Last update March 14, 2024

Fenugreek

Compatible

Safe substance and/or breastfeeding is the best option.

The seeds of this leguminous herb are used. Contains: carbohydrates (galactomannan type mucilages), proteins, saponins, flavonoids, sterols (cholesterol, sitosterol) and sotolone (Fitoterapia.net). Attributed properties: orexigenic, hypolipidemic and hypoglycemic (Gong 2016). European Medicines Agency and German Ministry of Health Commission E indications: oral use for anorexia, topical use for dermatitis. (EMA 2018, Blumenthal 1998)

Widely used as a galactogogue in numerous cultures around the world. (Bazzano 2016, Sim 2013, The Royal Women's.. 2013, Winterfeld 2012, Ayers 2000)

Many papers find no galactogogue effect with fenugreek (Palacios 2023, Simbar 2022, Reeder 2011, Damanik 2006), or only in the first 3 days postpartum (Abdou 2018), or with honey added to the fenugreek. (Simbar 2022)

Studies documenting increased milk production attributable to fenugreek intake are scarce (Bumrungpert 2018, Ghasemi 2015, El Sakka 2014, Turkyılmaz 2011) and with various methodological flaws (mixing of several compounds, lack of blinding...):

  • A randomized, double-blind trial demonstrates that a mixture of fenugreek, ginger and turmeric increases milk production (50% at 2 weeks and 100% at 4 weeks) in exclusively breastfeeding mothers at 1 month postpartum. (Bumrungpert 2018)
  • A meta-analysis of 4 randomized trials (El Sakka 2014, Reeder 2011, Turkyilmaz 2011 and Damanik 2006) shows increased milk production of fenugreek vs. placebo, although less than Coleus amboinicus (torbangun, an oriental soup) and date palm, but there was no difference at 14 days (Khan 2018), but the results could be wrong according to another author. (Grzeskowiak 2021)

More and better studies are needed to provide sufficient evidence to make clinical recommendations for its use as a galactogogue. (Foong 2020, ABM 2018, Bazzano 2016, Mortel 2013, Forinash 2012, Zapantis 2012, AEP LM Committee 2012)

No problems have been observed in infants whose mothers took it (Wagner 2019, Bumrungpert 2018, Turkyılmaz 2011), nor in preterm infants. (Özalkaya 2018, Reeder 2011)

No increased antioxidant capacity could be demonstrated in the milk of women who drank mixed infusions of this and other herbs. (Kavurt 2013)

Given its wide use and lack of toxicity, moderate consumption would be compatible with breastfeeding, but high doses may produce hypoglycemia (Gong 2016, EMA 2011) , nausea, diarrhea, abdominal pain, headache, weight gain, and a characteristic odor of sweat, urine, feces, and breast milk due to sotolone that may force differential diagnosis with maple syrup disease. (McBride 2021, Bazzano 2017, Korman 2001, Sewell 1999)

Do not use as a galactogogue without sanitary control. The best galactogogue is frequent on-demand breastfeeding with correct technique in a mother who retains her self-confidence. (ABM 2018 and 2011, Anderson 2013, Forinash 2012, Mannion 2012)

Alternatives

  • Domperidone (Safe substance and/or breastfeeding is the best option.)
  • Metoclopramide (Safe substance and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Tradenames

Main tradenames from several countries containing Fenugreek in its composition:

