Assessment of Knowledge, Attitude and Practice Towards Galactagogues Consumption among Lactating Mothers (Age 21-40 Years) in Urban Setting

Abstract

Background: Galactogogues are substances that promote breast milk production and are commonly used in Indian traditional postpartum care. Despite their widespread use, particularly among urban mothers, there is limited scientific data exploring their consumption patterns, associated beliefs, and influencing factors in India’s urban context. This study aimed to assess the knowledge, attitudes, and practices (KAP) regarding galactogogue consumption among lactating mothers aged 21–40 years in Mumbai and to identify the socio-demographic and cultural factors influencing their use. Methods: A descriptive cross-sectional study was conducted on 100 lactating mothers recruited via purposive sampling from Mumbai. Data were collected using a structured questionnaire comprising demographic and socioeconomic details, a 3-day dietary recall for galactogogue consumption, and a validated KAP survey. Statistical analyses, including chi-square tests, were used to explore associations between galactogogue preference and socio-demographic variables. Results: Participants exhibited high levels of knowledge (78%), positive attitudes (93%), and strong practices (84%) toward galactogogue use, yielding an overall KAP score of 88%. Herbal and dietary galactogogue—such as fenugreek, ginger, garlic, oats, gond, and laddoos—were commonly used, with 73% of mothers consuming them daily and 93% using more than one type simultaneously. Shatavari use was significantly higher among mothers aged 31–40 years and in specific communities (p < 0.05), while other galactogogue showed no significant association with age, education, or income. Cultural norms and familial advice were the primary influences on galactogogue use, while pharmaceutical options were rarely used. Conclusion: Galactogogue consumption in urban Mumbai is a culturally ingrained practice, with high awareness and widespread daily use among lactating mothers. The findings emphasize the need for culturally sensitive, evidence-based lactation support strategies to ensure the safe and informed use of galactagogues in urban postpartum care.

Introduction

Breastfeeding is essential for neonatal nutrition, immune development, and cognitive growth. Breast milk composition adapts over time, and its production is influenced not only by hormones (prolactin, oxytocin) but also by maternal well-being and cultural support. The WHO and UNICEF recommend exclusive breastfeeding for the first six months, followed by continued breastfeeding with complementary feeding up to two years or beyond. However, adherence is impacted by cultural, social, and economic factors.

Galactogogues—substances that enhance milk production—are often used to support lactation. These include:

• Pharmacological agents (e.g., domperidone, metoclopramide), which raise prolactin levels but may carry risks.

• Natural/Traditional galactogogues (e.g., fenugreek, moringa, Shatavari), which are widely used in India based on cultural traditions (Ayurveda, postpartum recipes), though evidence from large clinical trials remains limited.

Objective

To assess the Knowledge, Attitude, and Practices (KAP) regarding galactogogue use among lactating mothers aged 21–40 years residing in Mumbai.

Methodology

• Study Design: Descriptive, cross-sectional.

• Sample: 100 lactating mothers (aged 21–40), recruited from a tertiary hospital in Mumbai.

• Data Collection Tools:

  • Demographic & socio-economic questionnaires.

  • 3-day diet recall.

  • KAP questionnaire.

• Exclusion Criteria: Mothers who never breastfed, had surgery or medical contraindications, or infants with special feeding needs.

• Analysis Tool: SPSS (v20); Chi-square tests used for association analysis (significance at p < 0.05).

Key Results

1. Demographics

• Age: All participants between 21–40 years.

• Education: 64% graduates, 36% postgraduates.

• Religion: 51% Muslim, 33% Hindu, 16% Christian.

• Children: 43% had one child; 38% had two.

• Delivery: 74% vaginal, 26% C-section.

• Infants: All aged 0–6 months; 60% male, 40% female.

2. Socio-economic Status

• 76% in the upper-middle class.

• 24% in the lower-middle class (per Kuppuswamy scale).

3. Health & Nutrition

• Chronic conditions: Diabetes (12%), hypertension (9%), thyroid disorders (9%).

• Diet: 70% non-vegetarian, 30% vegetarian.

• Food allergies: Reported by 8% of participants.

4. Anthropometrics

• Mothers: Avg. weight 66.8 kg, BMI 24.5, height 165.5 cm.

• Infants: Avg. birth weight 4.46 kg; current weight 6.37 kg.

5. KAP Scores

• Knowledge: 78%

• Attitude: 93%

• Practice: 84%

• Total KAP Score: 88%, indicating good overall knowledge and behavior regarding galactogogue use.

6. Commonly Known Galactogogues

• 100% awareness: Ginger, garlic, oats, fenugreek, fennel seeds.

• 91% awareness: Gond, galactogogue laddoo.

• 61% awareness: Shatavari.

• Others: Coconut water, dal, Lactare capsules (8%).

Association Analysis

Galactogogue Preference vs. Age

• Shatavari use significantly associated with age (p = 0.018). Highest use in mothers aged 31–40 years (90%).

Galactogogue Preference vs. Education

• No significant association. Awareness and usage remained high among both graduates and postgraduates.

Galactogogue Preference vs. Socio-economic Status

• No significant association. Usage patterns were culturally consistent across income groups.

