2. DEFINITION
Galactogogues are synthetic or plants molecules used to induce , maintain , and
increase milk production , which mediate complex processes involving interaction
between physical and physiological factors.
Among the most important factors are hormones such as prolactin (PRL). However ,
somatotropine , cortisol , insulin , leptin , estrogen , progesterone and
medroxyprogesterone , oxytocin , recombinant bovine somatotropin (rBST) , and
thyrotropin releasing hormone (TRH) also play important role as galactogogues .
4. PLANTS ORIGIN GALACTOGOGUES
Many of plants can play a role in stimulate milk production and synthesis from mother’s breast by
increasing prolactin level including :
• Fenugreek (Trigonella graecum foecum)
• Fennel (Foeniculum vulgare)
• Asparagus (Asparagus racemosus)
• Anise (Pimpinella anisum)
• Goat’s rue (Galega officinalis)
• Milk thistle (Silybum marianum)
5. FENUGREEK (TRIGONELLA GRAECUM FOECUM)
Funugreek cconsidered the most commonly used substances to induce milk production since ages due
to its beneficial effect and safety compared to others.
Funugreek contain two main alkaloids:
1. Trigonelline which act as an NAD+ precursor and promoting energy supply for milk synthesis so
that support mammary cells to produce milk
2. Phytoestrogens which is similer to estrogen female hormone that cause an increase in prolactin
level and result in increased milk supply and volume .
Dose :
1 capsule two to three times daily
6. SYNTHETIC GALACTOGOGUES (DRUGS)
There are some drugs can increase prolactin level and milk production from mother’s breast by different
mechanism of actions such as :
1. Metoclopramide (Plasil(
2. Domperidone (Motilium(
3. Sulpride
4. Chlorpromazine (Largactil)
5. Thyrotrophin-Releasing Hormone (TRH)
6. Growth Hormone
7. Oxytocin (Pitocin(
7. METOCLOPRAMIDE
Metoclopramide is an antiemetic drug can increase milk production by blocking the
dopamine 2 receptors (D2R) in the central nervous system which induces an
increase in PRL synthesis in lactotrophic cells of the anterior pituitary .
Dose : 10
-
15 mg three times daily for 10 days.
The use can be for more than 10days if there was no adverse effect seen such as
anxiety , and several gastrointestinal disorders , insomnia , severe depression ,
seizures and in infants that consume milk from treated mothers cause intestinal
discomfort (
8. DOMPERIDONE
Domperidone is antiemetic and cause increased milk synthesis as a dopamine
antagonist which result in a prolactin increase level .
Dose :
10
-
15 mg three times daily for 10 days or more if there was no adverse effect seen such
as : xerostomia , gastrointestinal disorders , cardiac arrhythmia.
Comparing with Metoclopramide, Domperidone might show more safety in patients
with CNS problem since it can’t cross blood brain barier (BBB) .
9. CHLORPROMAZINE
Largactil is a typical antipsychotic used for Schizophrenia, Psychotic Disorders and
for Nausea & Vomiting .
The similarity with dopamine molecule make Chlorpromazine play a role in
blocking dopamine receptors and increase prolactin level .
Dose 25
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,ygrahteL sexelfer gnithgir eht fo ssol , ytidigir , gnirevihs , sromert : sa deciton
enot retcnihps lana fo ssol dna aehrraid
.
10. SULPRIDE
Sulpride (Dogmatil) is atypical antipsychotic used mainly in the treatment of
schizophrenia and major depressive disorder.
Also have a role in Increasing hypothalamic prolactin releasing hormone so then
increase milk production.
Dose50 mg twice or three times daily.
11. GROWTH HORMONE
Growth hormone stimulates milk synthesis by direct action on the mammary gland
by affecting the supply and utilization of key nutrients (non-esterified fatty acids) by
tissues , resulting in the supply to the mammary gland of additional precursors for
milk synthesis.
Dose : 0.1IU/kg/day for seven to ten days .
12. OXYTOCIN
Oxytocin is a hormone produced from hypothalamus have a role in inducing
woman to start labor if she cannot start naturally (stimulates the uterine muscles to
contract( .
Also oxytocin causes the muscles around the milk-making glands in breast to
contract , and when the glands contract , they squeeze the breast milk into the milk
ducts. The milk ducts also contract to push the breast milk through breast .
Dose : 4
-
10 IU intranasally 4 times daily before 10 minutes of breastfeeding .
13. THYROTROPHIN-RELEASING HORMONE (TRH)
TRH play a role in increasing the release of both Thyroid thyroid stimulating
hormone (TSH) and prolactin levels so that increase milk production .
Dose ( yarps lasan enO :
1 mg) four times daily for ten days
Or 5mg sublingual tab 4 times daily .
14. BREAST MILK
Breast milk is the best source of nutrients for infant to meet his needs for growth
and development .
It contains many valuable ingredients , such as antibodies , living immune cells and
enzymes and helps baby to build up immunity , and reduce the chances of having
diarrhea , chest infection and hospital admissions.
It contains substances which cannot be obtained from infant formula , that help
both the digestion and absorption of nutrients.
15.
16.
17. REFERENCES
1. Hatzopoulos FK, Sagraves R, Hardman JL. Women’s health. In: Koda-Kimble MA,
Young LY, eds. Applied Therapeutics: The Clinical Use of Drugs. V.ancouver:
Lippincott Williams & Wilkins; 2001
.
2. Zuppa AA, Sindico P, Orchi C, et al. Safety and efficacy of galactogogues: substances
that induce, maintain and increase breast milk production. Journal of Pharmacy and
Pharmaceutical Sciences.
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC 4165197
/
4. https://www.verywellfamily.com/oxytocin-and-breastfeeding- 3574977
