A critical review of pharmaceutical galactagogues.

Use of plant and drug products to enhance lactation is widespread, and numerous papers have been published in the medical literature claiming efficacy for various products. This paper will review and evaluate the published literature on the most widely used pharmaceuticals that are used as galactagogues. Breastfeeding physiology is reviewed with the aim of creating a framework for understanding galactagogue pharmacology. Published articles were selected and evaluated using the principles of evidence-based medicine, and were also evaluated using the principles of good lactation management. Only three studies on oxytocin and seven studies on dopamine antagonists were found to be useful. Oxytocin is probably not useful as a galactagogue, except possibly in rare circumstances of tetraplegic mothers. Dopamine antagonists appear not to enhance milk supply if mothers are given good lactation support and employ these practices. The safety of the dopamine antagonists has not been adequately evaluated, so their use should be avoided unless other measures have failed.