From the Guidelines
First-time mothers wanting to exclusively breastfeed should focus on a balanced diet that includes foods rich in omega-3 fatty acids, such as seafood, and stay hydrated with at least 2.7 L of water per day, as recommended by the EFSA 2010 1. To support lactation, it is essential to consume a variety of foods, including:
- 7 serves/day of vegetables
- 2 serves/day of fruit
- 2 serves/day of grain/cereal
- 2 serves/day for milk, yoghurt, cheese and/or alternatives
- Lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans, as suggested by the Australian dietary guidelines 2013 1 Additionally, lactating women should consider taking supplements, such as:
- Vitamin D (10 mg/day) to ensure adequate levels, as recommended by the NICE 2014 1
- Iodine (250 mg/day) to support thyroid function and milk production, as suggested by the WHO 2014 1
- Folate (500 mg DFE/day) to compensate for losses through breast milk, as recommended by the EFSA 2014 1
- Omega-3 fatty acids (250 mg of EPA and DHA) to support infant health outcomes, as suggested by the Dietary Guidelines for Americans 2010 1 It is crucial to note that while these supplements and foods may support lactation, frequent and effective nursing or pumping every 2-3 hours remains the most effective strategy for increasing milk production, as milk removal is the primary signal for continued production 1.
From the Research
Evidence-Based Foods and Supplements for Increased Lactation
There are several evidence-based foods and supplements associated with increased lactation for first-time mothers wanting to exclusively breastfeed. These include:
- Galactagogues, which are substances used to enhance breast milk production 2, 3, 4, 5, 6
- Herbal supplements such as fenugreek, milk thistle, and Galega officinalis 3, 4, 5, 6
- Foods and beverages like lactation cookies and brewer's yeast 6
- Pharmaceutical galactagogues like domperidone and metoclopramide 3, 6
Prevalence of Galactagogue Use
Studies have shown that the use of galactagogues is common among breastfeeding mothers. For example:
- A study found that more than half of participants (57.5%) reported using any galactagogues, with 55.4% consuming foods or beverages and 27.7% using herbal supplements 2
- Another study found that 60% of respondents reported using one or more galactagogues, with the most commonly reported galactagogues including lactation cookies, brewer's yeast, fenugreek, and domperidone 6
Safety and Efficacy of Galactagogues
While some studies suggest that galactagogues may be effective in increasing milk production, the evidence is limited and more research is needed to support their safety and efficacy 2, 3, 4, 6. For example:
- A study found that a Galega officinalis-based food supplement was reported to improve milk production and promote psychological benefits, with a high level of safety perceived by participants 5
- Another study found that the perceived effectiveness of galactagogues varied greatly, with domperidone having the highest mean rating of effectiveness, but also a higher rate of reported side effects 6