References

  1. Fitoterapia.net. Vanaclocha B, Cañigueral S. Fitoterapia.net. 1992 - - Disponible en: https://www.fitoterapia.net. Consulted on Dec. 21, 2023 Abstract
  2. Palacios AM, Cardel MI, Parker E, Dickinson S, Houin VR, Young B, Allison DB. Effectiveness of lactation cookies on human milk production rates: a randomized controlled trial. Am J Clin Nutr. 2023 May;117(5):1035-1042. Abstract Full text (link to original source)
  3. Simbar M, Nazarpour S, Mojab F, Kholosi Badr F, Khorrami M, Jafari Torkamani Z, Alavi-Majd H. A Comparative Study on the Effects of "Honey and Fenugreek" with "Fenugreek" on the Breastfeeding Success: A Randomized Trial. Evid Based Complement Alternat Med. 2022 Jun 23;2022:6048280. Abstract Full text (link to original source)
  4. McBride GM, Stevenson R, Zizzo G, Rumbold AR, Amir LH, Keir AK, Grzeskowiak LE. Use and experiences of galactagogues while breastfeeding among Australian women. PLoS One. 2021 Jul 1;16(7):e0254049. Abstract Full text (link to original source)
  5. Grzeskowiak LE. No evidence that fenugreek is more effective than placebo as a galactagogue. Phytother Res. 2021 Apr;35(4):1686-1687. Abstract
  6. Foong SC, Tan ML, Foong WC, Marasco LA, Ho JJ, Ong JH. Oral galactagogues (natural therapies or drugs) for increasing breast milk production in mothers of non-hospitalised term infants. Cochrane Database Syst Rev. 2020 May 18;5:CD011505. Abstract Full text (link to original source)
  7. Wagner CL, Boan AD, Marzolf A, Finch CW, Morella K, Guille C, Gardner Z, Marriott BP. The Safety of Mother's Milk® Tea: Results of a Randomized Double-Blind, Controlled Study in Fully Breastfeeding Mothers and Their Infants. J Hum Lact. 2019 May;35(2):248-260. Abstract
  8. Özalkaya E, Aslandoğdu Z, Özkoral A, Topcuoğlu S, Karatekin G. Effect of a galactagogue herbal tea on breast milk production and prolactin secretion by mothers of preterm babies. Niger J Clin Pract. 2018 Jan;21(1):38-42. Abstract Full text (link to original source) Full text (in our servers)
  9. EMA. European Medicines Agency Community herbal monograph on Trigonella foenum-graecum L., semen. Committee on Herbal Medicinal Products (HMPC) 2018 Full text (link to original source) Full text (in our servers)
  10. Abdou RM, Fathey M. Evaluation of early postpartum fenugreek supplementation on expressed breast milk volume and prolactin levels variation. Gaz Egypt Paediatr Assoc. 2018;66:57-60. Full text (in our servers)
  11. Bumrungpert A, Somboonpanyakul P, Pavadhgul P, Thaninthranon S. Effects of Fenugreek, Ginger, and Turmeric Supplementation on Human Milk Volume and Nutrient Content in Breastfeeding Mothers: A Randomized Double-Blind Controlled Trial. Breastfeed Med. 2018 Nov 9. Abstract
  12. Khan TM, Wu DB, Dolzhenko AV. Effectiveness of fenugreek as a galactagogue: A network meta-analysis. Phytother Res. 2018 Mar;32(3):402-412. Abstract
  13. ABM: Brodribb W. ABM Clinical Protocol #9: Use of Galactogogues in Initiating or Augmenting Maternal Milk Production, Second Revision 2018. Breastfeed Med. 2018 Jun;13(5):307-314 Abstract Full text (link to original source) Full text (in our servers)
  14. Bazzano AN, Cenac L, Brandt AJ, Barnett J, Thibeau S, Theall KP. Maternal experiences with and sources of information on galactagogues to support lactation: a cross-sectional study. Int J Womens Health. 2017 Feb 27;9:105-113. Abstract Full text (link to original source)
  15. Bazzano AN, Littrell L, Brandt A, Thibeau S, Thriemer K, Theall KP. Health provider experiences with galactagogues to support breastfeeding: a cross-sectional survey. J Multidiscip Healthc. 2016 Abstract
  16. Gong J, Fang K, Dong H, Wang D, Hu M, Lu F. Effect of fenugreek on hyperglycaemia and hyperlipidemia in diabetes and prediabetes: A meta-analysis. J Ethnopharmacol. 2016 Abstract
  17. Bazzano AN, Hofer R, Thibeau S, Gillispie V, Jacobs M, Theall KP. A Review of Herbal and Pharmaceutical Galactagogues for Breast-Feeding. Ochsner J. 2016 Abstract Full text (link to original source) Full text (in our servers)
  18. Ghasemi V, Kheirkhah M, Vahedi M. The Effect of Herbal Tea Containing Fenugreek Seed on the Signs of Breast Milk Sufficiency in Iranian Girl Infants. Iran Red Crescent Med J. 2015 Abstract Full text (link to original source) Full text (in our servers)
  19. Powers CN, Setzer WN. A molecular docking study of phytochemical estrogen mimics from dietary herbal supplements. In Silico Pharmacol. 2015 Mar 22;3:4. Abstract Full text (link to original source) Full text (in our servers)
  20. El Sakka A, Salama M, Salama K. The effect of fenugreek herbal tea and palm dates on breast milk production and infant weight. J Pediatr Sci. 2014;6:e202 Full text (in our servers)
  21. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  22. Sachs HC; Committee On Drugs. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics. 2013 Sep;132(3):e796-809. Abstract Full text (link to original source) Full text (in our servers)
  23. Anderson PO. The galactogogue bandwagon. J Hum Lact. 2013 Abstract
