Uses and Forms
Fenugreek is most often taken as capsules. The dose usually recommended is 1-2 g three times a day.
It can be taken as a tincture, the dosage being 3-5 dropperfuls three times a day depending on how much of an increase you need.
It can also be drunk as a tea made with the whole seeds. To make the tea, cover 1-3 tsp. of seeds with boiling water and let it steep for 10 minutes. This can be drunk 3 times a day.
There are many teas and food products with combinations of herbs including fenugreek. These products are difficult to compare because there are no studies on them, and it's difficult to know how much you're getting each day. I would caution women on products like fenugreek granola bars and lactation cookies, as they are quite expensive, and you're probably not going to be eating enough fenugreek to have any effect on your milk. There certainly would be a lot of empty calories with that fenugreek if you did!
Studies on Fenugreek- How do we know it works?
There are many, many foods and herbs that have been said to increase milk supply, but what do studies show? There aren't many studies on most "natural" remedies, and those that are done are usually pretty small. Fenugreek probably has more studies than any other herbs, and here's what they show:
A study of mothers of preterm babies showed no difference between those taking fenugreek capsules and those taking a placebo.
BUT another study using fenugreek tea showed it did help some mothers produce more milk in the first week postpartum. This study seemed to imply there were other ingredients in this tea, but I have no information on the dosage other than they drank it daily.
These studies leave me with many questions, such as how effective is fenugreek used later in lactation instead of right after birth? How does fenugreek work? Is it cost effective? What are the long-term effects on the children of these breastfeeding mothers? The fact is, we don't know these answers.
The medical community is pretty unanimous in saying that fenugreek doesn't have evidence as a galactagogue at all.
The Academy of Breastfeeding Medicine put out a thorough paper on increasing milk supply in which it states that fenugreek has, "Insufficient evidence, likely a significant placebo effect." Since many breastfeeding moms are not accurately measuring milk production each day they may feel like they have more milk once starting to take fenugreek since they've been told so often it has worked for others.
The Memorial Sloan Kettering Cancer Center explains several uses for fenugreek, including preventing some cancers, but says that "evidence of its potential to stimulate lactation is limited."
So when someone tells you, as I've seen on online many times, that fenugreek is "very effective" please understand that it's certainly not true for everyone or we'd have more evidence that it works.
It's very important to understand the side effects of every medication you're taking, even if it's a herb you're taking medicinally. While it is considered "Moderately Safe", fenugreek actually has several possible side effects mothers need to be aware of, such as:
- Diarrhea, in mother and baby. This seems to be worse when starting suddenly with large doses.
- Allergic reaction especially in those who are also allergic to peanuts, chickpeas, or soy. Keep in mind you may not know your baby's allergies and that fenugreek exposure may lead to sensitization to other legumes.
- Some women have reported worsening of asthma.
- Can thin your blood.
- Can lower your blood sugar. Diabetics and those with other blood sugar issues or PCOS need to be careful and monitor their levels.
- Can lower effectiveness of other medications. Remember, birth control is a medication, too!
- Interference with thyroid hormone levels.
- Has been shown to stimulate breast cancer growth.
- SHOULD NOT BE TAKEN DURING PREGNANCY. Can cause premature labor and miscarriage.
- One of the most interesting side effects is that when taken in large doses it will make your breath, sweat, and urine smell like maple syrup. That goes for babies, too. Some people say to increase dose until this happens, while others notice an increase at lower dosages.
Also keep in mind that herbs are not tested by the FDA, and there are many instances of herbal supplements being contaminated with other substances or the wrong herb. Are you absolutely sure what you're taking is fenugreek?
There are several known interactions between fenugreek and some medications. Mention taking fenugreek to your and your baby's doctors, especially if you're taking large doses or taking it long-term. We know it can interact with:
- Warfarin and other blood thinning supplements/medications
- Metformin and other blood sugar lowering supplements/medications
Other Ways to Increase Milk Supply
If fenugreek doesn't perform as you hoped or doesn't sound right for you - don't give up! Keep in mind that there are plenty of other ways to increase your milk supply. Often we look for solutions outside ourselves, but a breastfeeding relationship begins with you and your baby. Increasing feedings (especially night feedings), breast massage and compression, pumping schedules, skin-to-skin time, relaxation, and improving baby's latch are all things that should be tried before any galactagogues, since they are risk-free and have lots of evidence that they work to increase amount of milk produced. Please feel free to contact me if you would like more information on these techniques or how to tell if your baby needs more milk.