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The Pre-Menstrual Dip in Milk Supply

The Pre-Menstrual Dip in Milk Supply

For information on our classes for mothers, IBCLCs, and postpartum caregivers, go HERE.

The Pre-Menstrual Dip in Milk Supply

With the early return of menstruation, mothers often see a noticeable dip in their milk supply during the week or two before menstruation. The taste of the milk often changes as well, and this can be off-putting to some sensitive babies.

After the return of menstruation, some mothers resume their monthly rhythm. But for some, the periods will be sporadic and only slowly become monthly. 

The Causes of an Early Return of Menstruation

 I like to compare today’s women to how we were for three hundred thousand years before we could eat a western-style packaged and refined foods diet. On our original, unrefined diet, breastfeeding mothers easily remained free of ovulation and menstruation for more than a year. But today, due to a condition called “insulin resistance” which develops in response to our western diet, we not only see increasing numbers of true milk supply problems but we also see an earlier return of ovulation and menstruation.

Another cause of early menstruation however is if a mother does not exclusively breastfeed. It is the constant production of milk that signals the brain to keep menstruation at bay. When mothers partially breastfeed, the brain assumes you are weaning and the cycles of fertility begin. For more about this, see my article on the Dance of the Postpartum Hormones.

Pre-Menstrual Supply-Dip, a Red Flag for Milk Supply Problems

The early return of menses, because it is associated with insulin resistance, is a red flag and a sign that the milk supply is at risk to become unreliable (up and down from day to day and morning to night).

In this case, a true lactogenic diet in combination with well-chosen herbs and spices is essential to ensure the optimal longterm outcome of steady and sufficient milk production. 

Mineral Supplements prevent the Pre-Menstrual Dip

To prevent the dip in milk supply, you can take extra calcium and magnesium at a ration of 2:1 when you begin feeling hormonal or at ovulation (two weeks before the next expected period.)

Mothers whose diets are calcium-depleting (drinking caffeine, soft drinks, consuming a lot of sugar, refined carbs, or meat) should take 1000 mg of calcium a day, together with 500 mg of magnesium.

Larger body sizes may need more, and mothers on very healthy diets may need only half this amount.

You can use supplements that you may already have, or try one like the supplement linked just below. Here, four capsules equal a full dose. You can spread the dose throughout the day with one capsule taken before meals.

Calcium/Magnesium plus Vit D3

The Lactogenic Diet

Because early return of menstruation is a sign of insulin resistance (see this article), making changes to your diet can not only help normalize your milk supply but also begin to normalize your blood sugar levels. 

This is a big topic. To learn more about it I recommend taking one of the classes which are generally listed here. You can also read my book Mother Food.

A Galactagogue for Menstrual Cramps

By the way, if you tend to have menstrual cramps, the delicate herbal tea, Vervain officinalis, is milk-boosting and especially cramp-soothing.

2 – 3 cups a day. (Be sure to get Vervain officinalis, or Verbena Officinalis, and not Blue Vervain or other variety.)

 

For information on our classes for mothers, IBCLCs, and postpartum caregivers, go HERE.

Mother Food, a breastfeeding diet guide with lactogenic food and herbs

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A Mother's Garden of Galactagogues: growing and using milk-boosting herbs and foods

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Healing Breastfeeding Grief: how mothers feel and heal when breastfeeding does not go as hoped

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Red Madder Root, Tales of Initiations: A Novel of Fairytales and Forgotten Histories (color illustrations)

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Red Madder Root, Tales of Initiations: A Novel of Fairytales and Forgotten Histories (b&w illustrations)

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The Use of Beer as a Galactagogue, historically and today

The Use of Beer as a Galactagogue, historically and today

The Use of Beer as a Galactagogue, historically and today

The ancient civilizations of Sumer and Egypt discovered the secrets of malting and brewing over three thousand years ago, using the barley grain.

Barley is thought to possibly be the first grain cultivated by humans. It contains a long-chain polysaccharide, beta-glucan, that increases the hormone of milk production, prolactin.

Barley is used around the world in many different forms as a milk-supply boosting galactagogue, for instance as beer, soup, and broth.

According to pictorial hieroglyphs, women and slaves were involved in the labor of large-scale beer production in Egypt. Later, in Greek and Roman times, barley was one of many ingredients that might be freely combined in a variety of alcoholic recipes. When these ingredients included lactogenic herbs and fruit, the effect was doubtless noticed by breastfeeding women.

