Fenugreek and Nursing Mothers

Effect on milk production:

Fenugreek (Trigonella foenum-graecum L.) appears to be the most effective herb that is used to increase milk supply. It has been reported to be an excellent galactagogue for some mothers, and has been used as such for centuries. Non-pharmaceutical methods of increasing milk supply should be tried before taking prescription medications, as there can be significant side effects from prescription medications used to increase milk supply. See the Academy of Breastfeeding Medicine’s protocol #9 on the use of galactogogues.

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Mothers generally notice an increase in production 24-72 hours after starting the herb, but it can take two weeks for others to see a change. Some mothers do not see a change in milk production when taking fenugreek. Dosages of less than 3500 mg per DAY have been reported to produce no effect in many women. One way reported to determine if you’re taking the correct dosage is to slowly increase the amount of fenugreek until your sweat and urine begin to smell like maple syrup. If you’re having problems with any side effects, discontinue use and consider alternative methods of increasing milk supply.

Fenugreek has been used either short-term to boost milk supply or long-term to augment supply and/or pumping yields. There are no studies indicating problems with long-term usage. Adequate production is usually maintained as long as sufficient breast stimulation and emptying continues.

Safety:

Fenugreek is used to flavor artificial maple syrup, and is used as a common food ingredient (curries, chutneys, etc.) and traditional medicine in many parts of the world, including India, Greece, China, north Africa and the Middle East. It is a basic ingredient of curry powder (often used in Indian cooking) and the Five Spice mixtures (Asian blend). It is also eaten as a salad and sprouted. Fenugreek is considered safe for nursing moms when used in moderation and is on the U.S. Food and Drug Administration’s GRAS list (Generally Recognized As Safe). As with most medications and herbs, various side effects have been noted; see the side effects and safety information below.

Possible side effects and cautions:

• Sweat and urine smells like maple syrup; milk and/or breastfed baby may smell like maple syrup.
• Occasionally causes loose stools, which go away when fenugreek is discontinued.
• Use of more than 100 grams of fenugreek seeds daily can cause intestinal distress and nausea (recommended dose is less than 8 grams per day).
• Ingestion of fenugreek seeds or tea in infants or late-term pregnant women can lead to false diagnosis of maple syrup urine disease in the infant due to presence of sotolone in the urine.

Use with caution or avoid if you have a history of:

• Peanut or chickpea allergy: Fenugreek is in the same family with peanuts and chickpeas, and may cause an allergic reaction in moms who are allergic to these things. 
• Diabetes or hypoglycemia: Fenugreek reduces blood glucose levels, and in the few studies using it as a hypoglycemic, also reduces blood cholesterol. Dosages higher than the recommended may result in hypoglycemia in some mothers. If you’re diabetic (IDDM), use fenugreek only if you have good control of your blood glucose levels. While taking this, closely monitor your fasting levels and post-prandial (after meals) levels. Mothers with hypoglycemia should also use fenugreek with caution. 
• Asthma: Fenugreek is often cited as a natural remedy for asthma. However, inhalation of the powder can cause asthma and allergic symptoms. Some mothers have reported that it worsened their asthma symptoms.