Can herbs help mothers of premature babies produce more breast milk?

For mothers of premature babies, breast milk can make a huge difference. It helps protect fragile newborns from serious illnesses and supports healthy growth and development.

But producing enough milk is often difficult after a premature birth. Many mothers are separated from their babies in neonatal intensive care units (NICUs), may be recovering from surgery, and often need to pump milk instead of breastfeeding directly. Because of these challenges, many women look for natural ways to boost their milk supply.

A new review published in the *European Journal of Clinical Nutrition* looked at whether herbal remedies can safely help mothers of premature babies produce more breast milk.

Premature babies are born before 37 weeks of pregnancy. They are more likely to develop infections and other serious health problems than full-term babies.

Breast milk helps lower these risks. It provides nutrients, antibodies, and other protective substances that formula cannot fully replace. However many mothers of premature babies struggle with low milk supply. Also, the concerns about not producing enough milk are one of the main reasons women stop breastfeeding.

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Researchers reviewed 10 clinical trials involving 856 mothers of premature babies. These studies tested different herbal products that are traditionally believed to increase milk production. These products are called galactagogues, which simply means substances that help stimulate breast milk production.

The researchers wanted to know if these herbs increase milk supply, safe for mothers and babies and they actually help babies gain weight. They also wanted to identify which worked the best.

Several herbal products showed promising results. Among the most promising options are moringa, barley malt, anise tea, lettuce syrup, and milk thistle-based supplements.

From studies, the combination of barley malt and lemon balm produced one of the biggest increases in breast milk.

Mothers using it produced about 149 millilitres more milk per day after one week compared with those taking a placebo.

Researchers believe barley malt may help increase levels of prolactin, the hormone responsible for milk production.

Moringa is a nutritious plant commonly used in many tropical countries. Leaves are eaten as vegetables, powders, teas, or capsules. Studies showed that mothers taking moringa capsules produced more milk within a few days. Moringa is rich in vitamins, minerals, protein, and antioxidants, making it an attractive option for further research.

In addition, mothers who drank anise seed tea produced nearly 100 millilitres more milk per day after seven days.

Anise has been used traditionally for centuries to support breastfeeding and appears to help increase hormones involved in milk production.

Syrup made from lettuce also increased milk production. Although the increase was smaller than some other products, the results were still encouraging. Because lettuce is a common food, it is considered very safe.

A supplement containing milk thistle extract and Galega showed positive results, increasing milk production after one week. However, researchers noted that not all milk thistle products worked equally well, suggesting that the specific preparation may be important.

Fenugreek is one of the most popular herbs used to increase breast milk. Surprisingly, this review found not enough evidence to show that fenugreek helps mothers of premature babies. The studies were too small to provide a clear answer.

Researchers say more high-quality studies are needed before fenugreek can be recommended for this group of mothers.

The good news is that most studies reported no serious side effects from these herbal products. Only one study reported minor problems such as headaches, nausea, increased sweating and a maple syrup-like body odour

No harmful effects were reported in babies.However, researchers warned that herbal products can vary in quality and strength, so safety should continue to be studied.

The studies did not show clear evidence that babies gained more weight because of the herbal treatments, maybe probably because the studies were short, often lasting only one week.

The researchers reasoned that longer studies are needed to see whether increased milk production leads to better growth in babies.

The review suggests that several herbal products may help increase breast milk production in mothers of premature babies, especially barley malt with lemon balm; moringa leaf capsules, anise seed tea, lettuce syrup and milk thistle combined with Galega.

Considering that the evidence is still limited, the researchers said that larger and better-quality studies are needed before these products can be strongly recommended.

For most mothers, the biggest driver of milk production is frequent and effective milk removal, either through breastfeeding or pumping. Herbs may help some women, but they are generally considered supportive rather than a substitute for good breastfeeding support.

However, mothers should discuss any herbal supplement with their healthcare provider and continue to focus on proven ways to support milk production, such as frequent breastfeeding or pumping, skin-to-skin contact, and support from lactation specialists.