The Greek doctor Dioscorides (1st century C.E.) describes an alcoholic beverage to increase milk supply made with dried black figs, freshly pressed grapes, fennel, and thyme, all of which are known lactogenic ingredients.

The Greek surgeon Antyllus (2nd century CE), mentions a fermented grain beverage that was combined with the crushed unripe seeds of the sesame plant and crushed palm dates–two very potent, lactogenic ingredients.

These were doubtless just two of perhaps countless beverages that were enjoyed by breastfeeding women across the ancient world.

Moving on to Europe

During the Dark Ages, when the skills and knowledge of the ancient world were largely forgotten (suppressed), the art of brewing was kept alive in monasteries across Europe. Eventually, however, with the development of small farmsteads, brewing techniques passed into the hands of women as domestic work. Each thriving family farm brewed its own beer, and the term “Brewster” referred to a woman who brews in her home. 

Brewsters used barley and other grains, and a range of herbs were added in for their taste and medicinal properties. The preferred herbs had a bitter taste to balance the sweetness of the grain, were antiseptic to keep the drink free of pathogens, and were anti-parasitic (for instance, they killed intestinal worms). Lactogenic herbs such as pepper, cinnamon, coriander, caraway, and anise were used in brewing. They may well have been added in when the Brewster was breastfeeding. Mind-altering, narcotic and sexualizing herbs might also be used in brewing. Such drinks were later ascribed to the practice of witchcraft and were forbidden. (See my Red Madder Root post for more about the suppression of women’s herbs.)

Hops flowers, a bitter, relaxing, and slightly narcotic herb that reduces sexual drive and potency, and that most likely reduced violence and rape in the general population, became the standard herb for brewing.

Hops is also an estrogenic galactagogue with a strong reputation for the milk ejection reflex. Hildegard of Bingen (1098-1179), an influential nun, author, herbalist, songwriter, and philosopher of her day, is said to have strongly advocated for hops to become the standard herb used in beer. My guess is that Hildegard knew what she was doing for women and mothers. Thank you, Hilde!

For several centuries, brewing remained domestic work. It became a source of family income, with beer sold through local pubs or directly from the farm. As economies began to evolve, however, the upper classes passed laws that successfully suppressed these small family businesses.

For several centuries, brewing remained domestic work. It became a source of family income, with beer sold through local pubs or directly from the farm. As economies began to evolve, however, the upper classes passed laws that successfully suppressed these small family businesses.

Brewing recipes were strictly regulated, and fees and fines imposed. Brewing became impractical for small domestic breweries and pub houses, and the way was now clear for large industrial breweries to dominate the market, industries that have prospered to the present day.

Today, small breweries are attempting to break free from the stranglehold of the commercial beer industry. If you enjoy beer, I urge you to support them!

Guinness, one of the big British breweries, specializes in a stout that is made with barley malt and barley grain. The added barley makes the stout “silkier” and “thicker” due to beta-glucan, the viscous polysaccharide (long-chained sugar molecule) in barley that increases prolactin. It makes sense that Guinness is the commercial beer most frequently recommended today for breastfeeding mothers, as it is one of the very few to still contain good amounts of beta-glucan. 

Beginning in the early 1500s, German law limited the ingredients to barley, hops, yeast, and water. Reasons for this went beyond taste preferences. By prohibiting the use of wheat, more wheat was available to bake bread. By restricting the allowed ingredients, various other types of beer were pushed into obscurity and could no longer compete with the large breweries.

The law effectively got rid of international competition as it formed a protective barrier to the importation of any foreign beer that used other ingredients. These restrictions would eventually influence the international production of beer, as brewers in neighboring countries conformed to the restrictions so that they could compete within the large German market.

Luckily for breastfeeding mothers, the “pure” ingredients defined by German-type beer, barley, malt, hops, and yeast, are intensely lactogenic. This is why classical European beer is recognized by breastfeeding mothers as the best beer-type galactagogue.

To beer or not to beer

Alcohol is anti-galactagogue. Studies on animals and humans show that alcohol impairs the milk ejection reflex, slows the flow of milk, and leads to a reduced intake of milk by the baby for approximately four hours after mom’s drinking.

