GALACTAGOGUE USE, EXPERIENCES, AND INFORMATION SOURCES AMONG LACTATING MOTHERS IN PALESTINE: A CROSS-SECTIONAL STUDY

Abstract

Background: The importance of breastfeeding for infant and mother well-being has been established, but a large percentage of mothers utilize galactagogues (substances to improve milk supply) based on their feeling of inadequate supply or other reasons. In Palestine, traditional postpartum care is very important, but little is known about how galactagogues are used in this society. This study aims to assess Palestinian mothers' use of galactagogues, their understanding of these substances, the availability of support services, their perceptions of efficacy and safety, and their experiences when using these substances. Methods: In a cross-sectional study, 394 mothers (average age 28.2 ± 4.9 years) were questioned about their breastfeeding habits, sociodemographic characteristics, and, in particular, their usage and awareness of specific dietary, pharmaceutical, and herbal galactagogues. These data were analyzed using descriptive statistics with frequencies and percentages, and analytical statistics using chi-square test with respect to a p-value < 0.05. Results: Although 66.2% of mothers were familiar with the word "galactagogues," a great majority (97.2%) said they had used at least one substance to increase their milk production. Mothers who lived in cities (p = 0.004), those with higher levels of education (p < 0.001), and those receiving breastfeeding support (p < 0.001) had statistically significant associations with knowledge about galactagogues. Anise (72.6%), Tahini (66.0%), Black Seed (65.2%), and Caraway (64.2%) were the most often used traditional substances, while pharmaceutical choices such as Domperidone and Metoclopramide were not used, and awareness of them was infrequent (less than 5.5%). Traditional galactagogues were primarily recommended by family members, who also comprised the predominant source of nursing support (94.6%). On the other hand, 69.8% of respondents said that doctors were the best sources of factual information. The majority of traditional substances were started within the first three days postpartum and were judged to be moderately to very effective, and they had few side effects, less than 10.0%. Tahini was most frequently reported to cause weight gain (36.9%). Traditional herbs were thought to be quite safe (>90%), but pharmaceutical choices' perceived safety was still mostly uncertain (89.6%) for domperidone and (89.8%) for metoclopramide. Conclusion: Galactagogues, especially traditional herbal galactagogues, are used by many Palestinian mothers mainly due to the heavy influence of traditions, customs, cultural beliefs, and trust in herbal substances. Family advice plays a significant role in influencing and shaping galactagogue use among mothers. So, in this community, some of these substances may also be used as part of traditional postpartum care without a specific clinical or therapeutic case. The findings revealed a widespread use of galactagogues among mothers with different sociodemographic backgrounds and varying breastfeeding experiences, which emphasizes the need for medical providers to educate patients on the benefits and possible side effects of these substances based on evidence-based medicine.