“But what harm can they do?”
“What’s the problem?”
“My best friend makes them and she’s lovely”.
“They taste great and herbs have been used by women for thousands of years to increase milk supply.”
“They really worked for me!”
I am willing to join a throng of my lactation consultant and breastfeeding counsellor colleagues to be a party pooper when it comes to the world of lactation cookies. We would build a bonfire from all the lactation cookies that were given at the wrong time to the wrong people – and it would probably smell quite nice.
1. They can be a barrier to getting the right help.
If you suspect you are struggling with low milk supply, or suspect your baby may not be getting the milk they need, you need support and information quickly. Even delaying that conversation by an extra day could be a problem.
I have just read all the recipes for lactation cookies on the first page on my internet search results. How many of those recipes mentioned that if you do fear you may have some issues with your milk supply, please contact a breastfeeding counsellor, lactation consultant or health professional for support? NONE.
I am looking at a website that is selling commercially-made cookies and at the bottom of the home page we are seeing a ‘seek advice’ type comment. But nothing on the individual product pages. In all the cases I found, any comment about getting the right support was at the end of some text, often at the bottom of a paragraph, and not highlighted.
Milk supply is governed by milk removal. When the breasts are stimulated, we get surges of prolactin hormone. When milk is removed frequently and with an effective latch, the body receives signals to make more milk. For those of us in breastfeeding support, it’s easy to forget that not everyone understands the basic mechanisms of milk production. The more milk that is removed, the more we will go onto make.
As weeks go by, our milk supply settles and we may not experience fullness or engorgement in the way we once did. We need parents to understand how breasts work. As time goes by, the regulation of lactation has shifted to activity within the glandular tissue of the breast rather than being regulated by hormones. It's really common for this altered feeling of softer breasts to be misinterpreted as a sign that supply has been 'lost'.
Oxytocin, sometimes called the hormone of love, regulates milk release. It can be inhibited by cortisol and adrenaline. If a mum is feel extreme stress, perhaps they are expressing on return to work and not getting the results they were expecting, again they may worry milk supply has been 'lost'. Sending this mum off on a journey for lactation cookies, in a bid to 'fix' a problem is unhelpful. Instead we should be explaining how our bodies work, talking about mindfulness and relaxation techniques and ways to reduce stress and increase oxytocin flow.
If someone is worried about low milk supply, it may be that their baby’s latch needs adjusting. It may be that they need to reflect on how often milk is being removed and for how long for. There may be a factor that requires some specialist help such as a baby with a tongue tie, some retained placental fragments or a medical issue. Adding a, ‘Here, try some lactation cookies’ is stealing time and depriving someone of getting information and support that could make all the difference to their situation.
If your best friend makes them, and she is lovely, please ask her to create a banner at the TOP of her website that highlights the importance of getting qualified support and she can throw in some helpline numbers while she is at it. If you sell cookies and it’s possible for me to spend more than 3 minutes on your website without seeing a message about the importance of getting breastfeeding support, you need to change your website.
Sometimes we could be distracted by cookies when an immediate answer is just seconds away: the mum who was worried about their baby’s weight gain but had been told to always restrict breastfeeding to one breast, the baby whose chin just needed to be closer to the breast. How about the exclusively pumping mum who felt desperate when her pumping output dramatically reduced but her pump just needed replacement parts? All the cookies in the world are not going to repair her pump valve. All the cookies in the world won’t change your baby’s positioning.
2. Some of the ingredients could do actual harm.
Cookie is a word that sounds so harmless, but that friendly word is masking a potential risk. Lots contain a seed called fenugreek. Fenugreek has been used around the world to support lactation for a long time but just because something is a plant and ‘natural,’ it doesn’t mean it’s safe for everyone to ingest. The evidence on whether fenugreek does aid milk supply is patchy. There are some studies that suggest it could, but we also know that some people should avoid taking it.