As the milk backs-up in the breast, the breast feels fuller. Researchers believe that this combination–the breast feeling fuller, and the baby needing more time to remove milk from the breast, fools mothers into believing that her baby is drinking more milk.

However, in historic beer brewing, the brews of “small beer” and “second brew” (see next section) were preferred by lactating mothers, children, and laborers. In these types of beer, the level of alcohol is considerably lower while the nutritional and herbal value is far higher.

When drinking a small beer or second beer, the nutrients and herbs may have prevailed over the effect of the reduced alcohol content. 

Other factors that may override the anti-galactagogue effect would be whether the mother drinks the beer on an empty stomach or if she has recently had a meal, and also how soon after drinking she breastfeeds again. It is likely that if a mother first eats and then drinks, and if several hours pass between drinking and nursing, the effects of the alcohol will have worn off while the effects of the lactogenic ingredients will still be potent. 

This seems to be the case, according to reports by exclusively pumping mothers who say that by drinking one glass of beer after dinner in the evening (beer rich in barley or hops, such as Guinness Dark Stout or non-alcoholic, malty St. Pauli Girl), they pump measurably more milk the next day. Some also say that they have more frequent and stronger let-downs at the pump that same evening.

Small Beer – Big Effect

In home brewing, the so-called “mashing” (or boiling of malt, grains, and herbs) was performed twice with the same grains and herbs. Whereas the first mashing returns a strong alcoholic beer, the second mashing returns a low-alcoholic beverage called “small beer” that was loosely filtered—a thin, porridge-like fluid that could practically be eaten!

Up until 150 years ago, “small beer” was viewed as a healthy, nutritious beverage that could be given to children, servants, to men performing hard labor, and to pregnant and breastfeeding mothers. In Germany, the second mash was called “Nährbier,” meaning, literally, “nutritional beer.” Into the mid-20th century, Nährbier was produced in Germany commercially and recommended to breastfeeding mothers as nutrition and to enhance their milk production.

This then is the typical historic beer used by breastfeeding mothers: stronger in nutrition, weaker in alcohol. It is quite a different brew from any commercial beer today.

It is important to keep this in mind. Our typical, light-colored alcoholic beers do not contain enough lactogenic ingredients to counteract the anti-galactagogue effects of alcohol. Commercial, light beers made with corn and rice and wheat rather than barley can lead to a decrease in supply! Non-alcoholic beer, however, especially if rich in barley and hops, can be a good galactagogue.

Our Grandmothers were right!

Clearly, our foremothers knew what they were doing when they used beer as a galactagogue. They would use a classic stout-type beer, rich in beta-glucan, or they would drink “small beer.”

The British OBGYN, Charles Routh, writes about beer in his book Infant Feeding and Its Influence on Life (1869). He writes that too much beer and not enough food will reduce supply and risk alcoholism. To use beer as a galactagogue, Routh suggests one oz of dark beer mixed together with one oz cream (delicious!) and drunk every few hours (I believe he was weaning mothers off of their beer habit). He also recommends the specific brands of stouts/ales that were reputed to be most effective by the professional wet-nurses of his time.

Malt Beer

During the 19th century, “temperance movements” formed in many countries around the world to discourage the use of alcohol. In response, beer industries produced non-alcoholic beer-like beverages using hops, yeast, and malt. In the US, malt beer was called Near-Beer; in Germany, Malz-Bier, and in France, bière de nourrice, or “wet-nurse beer.” All were recommended as nourishing beverages for pregnant and breastfeeding mothers and were reported to support milk supply.

Malt is derived from barley grain. Both malt syrup and malt powder are a widely used historic galactagogue. Today, many new brands of malt-beer are available commercially. The best known is the Guinness Malta. Malt beers are very popular in South America, Africa, and Israel. Many mothers swear that Malta helps support their supply.

The Bad News and a Solution

Very sadly, many if not most mothers and their newborn babies are sensitive to gluten, which is found in barley. Products and meals that have barley as an ingredient are best avoided, especially in the early postpartum, when a baby’s digestion is just learning how to function. Inflammatory substances such as gluten contribute to infant colic and are therefore best avoided, at least for the first several weeks of the baby’s life.

Here is an article on infant colic, how it develops and why it is so important to calm colic in babies.