Conclusion

This study demonstrates that galactogogues consumption among lactating mothers in Mumbai is a culturally rooted and widely practiced behavior, driven more by familial traditions and cultural beliefs than clinical guidance. Mothers exhibited good knowledge, positive attitudes, and consistent practices, with frequent use of herbal and dietary galactogogues such as laddoo, fennel, fenugreek, ginger, and Shatavari. Pharmaceutical use was minimal, and preferences showed limited association with socio-demographic factors, except for Shatavari, which was more commonly used among women aged 31–40 and specific communities. Other galactogogues showed no significance with age, education, or income, indicating cultural influence over usage patterns. The findings highlight the importance of integrating traditional postpartum practices with structured, evidence-based lactation counseling. Empowering mothers with accurate, accessible, and culturally appropriate information that can help improve both maternal confidence and breastfeeding outcomes, ensuring safe and effective galactogogues use in modern urban settings.

References

[1] Canales-Pérez, E. S. (1984). Control of lactation. Gaceta Médica de México, 120(2), 131–136. https://pubmed.ncbi.nlm.nih.gov/6735024 [2] Chung, M., Ip, S., Yu, W., Raman, G., Trikalinos, T., & DeVine, D. (2008). Interventions in primary care to promote breastfeeding: A systematic review. Agency for Healthcare Research and Quality (US). https://pubmed.ncbi.nlm.nih.gov/20722164 [3] Odent, M. (2012). The role of the shy hormone in breastfeeding. Midwifery Today with International Midwife, (101), 39–42. https://pubmed.ncbi.nlm.nih.gov/22486011 [4] Thapa, S., Short, R. V., & Potts, M. (1988). Breast-feeding and birth spacing save lives. Journal of Obstetrics & Gynaecology Research, 14(2), 117–129. https://pubmed.ncbi.nlm.nih.gov/12342408 [5] World Health Organization. (2021). Infant and young child feeding: Guiding principles for feeding non-breastfed children 6–24 months of age. https://www.who.int/publications/i/item/9241593431 [6] Lawrence, R. A., & Lawrence, R. M. (2021). Breastfeeding: A guide for the medical professional. Elsevier Health Sciences. [7] Saxena, U., Ota, S., Rajput, S., et al. (2025). Clinical evaluation of Ayush-SS granules in exclusively breastfeeding mothers with insufficient lactation. International Breastfeeding Journal. [8] Conaway, E.M., & O\'Donnell, A.E. (2025). Osteopathic manipulation to increase lactation quantity: a prospective case series. Journal of Osteopathic Medicine [9] Prakasam, A., Darji, P., Kumar, P. (2024). Therapeutic benefits of Fenugreek on Breast Milk Production and Weight Gain Among Newborns. Journal of Natural Products. [10] Kundarti, F.I., Aliza, N.N., & Indriani, R. (2025). Nigella sativa oil increases breast milk production post-caesarean. Jurnal Riset Kesehatan. PDF [11] Yanti, E.F., et al. (2025). Formulation of Katuk (Sauropus androgynus) extract effervescent tablets. Indonesian Pharmacopeia Journal https://ipj.uds.ac.id/ipj/article/view/44 [12] Hill, P. D., Aldag, J. C., Chatterton, R. T., & Zinaman, M. (2005). Comparison of milk output between mothers of preterm and term infants: the first 6 weeks after birth. Journal of Human Lactation, 21(1), 22-30. [13] Pahuja, A., Jain, M., & Rawat, K. (2024). A Review on Galactogogic Properties of India\'s Rich Tradition of Medicinal Herbs and Spices for Lactation. Traditional and Integrative Medicine, 308-317. [14] Shen, X., Lin, S., Li, H., Amaerjiang, N., Shu, W., Li, M., ... & Hu, Y. (2022). Timing of breastfeeding initiation mediates the association between delivery mode, source of breastfeeding education, and postpartum depression symptoms. Nutrients, 14(14), 2959. [15] Derakhshani, M., Asgarian, A., Tousi, H., Zainolabedini-Naeiny, Z., Miraj, S., & Gharlipour, Z. (2023). Cultural beliefs and practices in postpartum women in Iran: A qualitative study. Journal of West African College of Surgeons, 13(3), 28-35. [16] Garbacz, A., Juszczak, P., Nowicki, M., ?ukasz Kowalczewski, P., & Cz?apka-Matyasik, M. (2024). Exploring galactagogue use among breastfeeding women: Insights from an observational study. Plos one, 19(10), e0310867. [17] Sim, T. F., Hattingh, H. L., Sherriff, J., & Tee, L. B. (2015). The use, perceived effectiveness and safety of herbal galactagogues during breastfeeding: a qualitative study. International Journal of Environmental Research and Public Health, 12(9), 11050-11071. [18] Hauff, L. E., & Demerath, E. W. (2012). Poor positioning, decreased prolactin levels, and low milk output associated with early cessation of exclusive breastfeeding in obese women. [19] Khan, T. M., Wu, D. B. C., & Dolzhenko, A. V. (2018). Effectiveness of fenugreek as a galactagogue: A network meta?analysis. Phytotherapy Research, 32(3), 402-412. [20] McBride, G. M., Stevenson, R., Zizzo, G., Rumbold, A. R., Amir, L. H., Keir, A. K., & Grzeskowiak, L. E. (2022). Knowledge of galactagogue use during breastfeeding in Australia: a cross sectional online survey. Journal of Human Lactation, 38(4), 740-748.

Copyright

Copyright © 2025 Ms. Nabaa Khan, Dr. Vasudharani Agarwal. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.