Some side effects to consider when using herbal galactagogues to increase breast milk supply.

Fenugreek is used to flavor artificial maple syrup, and is used as a common food ingredient (curries, chutneys, etc.) and traditional medicine in many parts of the world, including India, Greece, China, north Africa and the Middle East. It is a basic ingredient of curry powder (often used in Indian cooking) and the Five Spice mixtures (used in Asian cooking). It is also eaten as a salad and sprouted.

Fenugreek is considered safe for nursing moms when used in moderation and is on the U.S. Food and Drug Administration's GRAS list (Generally Recognized As Safe). As with most medications and herbs, various side effects have been noted; see the side effects and safety information below.

Per Hale [Hale 2002], "The transfer of fenugreek into milk is unknown, but untoward effects have not been reported." Hale classifies it in Lactation Risk Category L3 (moderately safe).

Possible side effects and cautions
Sweat and urine smells like maple syrup; milk and/or breastfed baby may smell like maple syrup.
Occasionally causes loose stools, which go away when fenugreek is discontinued.
Use of more than 100 grams of fenugreek seeds daily can cause intestinal distress and nausea (recommended dose is less than 8 grams per day).
Repeated external applications can result in undesirable skin reactions [Wichtl 1994].
Ingestion of fenugreek seeds or tea in infants or late-term pregnant women can lead to false diagnosis of maple syrup urine disease in the infant due to presence of sotolone in the urine. See [Korman 2001] and other studies on fenugreek and maple syrup urine smell.
Use with caution or avoid if you have a history of:

Peanut or chickpea allergy: Fenugreek is in the same family with peanuts and chickpeas, and may cause an allergic reaction in moms who are allergic to these things. Two cases of fenugreek allergy have been reported in the literature. [Patil 1997, Ohnuma 1998, Lawrence 1999]

Diabetes or hypoglycemia: Fenugreek reduces blood glucose levels, and in the few studies using it as a hypoglycemic, also reduces blood cholesterol. Dosages higher than the recommended one (given above) may result in hypoglycemia in some mothers [Heller]. If you're diabetic (IDDM), use fenugreek only if you have good control of your blood glucose levels. While taking this, closely monitor your fasting levels and post-prandial (after meals) levels. Mothers with hypoglycemia should also use fenugreek with caution. For more on fenugreek and glucose levels, see the references below.

Asthma: Fenugreek is often cited as a natural remedy for asthma. However, inhalation of the powder can cause asthma and allergic symptoms. Some mothers have reported that it worsened their asthma symptoms. [Dugue 1993, Huggins, Lawrence 1999].
Abnormal menstrual cycles: Fenugreek is considered to be an emmenagogue (promotes menstrual flow). Per [White], it may cause breakthrough menstrual bleeding; this source recommends using fenugreek with caution if you have a history of abnormal menstrual cycles.

Migraines: Fenugreek is often cited as a natural remedy for migraines. However, [White] indicates that it may trigger a migraine and/or contribute to the duration and severity of a migraine.
Blood pressure problems or heart disease: Fenugreek is commonly reported to lower blood pressure and LDL blood cholesterol levels. [White] indicates, however, that it may cause or contribute to hypertension (high blood pressure) - this source recommends avoiding this herb if you have a history of hypertension, or if there is a strong family history of hypertension or heart disease.

Drug interactions
Oral drugs or herbs taken at the same time as fenugreek may have delayed absorption due to the mucilage content of fenugreek. [Wichtl 1994]
Glipizide and other antidiabetic drugs
Fenugreek reduces blood glucose levels and may enhance the effects of these drugs.
Insulin
Fenugreek reduces blood glucose levels, so insulin dosage may need to be adjusted.
Heparin, Warfarin and other anticoagulants
Ticlopidine and other platelet inhibitors
The fenugreek plant contains several coumarin compounds. Although studies have not shown any problems, it potentially could cause bleeding if combined with these types of drugs.
MAOIs
Fenugreek contains amine and has the potential to augment the effect of these drugs.

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