But there is good news, too. I recommend that mothers supplement with a yeast-derived source of beta-glucan. Mothers often have a big response to beta-glucan supplements resulting in more milk supply. (The author has no association to this beta-glucan brand, it just serves as an example.)

Writing the book “Mother Food”

Writing the book “Mother Food”

Writing the book “Mother Food”

A Slow Gestation

The idea for this book was conceived and then took hold of me, a little more each time, with the births of my four children. With each child, I learned a little more about overcoming my low milk supply issues by using traditional herbs and foods — an area of knowledge that was not at all in the mainstream twenty, or even ten years ago, and that today is still little understood.

The catalyst to actually begin researching and writing was the birth of my forth child and my only daughter. That was in 1992. With her, I encountered new and considerable obstacles to breastfeeding and bonding. I was able to overcome these with the knowledge I had gleaned with my older three children — knowledge that I believe every mother has a right to know.

Childbed Fever

The first major challenge was childbed fever and a stay at the hospital. A sliver of placenta had remained in my womb, and when it began to decay, bacterial infection invaded my body. My daughter was ten days old when I was rushed to the emergency room, shaking from fever, too weak to stand. Fortunately, my breastfeeding-friendly doctor agreed that I could continue nursing in spite of undergoing surgery and taking high-dosage antibiotics. I was also allowed to room-in with my daughter: she slept in my bed, right next to me on the extra-large pillow.

Although I was so weak, I responded to her needs as quickly as possible, day and night. I changed her clothes and her diapers right there in bed with me. At the first sign of hunger or fretfulness, I fed or comforted her. I loved being close to her and feeling the warmth and emotion flow between us, that incredible exchange of finest feelings, as comforting to the sensitive new mother as to the baby.

Each afternoon, a friend came by and was available to carry her around during the hours when she might be fretful. Evenings, my husband was there to do the same. The quintessence: my daughter never felt abandoned to discomfort.

As mentioned above, I struggle with chronic low milk supply. The causes were hormonal (mild PCOS), a minimal amount of glandular breast tissue, and possibly also my having a medical condition that suppresses my immune system (Lyme disease). To prevent milk supply problems in the hospital, I asked my husband to bring me bottles of “Rivella,” a soft drink flavored with herbal extracts that is drunk in Switzerland (where I lived) to increase milk supply. In addition, the nurses made me pots of an herbal lactation tea. The result was that although my body was struggling to maintain milk production throughout this medical crisis, I did indeed manage to exclusively breastfeed my daughter.

The Nurses

Then something happened that made a huge impression on me. Nurses I had never seen before began to visit us, to stand quietly and respectfully inside our room for a while, and then leave without saying a word. I finally asked one what was going on. She told me that the nurses “downstairs” were talking about my baby — about the remarkable baby who ever cried. The nurses wanted to see for themselves if it was true! She explained that in the maternity ward, the babies were fretful and crying a lot of the time.

You see, in Switzerland, health insurance pays for up to ten days of rest at the hospital after birth. During this time, mothers are supposed to learn about babycare from the nurses. In my case, however, I had gone straight home a few hours after the births of my first two babies. My last two had been homebirths, so I had never had the benefit of their guidance.

Well, the nurse’s amazement amazed me! Obviously, they didn’t understand the kind of interaction necessary to prevent a baby from becoming fretful. Indeed, I remembered the questionable “support” I’d received the first few hours after my two hospital births. With my first, because he was fretful, the nurse put him in a little bed, all alone, crying, so that I could rest. That separation ripped my heart, and his crying began to sound horribly angry. Being born and immediately initiated into anger and separation is not my idea of a good start in life! But since the nurse seemed to think it was okay, and I was a new mother and insecure, I trusted her. With my second, the nurses took him for testing and then didn’t return him for a half hour. I was aching for him all that time. When I asked about the delay I was told it was because he was so cute, and a very special baby. They had enjoyed their time with him. When a nurse then saw that I was attempting to breastfeed him, she said, “What? So soon? Don’t you want to rest?” It was now 45 minutes after birth. Didn’t she know that the best time to initiate breastfeeding was the first hour after birth?

