Breastfeeding and Fenugreek
Fenugreek seeds in a bowl with green leaves on a wooden plank background

Breastfeeding and Fenugreek

Fenugreek has gained its popularity as an herbal galactagogue. Galactagogues can either come in the form of medications or herbs that are believed to assist in the stimulation, maintenance, or increase of milk production. Can fenugreek help breastfeeding mothers who are struggling with their milk supply?

Fenugreek has for many years been used as a galactagogue for breastfeeding mothers. It can be consumed in either capsule, powder, tincture, or as a tea. There is no solid evidence to validate the use of fenugreek as a means to increase milk supply. Anecdotal reports have claimed fenugreek has increased some breastfeeding mothers milk supply. Side effects of taking fenugreek include maple scent in sweat, gastrointestinal upset, skin irritation, blood sugar imbalance, allergies to peanuts, and asthma. Pregnant women should not take fenugreek.

So What do Experts Suggest with Regards to the Use of Fenugreek and Breastfeeding

According to LactMed, there are limited studies evaluating the effectiveness of fenugreek as a galactagogue. Some existing studies suggest that this herb has a mild galactagogue effect. It is more effective for use within the first few days rather than two weeks after giving birth. 

In some of these studies, fenugreek is used together with other products. For example, in one study, the group of mothers who were given a mixture of fenugreek, ginger, and turmeric herbal supplement showed an increase in milk production by 49 percent, without the adverse effects. Since fenugreek was not studied alone, we cannot compare these results as to when fenugreek was evaluated by itself.

Due to these reasons, fenugreek’s galactagogue effect is believed to be mainly a placebo or psychological in nature. Still, many anecdotal reports testify about its effectiveness in helping mothers who are having problems with their milk supply. This article gives some tips on how to increase supply. Some women claim that fenugreek is effective, while others claim that it had little to no effect on their breast milk. Fenugreek’s mechanism of action is not yet clearly understood. Some of the possible explanations include:

Impact on the sweat glands. 

Fenugreek can induce the body’s sweat production. The human breasts are sometimes considered as “modified sweat glands,” and this is the reason why milk production is also stimulated.

Oestrogenic ability

Some theories suggest that fenugreek may stimulate the production of the female hormone estrogen in the body, influencing breast cell growth, and the enlargement of milk ducts. In one in vitro study, the chloroform extracts of fenugreek seeds showed positive estrogenic activity.

Though a galactagogue, such as fenugreek, may help in some ways, experts still recommend first to consider some other modifiable factors affecting the mother’s milk supply. In most cases, problems with breastfeeding can be handled using non-pharmacological techniques such as breast stimulation and continuous milk removal. Medications and herbal remedies may have potential side effects on mothers and their babies.

People have used fenugreek as a herbal remedy and food additive for centuries. However, there is very little evidence of its effectiveness as a galactagogue. Just like any other supplement, fenugreek may be contraindicated in some mothers, while others may experience side effects or some untoward symptoms if it is not used as recommended. Here, I’ve gathered some of the essential things to know if you’re currently thinking about taking a fenugreek supplement for breastfeeding.

How can I use fenugreek to increase breast milk supply?

Though there is not enough scientific evidence regarding its effectiveness, fenugreek has long been used as an herbal remedy to boost a mother’s milk production. Fenugreek may be prepared in several forms: capsules, powder, seeds, tincture, or tea. Since it is a maple-flavored spice which has traditionally been used in culinary practices, some mothers also mix fenugreek when cooking their curry or soups. Here are some ways to prepare fenugreek:

Tea

Steep one teaspoon of fenugreek seeds into boiling water for at least 15 minutes.

Sprouts

Soak 1 to 2 teaspoons of fenugreek seeds in water overnight. Rinse and place the seeds in a sprouter. Continue rinsing every day till the seeds sprout at around five days.