  24. Sim TF, Sherriff J, Hattingh HL, Parsons R, Tee LB. The use of herbal medicines during breastfeeding: a population-based survey in Western Australia. BMC Complement Altern Med. 2013 Abstract Full text (link to original source) Full text (in our servers)
  25. Kavurt S, Bas AY, Aydemir O, Yucel H, Isikoglu S, Demirel N. The effect of galactagogue herbal tea on oxidant and anti-oxidant status of human milk. J Matern Fetal Neonatal Med. 2013 Abstract
  26. Mortel M, Mehta SD. Systematic review of the efficacy of herbal galactogogues. J Hum Lact. 2013 May;29(2):154-62. Abstract
  27. The Royal Women’s Hospital Victoria Australia. Herbal and Traditional Medicines in Breasfeeding. Fact Sheet. 2013 Full text (link to original source) Full text (in our servers)
  28. Posadzki P, Watson LK, Ernst E. Adverse effects of herbal medicines: an overview of systematic reviews. Clin Med (Lond). 2013 Abstract Full text (link to original source)
  29. Winterfeld U, Meyer Y, Panchaud A, Einarson A. Management of deficient lactation in Switzerland and Canada: a survey of midwives' current practices. Breastfeed Med. 2012 Aug;7:317-8. Abstract
  30. Mannion C, Mansell D. Breastfeeding self-efficacy and the use of prescription medication: a pilot study. Obstet Gynecol Int. 2012;2012:562704. Abstract Full text (link to original source) Full text (in our servers)
  31. Forinash AB, Yancey AM, Barnes KN, Myles TD. The use of galactogogues in the breastfeeding mother. Ann Pharmacother. 2012 Oct;46(10):1392-404. Abstract
  32. CLM - Comité de Lactancia Materna de la AEP. Preguntas frecuentes sobre lactancia materna. Folleto. 2012 Full text (link to original source) Full text (in our servers)
  33. Zapantis A, Steinberg JG, Schilit L. Use of herbals as galactagogues. J Pharm Pract. 2012 Abstract
  34. Reeder C, Legrand A, O'Conner-Von S. The effect of fenugreek on milk production and prolactin levels in mothers of premature infants. J Hum Lact. 2011;27(1):74. Abstract.
  35. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011 Sep;40(9):684-90. Review. Abstract Full text (link to original source) Full text (in our servers)
  36. Turkyılmaz C, Onal E, Hirfanoglu IM, Turan O, Koç E, Ergenekon E, Atalay Y. The effect of galactagogue herbal tea on breast milk production and short-term catch-up of birth weight in the first week of life. J Altern Complement Med. 2011 Abstract
  37. ABM. Comité de Protocolos de la Academia Médica de Lactancia Materna. ABM Protocolo Clínico #9: Uso de Galactogogos para Iniciar o aumentar la tasa de secreción de Leche Materna. Breastfeed Med. 2011 Full text (link to original source) Full text (in our servers)
  38. Reeder C, Legrand A, O'Conner-Von S. The effect of fenugreek on milk production and prolactin levels in mothers of premature infants. In: ILCA abstracts, 2010 International Lactation Consultant Association Conference Outstanding Research J Hum Lact. 2011;27:74. Abstract.
  39. Muresan M. Successful relactation--a case history. Breastfeed Med. 2011 Abstract
  40. ABM. Academy Of Breastfeeding Medicine Protocol Committee. ABM Clinical Protocol #9: Use of galactogogues in initiating or augmenting the rate of maternal milk secretion (First Revision January 2011). Breastfeed Med. 2011 Abstract Full text (link to original source) Full text (in our servers)
  41. Zuppa AA, Sindico P, Orchi C, Carducci C, Cardiello V, Romagnoli C. Safety and efficacy of galactogogues: substances that induce, maintain and increase breast milk production. J Pharm Pharm Sci. 2010;13(2):162-74. Abstract Full text (link to original source) Full text (in our servers)
  42. Abdulrazzaq YM, Al Kendi A, Nagelkerke N. Soothing methods used to calm a baby in an Arab country. Acta Paediatr. 2009 Abstract
  43. WHO. World Health Organization. Geneva. WHO monographs on selected medicinal plants. Volume 3. WHO monographs. 2007 Full text (link to original source) Full text (in our servers)
  44. Damanik R, Wahlqvist ML, Wattanapenpaiboon N. Lactagogue effects of Torbangun, a Bataknese traditional cuisine. Asia Pac J Clin Nutr. 2006 Abstract Full text (link to original source) Full text (in our servers)
  45. Bryant CA. Nursing the adopted infant. J Am Board Fam Med. 2006 Abstract Full text (link to original source) Full text (in our servers)
  46. Gabay MP. Galactogogues: medications that induce lactation. J Hum Lact. 2002 Aug;18(3):274-9. Abstract
  47. Korman SH, Cohen E, Preminger A. Pseudo-maple syrup urine disease due to maternal prenatal ingestion of fenugreek. J Paediatr Child Health. 2001 Abstract
  48. Ayers JF. The use of alternative therapies in the support of breastfeeding. J Hum Lact. 2000 Abstract
  49. Sewell AC, Mosandl A, Böhles H. False diagnosis of maple syrup urine disease owing to ingestion of herbal tea. N Engl J Med. 1999 Abstract
  50. Blumenthal M, Busse WR, Goldberg A, Gruenwald J, Hall T, Riggins CW, Rister RS, editors. The American Botanical Council. The Complete German Commission E Monographs. Therapeutic Guide to Herbal Medicines. 1st ed. Integrative Medicine Com; Boston, MA, USA: 1998

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