Well, with my daughter cooing on my lap I assured the nurse that she was no angel. She would cry like any other baby if her needs were not met. The secret was recognizing her signals and responding to them as soon as possible — even within a split second. But there was more to it. I also knew how to keep up my fragile milk supply, and I knew that I should eat certain foods and not others to avoid risking my baby’s digestive distress. Indeed, I knew from repeated experience that a baby who has enough milk, and whose milk is easy to digest, is very simply going to be an “easier” baby. Every baby is different, of course, but a mother can learn how to be sensitive to those differences and gauge her choices accordingly.

Postpartum Depression

A few weeks later I encountered the next big obstacle: postpartum depression. I had gone through a long phase of exhaustion following each birth, but had not experienced depression before. Now I saw what it was like: parts of my brain shut down; I no longer felt involvement in life; I felt no joy in being a mother, or in my new baby.

Nonetheless, because I knew it was important, I continued doing things that contribute to a bonded relationship: I gave my baby the contact she required (she was the sensitive kind of baby who never sleeps if put down, so she had to be carried in a sling or snugly during the day, even when sleeping, the first three months of her life). I continued taking foods and herbs to maintain my supply. I observed which foods caused her digestive distress, and I avoided these. When I watched TV, I wore a headphone. I believe that babies who listen to television or radio and who hear, for instance, sudden loud sounds or music that convey shock, horror, surprise, or pathos are at greater risk for the sensorial disorganization that many children have today. I also sang to her throughout the day, including when I watched TV with headphones on, even though it felt very odd to do so. The result was that when I came out of depression (the healing process took about four months; I was not informed enough to take medication), I had a trusting, happy baby, (and a very musical child as we would discover) who would continue to be confident in our relationship, and to nurse for several years.

My Happy Baby

My happy baby was my little miracle. How had I come through postpartum depression with an intact relationship to my daughter, including an intact breastfeeding relationship? Everyday, I marveled and rejoiced. I also rejoiced that I had known how to overcome my low milk supply, and to produce milk that did not cause my daughter to have an upset stomach. (She would get an upset stomach and become colicky whenever I ate certain foods or combinations of foods, so I was sure to avoid these.) I had learned these tools not from doctors but from mothers, especially mothers from the “anthroposophic” community (Waldorf school) which, in Germany, has studied the effect of foods and herbs on mothers and babies for decades.

I felt as though I had stumbled upon a treasure chest of insights – to which mothers held the key. This set of insights seemed ancient in its “rightness.” I believed that all mothers should have access to it.
Putting this key back into the hands of all mothers was the motivation for researching and writing Mother Food.

Now, there are two types of persons in my family: scientists and artists. I lean toward the latter. My degree is in music. I also love to write, especially poetry, fiction, and creative non-fiction. Well, research shows that musicians use their brain in an integrated way, using both halves creatively. That was the approach I took to researching this material: get the whole picture, discover the interconnections, and explain these in simple terms that make the reader think, “Oh, I get this now! It’s so clear!”

Imagine a mother of four lively children, bringing home boxes of books from the university library, and reading these each evening in bed while nursing her baby – then toddler, then young child. My daughter was four years old when I published an article in “c u r a r e,” a German academic journal of ethnomedicine, titled, “Have Lactation Medicinals an Influence on Culture?” This article summed up my findings: that lactation medicinals had been ignored by science (this has now changed), that foods that increase milk production were the crops earliest cultivated by Neolithic peoples (perhaps because breastfeeding mothers preferred these foods), that lactation medicinals are plentifully found in world mythology, associated with breastfeeding goddesses or mother goddesses. Finally, I included a description of some of the chemical pathways that lactogenic foods and herbs use to increase milk production.

What Kind of Book Should I Write?

In 1996, I sent my initial manuscript, then titled “Ancient Tools of Motherhood,” to a Swiss publishing house, the Kreux Verlag. Their main editor responded that I was writing not one book, but two: I was writing a self-help book, but also a book about history and culture. She said that this combination would be hard to market, and that I should instead write one book or the other.

I thought about this suggestion a long time, but remained convinced that mothers deserve and require a book connecting both history and culture to their practical experiences today. One of the remarkable moments of motherhood is the realization that one is sharing an experience common to women of all times and places. The next step is to understand how this universality includes our choices for diet and health, with respect to how these choices influence our breastfeeding and mothering experience.