Post-partum thyroiditis affects about 5-10% of new mothers. That’s a surprisingly high number and potentially a significant proportion of those struggling with supply issues. It may start out with hyperthyroidism (which could mean a strong milk supply) and then shift into hypothyroidism (when milk supply could be negatively impacted). Lisa Marasco and Diana West, in their book ‘Making more milk: The breastfeeding guide to increasing your milk production’, talk about the association between taking fenugreek and lowered milk production. Fenugreek is also not recommended if the parent has diabetes, hypoglycemia, asthma, a peanut or chickpea allergy or a bleeding disorder. We also have cases of it causing gastro-intestinal issues in both mother and baby.
I have spoken to mothers who took weeks and even months to get a diagnosis of thyroid issues, and during than time milk supply was a worry. If they had been buying and eating lactation cookies throughout that time (and one had), it could have made the situation worse. Imagine the mum with undiagnosed thyroiditis feeling she just hadn’t ‘found the right recipe’.
When we are a new parent, we are very vulnerable and if a bunch of people are telling you lactation cookies are the go-to, why would you not believe them? Guess how many of those recipes I checked mentioned that some of the ingredients may not be safe for everyone?
Brewer’s yeast is another commonly used ingredient. It tastes bitter in large quantities so is often used sparingly. Maybe that’s not a bad thing when you consider that it interacts with more than 200 medications. It interacts with some medications used to treat depression and as you can imagine can impact on anti-fungal treatments.
3. Even if they are safe for you to use, what messages are being reinforced?
Let’s imagine your thyroid is fine and you don’t have an underlying latching or breastfeeding management issues and you just fancy some lactation cookies. I would still argue that you are receiving a message that your body is insufficient. One of the biggest arguments pro-lactation cookies is that they are a placebo and they often have a positive impact because we BELIEVE that they work. Perceptions of low milk supply are widespread among new parents and in the majority of cases there is nothing to worry about. It’s normal for babies to sometimes be fussy, for breasts to start to feel softer, for leaking to stop, for pumping output to shift, for feeds to get shorter in length.
I would much rather that the placebo, which may cause parents to feel more relaxed, is a dose of accurate information about how breasts change and how babies behave, what growth spurts are and what’s normal in lactation. I don’t want someone to spend £10 a box for that sense of calm or a feeling that they are ‘doing something’. When we are telling new parents that breastfeeding means eating and making lactation cookies, we are telling them that bodies don’t work on their own. We are saying that low milk supply is the norm and we need help to be mammals. We already live in a society where breastfeeding is often not trusted. I don’t feel the answer to this lack of confidence is to imply cookies will fix us. Do we really want a placebo that normalizes perceptions of low milk supply?
4. They are often expensive.
Here is one company selling 500g of lactation cookies for nearly £10. Here’s some more for £14. Here’s a monthly subscription for around £50. Even if you make your own, some of the individual ingredients can really add up. Oats are a staple of many recipes. They are not expensive. Does that box really need to cost £14? We know new parents often feel that paying more means a product will be better quality. We are a vulnerable bunch. Flapjacks made with oats and some flaxseed are going to cost a fraction of some of the commercial products. You can get a packet of oaty biscuits from a supermarket for about £1.
Let’s be really careful about lactation cookies. For the minority who do have genuine supply issues, there may be better galactagogues (substances that increase milk production) that they should be signposted to. Even if you have researched fenugreek and other herbs carefully, and feel they are worth trying, there are other ways to take them that are cheaper and more easily controllable and potentially in more useful quantities.
Jil (@midsussexdoula) on Twitter pointed out that men struggling with erection problems wouldn’t be palmed off with ‘erection cookies’. They would expect knowledgeable support.
If you feel lactation cookies helped you, your role as a supporter of others is not to suggest lactation cookies before you suggest anything else. You could be delaying someone from getting the help they need and wasting their time and money. If you absolutely believe that lactation cookies had a magical effect on you, you need to work even harder to check yourself before you mention them.
And finally, cookies are good. Eat all the cookies you want, just because they are cookies. Find ones that taste nice, make you happy and bring positives to your life. This is not an anti-cookie message, this is an anti-'cookies that undermine breastfeeding' message.