Lactation supplements, often known as galactagogues, are substances taken to increase breast milk production. These can include herbal preparations, certain foods, or prescription medications. The timing for starting these supplements depends entirely on the unique circumstances of the feeding parent and infant.
Identifying Actual Low Supply
Before considering any supplement, it is important to confirm that a true low milk supply exists, as many concerns are based on common, normal infant behaviors. Parents often perceive low supply when the baby is fussy, feeding frequently, or when breasts feel softer after initial engorgement subsides. These feelings are often a natural part of milk supply regulation and do not indicate a problem.
Actual low supply is determined by objective measures of the infant’s health, not subjective feelings. Signs of a healthy supply include consistent weight gain, generally 5.5 to 8.5 ounces per week after the first few days, and adequate output of wet and dirty diapers. For a baby a few days old, this means around six or more heavy wet diapers and three or more bowel movements daily.
The most effective way to establish and maintain supply is through frequent and effective milk removal, requiring a proper latch and nursing or pumping sessions at least eight to twelve times in 24 hours. A confirmed diagnosis of true low supply must first rule out factors like a poor latch, ineffective sucking, or infrequent milk removal. Supplements are not a substitute for correcting these mechanical issues.
Timing: Immediate Postpartum Use vs. Reactive Use
For most feeding parents, the recommended approach is to wait until breastfeeding is well-established before introducing a supplement. This typically means waiting past the first two weeks postpartum, allowing time for the milk supply to regulate and for underlying issues, such as a poor latch, to be addressed. Starting a supplement too early can mask a root cause like an ineffective latch, potentially delaying necessary corrective action.
Waiting also ensures that natural hormonal shifts supporting milk production are not interfered with. The body’s initial supply is driven by hormonal changes following the delivery of the placenta, and the long-term supply is regulated by the principle of supply and demand. Galactagogues function best when milk removal is already optimized.
A healthcare provider may recommend starting a galactagogue immediately after birth in certain circumstances. These scenarios include parents with a known medical history that predisposes them to low supply, such as polycystic ovary syndrome (PCOS), thyroid conditions, or a history of prior breast surgery. Immediate use may also be part of a protocol for induced lactation or relactation. The decision to start immediately is made under the supervision of a medical professional who has assessed the individual’s risk factors.
Why Starting Supplements During Pregnancy is Generally Discouraged
Starting lactation supplements during pregnancy is generally not recommended and can pose specific risks. The body does not produce mature breast milk until after the placenta is delivered, which triggers the final stage of milk production. Taking supplements before this event is unlikely to build a supply and may instead cause adverse effects.
Many herbal galactagogues, such as Fenugreek and Blessed Thistle, may contain compounds that act as uterine stimulants. Introducing these substances during pregnancy could potentially lead to premature contractions or even cause a miscarriage. Some of these herbs can also affect blood sugar levels or blood clotting, which may complicate the pregnancy or labor process.
Because herbal supplements are not regulated as medications, there is a lack of standardized safety data regarding their use during gestation. The focus during pregnancy remains on maternal and fetal health, with lactation support beginning only after delivery.
Prioritizing Professional Consultation
Regardless of when a supplement is considered, professional input is necessary before starting any regimen. The first step should be a thorough assessment by an International Board Certified Lactation Consultant (IBCLC). An IBCLC is trained to diagnose the root causes of low supply, which may be related to positioning, suck mechanics, or underlying maternal conditions.
The consultant can then work with the parent’s primary care provider, obstetrician, or pediatrician to develop a care plan. This plan includes recommending the appropriate type of supplement—be it herbal, food-based, or prescription—and the correct dosage. This consultation also ensures that the chosen supplement will not interact negatively with any existing medications or maternal health conditions.
Professional guidance helps ensure that the chosen supplement is safe and effective for both the parent and the infant. They can monitor for side effects, such as gastrointestinal distress or allergic reactions, and track objective measures of milk transfer and infant growth.