Fenugreek compress

Steep fenugreek seeds in a cup of water. Allow to cool and mash the seeds. Place the mashed seeds on a clean, warm cloth. This compress can be used to promote let-down or relieve mastitis.

The Academy of Breastfeeding Medicine (ABM) suggests that galactagogues should only be considered as a last resort for problems with milk supply. This includes any other specific problem that can’t be addressed by other non-pharmacological interventions. The stimulation of milk synthesis is determined by the effective and continuous draining of milk from the breasts. Before considering the use of fenugreek, consult a lactation specialist to establish the cause of low milk supply. A lactation specialist can help you determine whether a galactagogue, such as fenugreek, is right for your condition. 

How much fenugreek should I take for milk supply?

Before taking any herbal supplement for breastfeeding, it is important to consult a health care professional first so that proper assessment and dosages can be recommended. There are no standardized recommendations with regards to the use of fenugreek, but here are some reference data that you can use:

  • There have been reports that taking less than 3500 mg (3.5 grams) a day produce no effects. 
  • The German Commission E suggests taking 6 grams a day. 
  • The Academy of Breastfeeding Medicine’s protocol #9 states that the usual dosage is 1-4 capsules, 3 to 4 times a day.
  • Hale & Hartman’s Textbook of Human Lactation suggests the most useful dose is 1.74 to 4.9 grams.
  • I have also read about the strategy of gradually increasing the dosage of fenugreek until you notice a maple scent in your sweat or urine. 

For a quick reference, here is the compilation of the commonly suggested dosages of fenugreek depending on their preparation:

Capsules

  • 580 to 600 mg capsule: 2 to 4 capsules, three times a day (total of 3.5 to 7.3 grams /day)
  • 500 mg capsule: 7 to 14 capsules/ day

Seeds/ Powdered form

  • ½ to 1 teaspoon, three times a day
  • Can be combined with some water or juice

Tincture

  • 1 to 2 ml, three times a day
  • Instructions may vary per packaging

Tea

  • 1 cup, 2 to 3 times a day

How long does it take for fenugreek to increase milk supply?

The effectiveness of fenugreek generally depends on each individual. There are reports that some mothers have noticed an increase in their milk production at around 1 to 3 days. Others have seen no noticeable change for around two weeks. 

Galactagogues will most likely take effect if the mother is experiencing a significantly low milk supply. This is in addition to having received advice on how naturally increase milk production such as proper positioning and effective latch on. Fenugreek should be used in combination with the efficient removal of your breast milk.

What are the side effects of fenugreek?

Fenugreek is listed as a flavoring in the GRAS (Generally Considered As Safe) category of the U.S. Food and Drug Administration (source). Just like any other supplement, fenugreek may cause some side effects. Among the most common side effects include:

Maple scent in the sweat, urine, feces, and possibly breast milk

Maple scent is probably the most common side effect of fenugreek. Fenugreek contains sotolone which is responsible for its maple-like scent.

Gastrointestinal upset 

Occasional loose bowel movements occur in some mothers but disappear when they discontinue taking fenugreek supplements. Using more than 100 grams of fenugreek seeds each day is linked to stomach distress and nausea. Vomiting and flatulence may also occur.

Skin irritation

Repeated use of fenugreek externally may cause skin reactions. One mother reportedly developed toxic epidermal necrosis which is believed to be caused by taking fenugreek for her milk production. Care should be taken if applied externally on the skin.

False diagnosis of maple syrup urine disease

Ingestion of tea or seeds among infants and pregnant women may lead to this false diagnosis due to the presence of sotolone in their urine.

Fenugreek may also be contraindicated to some individuals as it could cause side effects that may aggravate their current medical condition. It is advised to avoid or be extra cautious in taking fenugreek if you have:

Blood sugar problems

Breastfeeding mothers who have diabetes or hypoglycemia (low blood sugar) should make sure their blood sugars are well controlled and regularly monitored while using fenugreek. This herb is known to decrease blood glucose levels if taken in dosages higher than what is recommended for lactation. Fenugreek may enhance the effects of insulin and other medications used to treat diabetes. 

