Fenugreek

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)}