Synthetic galactagogues such as
domperidone and
metoclopramide interact with the
dopamine system in such a way to increase the production of
prolactin; specifically, by blocking the
D2 receptor. There is some evidence to suggest that mothers who are unable to meet their infants' breastfeeding needs may benefit from galactogogues. A more recent study questions the effectiveness of commercial lactation cookies finding no significant difference. Galactagogues may be considered when non-pharmacologic interventions are found to be insufficient. For example, domperidone may be an option for mothers of
preterm babies who at over 14 days from delivery and after full lactation support still have difficulty
expressing breast milk in sufficient quantity for their child's needs. Lactation induction may also be possible in certain circumstances for women planning to adopt an infant. Domperidone (like metoclopramide, a D2 receptor antagonist) is not approved for enhanced lactation in the USA. By contrast,
Australian guidelines consider domperidone to be the preferred galactagogue when non-pharmacological approaches have proved insufficient. Unlike metoclopramide, domperidone does not cross the
blood–brain barrier and does not tend to have adverse effects such as drowsiness or depression. • Certain
hormones such as
oxytocin,
growth hormone (GH), and
thyrotropin-releasing hormone (TRH). ==Herbal==