Allergies to peanut and chickpea

Fenugreek belongs to the legume family and may trigger an allergic reaction to breastfeeding mothers who are sensitive to peanuts and chickpeas. This article discusses what you can do if you have had an allergic reaction while breastfeeding. Specifically, this article gives the most updated advise regarding what to do if you are concerned about getting an allergy to peanuts while breastfeeding.

Asthma

There are some reported cases where the inhalation of fenugreek powder had worsened asthma symptoms.

Pregnant women

Pregnant women are not advised to take fenugreek as medicinal doses are linked to uterine contractions that may lead to premature labor. In fact, fenugreek has traditionally been used to help induce labor.

Taking anti-coagulants

Fenugreek may have some interaction with anticoagulant medications like Warfarin and Heparin and may cause bleeding problems.

Liver problems

There are some reported cases of hepatomegaly or liver enlargement in people taking fenugreek alone and in combination with other herbs.

Can Fenugreek Make a Breastfed Baby Gassy?

Several studies show that the use of fenugreek produces no significant adverse effects in breastfed babies. However, since fenugreek can cause some gastrointestinal side effects to the mother, your baby may experience some mild symptoms as well. Some mothers who use fenugreek claim their baby was fussy with symptoms of green, watery stools. They claimed these symptoms disappeared when they discontinued using the herb. According to some experts, these symptoms may also indicate that the mother has an oversupply. Gas, green watery stools and fussiness are common symptoms of a baby who is getting too much foremilk. 

 If your baby becomes extra gassy while you are taking fenugreek, here are some things you can do:

  • Gradually adjust your dosage to a level that is tolerable enough for your baby.
  • Extend your time of nursing to 2 to 3 hours so that your baby can get enough hindmilk as well.
  • Seek an alternative herbal galactagogue or discontinue usage if you now have enough milk for your baby.
  • If symptoms get too much distressing, your baby may be sensitive or allergic to fenugreek. It is better to discontinue fenugreek and seek a consultation from a health care provider right away.

Does fenugreek cause weight gain?

On the contrary, fenugreek can decrease a breastfeeding mother’s appetite, which is one factor that may lead to weight loss. In one study, overweight Korean women were given fennel, fenugreek, and a placebo tea. Those who had fenugreek tea reported to feel less hungry, feel fuller, and less likely to consume more food. One probable reason is its high fiber content. Fiber is known to increase bulk in your diet, giving you a sense of satiety without consuming too much.

Does fenugreek make your breasts bigger?

As mentioned earlier, fenugreek has some estrogenic effects on the body. At present, there have been no studies focused on its breast enlargement effects. Fenugreek is known for having the hormone precursors called phytoestrogens, which can stimulate the production of estrogen in a woman’s body. Estrogen may dilate a woman’s milk ducts and promote breast cell growth. Due to this reason, a lot of women use fenugreek supplements as an alternative way to augment their breast size.

Overall, fenugreek’s popularity as a lactogenic herb is based on the subjective responses of the people who had experienced using it for their milk supply concerns. More scientific research is required to prove that fenugreek is an effective galactagogue. Fenugreek is generally considered safe for breastfeeding mothers and their babies. In rare circumstances, some breastfeeding mothers may either be sensitive to the herb or have a medical condition that is not compatible with fenugreek. Always consult a professional before taking any herbal supplement and to find alternative ways to boost your milk supply.

References:

https://www.ncbi.nlm.nih.gov/books/NBK501779/

https://www.ncbi.nlm.nih.gov/pubmed/20571172

https://www.liebertpub.com/doi/pdf/10.1089/bfm.2011.9998

https://www.liebertpub.com/doi/full/10.1089/bfm.2018.0159

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4586661/

https://www.breastfeeding.asn.au/bfinfo/galactagogues-substances-claimed-increase-supply

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525133/

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