and often in such good quality and variety. And yet. I want to discuss all of the above, with pros, peers, moms, and companies too, but I also want to convey this bottom line:

Moms, you do not have to take galactagogues Just Because. Not as a preventative measure, not even "just in case."

So say we all.*

P.S. Yes, I am hereby claiming the Battlestar Galactagogue name as my very own, especially if I decide to create my own herbal blends as part of my future practice. I CONTAIN MULTITUDES.

P.P.S. Aside from galactagogues, there are many other 'helpful' products being marketed to breastfeeding mothers which have a very much related effect, as corporations recognize this category of mothers as a largely untapped group and try to figure out how to profit off of them. (This sounds terribly cynical, I realize.) Take the recent Milkscreen products as merely one example.  Since I like to drop in on Babies R Us et al once in a while to keep in touch with the latest products that are widely available - and thus the marketing moms are being exposed to -  I may address these other products in a follow-up post.

*Not actually speaking for all. Just geeking.