At the risk of sounding dramatic, I believe that understanding motherhood has never been as crucial as it is today. More of our children are born prematurely, or are born at term but with neurological damage such as learning problems (and suck problems), concentration or sensorial disorders, and a spectrum of autistic disorders. Indeed, it is estimated that 1 out of 96 children are born with an austistic disorder, and nearly every second boy has some degree of concentration or sensorial integration disorder. We need to understand how we got where we are today and what we can do about it — for although this problem belongs to society as a whole, and as a society we will eventually have to come to terms with it, we mothers can be proactive now, both before conception, during pregnancy and birth, and again through our choices for our baby’s nourishment. “Mother Food,” precisely because it is many books in one, can offer important impulses to this discussion.

In 1999, I was thrilled to learn that a new venue of publishing had opened up: “Print on Demand,” a digital publishing arrangement that leaves complete responsibility for content and editing to the writer. This venue would allow me to write the combination how-to and cultural book that I had planned. I was energized to concentrate on writing again.

In 2000, I was almost ready to publish. Then I was bit by a tick and my life turned upside down. My doctor believes I’d had Lyme disease since my early twenties, but without its having broken out actively. With the new tick bite, Lyme disease quickly developed and put me out of function for six months of antibiotic treatment. When I began to recover, enough that I could consider working on this book again, I realized that I could not return to this book as it was. I had to re-write it in order to remember what it was about (Lyme disease affects memory and thinking processes)! And that was a good thing.

Again I had boxes of books to read. Wonderfully, everything I read in the very most recent books on diet, the immune system, allergy, and babycare confirmed and complimented what I already knew. Now I had many more insights for mothers. I continued to work toward publication, and in 2001, became a certified holistic lactation consultant in a new school founded in Switzerland. Local midwives referred mothers to me who had extraordinary problems with milk supply. Most wonderfully, I moderated a breastfeeding group on the internet where mothers with exceptional breastfeeding difficulties congregate for support. In 2005, this group became a non-profit, MOBI Motherhood Intl. (Mothers Overcoming Breastfeeding Issues).

What is Unique about Mother Food?

The central goal of Mother Food is to address breastfeeding issues that are linked to a baby’s apparent suffering at the breast, such as persistent hunger from true low supply, and pain from colic, reflux, and allergy. These conditions are the least well explored in breastfeeding literature today, and mothers who describe having these problems often feel misunderstood by their healthcare providers.

Another goal is to include a historic overview of mother foods from ancient Greece, India and China. These comparisons offer fascinating surprises and insights that are the birthright of all mothers.

Starting Sweet Potato Slips for your Galactagogue Garden

Starting Sweet Potato Slips for your Galactagogue Garden

Starting Sweet Potato Slips for your Galactagogue Garden

 

In my attic office, next to a south-facing window, I’m setting up sweet potato slips.

Instead of growing them, I could just buy sweet potato slips in the garden center in the second week of May. But because it’s doable and fun, I’m growing them myself.

One method is to fill a plastic container half-way with potting soil or coconut coir or a mixture of both.

Keep the soil moist but not sopping. Keep it in a set-up that holds humidity. Give it sunlight, too, and open the container every day to let out some of the extra moisture to prevent mold. Add water as needed.

In a month or so, several “slips” (leaf shoots ) will be a few inches long. They can then be removed and put in a glass of water, to develop a set of roots.

It is now March 7. In mid-May, the slips will be planted. Beneath the soil, lots of tubers will grow, so in autumn we’ll have a small harvest. At the same time, long vines bearing edible leaves grow in abundance.

Sweet potato leaves are considered an important potential food source, both because they are nutritious and because the sweet potato will grow in near-drought conditions.

The leaves have been studied for their medicinal properties. They are rich in antioxidants and are strongly anti-diabetic. As a vegetable, the leaves are eaten raw or cooked like spinach.

Sweet potato leaves are listed as a galactagogue and used to support milk production in parts of Africa and Asia.

For more information, see my book A Mother’s Garden of Galactagogues.

I personally experienced that #galactagarden fresh vegetables and herbs were powerful milk-boosters, stronger than herbs in capsules, tinctures, or tea.

I have risk factors for low supply: PCOS and IGT. My exploration of #galactafood led to my book Mother Food.

The fact is that mothers around the world prefer #galactafood – that is, using lactogenic ingredients in their food – instead of concentrated tea or tinctures.