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A galactagogue, or galactogogue (from Greek: γάλα [γαλακτ-], milk, + ἀγωγός, leading), also known as a lactation inducer or milk booster, is a substance that promotes lactation in humans and other animals. [1] [2] It may be synthetic, plant-derived, or endogenous. They may be used to induce lactation and to treat low milk supply.
A sharp increase in citrate and lactose concentration; [8] [9] Plasma α-lactalbumin levels peak; [8] and; Decreased breast milk sodium concentration. [10] [11] Note that delayed onset of lactogenesis II is distinct from low milk supply, where there is a normal onset of lactation, but breast milk is produced in small and insufficient amounts. [12]
When the milk supply is more firmly established, autocrine (or local) control system begins. During this stage, the more that milk is removed from the breasts, the more the breast will produce milk. [9] [10] Research also suggests that draining the breasts more fully also increases the rate of milk production. [11]
Galactagogues increase milk supply, although even herbal variants carry risks. Non-pharmaceutical methods should be tried first, such as pumping out the mother's breast milk supply often, warming or massaging the breast, as well as starting milk pumping earlier after the child is born if they cannot drink milk at the breast. [41] [42] [43] [44]
A 2018 meta-analysis of five randomized controlled trials found that domperidone resulted in a moderate increase of in breast milk volume for mothers of preterm infants with insufficient milk supply. The analysis also indicated that domperidone was well tolerated with no significant difference in maternal adverse events compared to placebo. [35]
Whereas D 2 receptor agonists suppress prolactin secretion, dopamine D 2 receptor antagonists like domperidone and metoclopramide have the opposite effect, strongly inducing the pituitary secretion of prolactin, and are sometimes used as prolactin releasers, for instance to correct hypoprolactinemia (low prolactin levels) in the treatment of lactation failure. [2]
Prolactin has a wide variety of effects. It stimulates the mammary glands to produce milk (): increased serum concentrations of prolactin during pregnancy cause enlargement of the mammary glands and prepare for milk production, which normally starts when levels of progesterone fall by the end of pregnancy and a suckling stimulus is present.
The anti-inflammatory components in breast milk are those bioactive substances that confer or increase the anti-inflammatory response in a breastfeeding infant. [ 1 ] Anti-inflammatory Components of Breastmilk