Barley and Breastfeeding

Summary of use during lactation

Barley (Hordeum vulgare) contains starch, dietary fiber such as beta-glucan, and the enzyme diastase. Barley is a purported galactogogue and is used by mothers in many cultures to increase their milk supply.[1-6] Some animal evidence indicates that a polysaccharide in barley can increase serum prolactin,[5,7,8] and some evidence of galactogogue activity of barley malt and lemon balm in mothers of preterm infants.[9,10] Galactogogues should never replace evaluation and counseling on modifiable factors that affect milk production.[11,12] No data exist on the excretion of any components of barley into breastmilk, or on the efficacy of barley as a galactogogue. Barley is safe to be consumed during breastfeeding, except by persons with celiac disease. Allergy to barley occurs rarely. Dietary supplements do not require extensive pre-marketing approval from the U.S. Food and Drug Administration. Manufacturers are responsible to ensure the safety, but do not need to prove the safety and effectiveness of dietary supplements before they are marketed. Dietary supplements may contain multiple ingredients, and differences are often found between labeled and actual ingredients or their amounts. A manufacturer may contract with an independent organization to verify the quality of a product or its ingredients, but that does not certify the safety or effectiveness of a product. Because of the above issues, clinical testing results on one product may not be applicable to other products. More detailed information about dietary supplements is available elsewhere on the LactMed Web site.

Drug levels in milk and infant serum

Maternal Levels. Relevant published information was not found as of the revision date. Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

Relevant published information was not found as of the revision date.

Effects on lactation and breastmilk

Studies in animals indicate that a polysaccharide found in barley is apparently responsible for an increase in prolactin after beer ingestion.[5,7,8] Refer to the LactMed record on Alcohol for details. A double-blind study compared a commercial galactogogue product (Femaltiker, Nutropharma Llc., Poland) containing barley malt, 70% barley glucan and powdered lemon balm (Melissa officinalis) leaves to an identical placebo in the mothers of preterm infants. Mothers took one packet twice a day for 2 weeks, starting within 3 days of delivery. Milk volume was measured by mothers after extraction using an electric breast pump. Forty mothers in each group completed the study. On day 14 of the study the mothers in the barley group produced more milk than the mothers taking placebo (average 95 mL vs 62.5 mL). The total milk volume over the 2-week period was also greater in the active group compared to the placebo group (average 6036 mL vs 4209 mL).[9] The study had a rather high dropout rate and the results were not subjected to intention-to-treat analysis. A meta-analysis of randomized, controlled studies in the mothers of preterm neonates examined the efficacy of various herbal galactogogues in increasing milk supply. The authors concluded that a commercial product of barley malt with lemon balm (Femaltiker®) provided a significant increase in milk volume on day 4 postpartum, but low certainty evidence that it increases milk volume at day 7 and very low certainty evidence that the product increases milk volume throughout the 14-day intervention period.[10]

References

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2. Yarnell E. Botanical medicine in pregnancy and lactation. Altern Complement Ther 1997;3 (April):93-100.doi:10.1089/act.1997.3.93
3. Scott CR, Jacobson H. A selection of international nutritional and herbal remedies for breastfeeding concerns. Midwifery Today Int Midwife 2005;75:38-916320878 PubMed
4. Winterfeld U, Meyer Y, Panchaud A, et al. Management of deficient lactation in Switzerland and Canada: A survey of midwives' current practices. Breastfeed Med 2012;7:317-822224508 PubMed
5. Sawadogo L, Thibault JF, Rouau X, et al. The lactogenic action of plant extracts. In: Martinet J, Houdebine L, Herbert H, eds. Biology of lactation. Paris: Institut National de la Research Agrono; 1999:553-64.
6. Erarslan ZB, Kültür S. Medicinal plants traditionally used to increase breast milk in Turkey: An ethnobotanical review. J Herbal Med 2024;44:100849.doi:10.1016/j.hermed.2024.100849
7. Sawagado L, Houdebine LM. Identification of the lactogenic compound present in beer. Ann Biol Clin (Paris) 1988;46:129-343382062 PubMed
8. Koletzko B, Lehner F. Beer and breastfeeding. Adv Exp Med Biol 2000;478:23-811065057 PubMed
9. Wesolowska A, Pietrzak B, Kociszewska-Najman B, et al. Barley malt-based composition as a galactagogue - a randomized, controlled trial in preterm mothers. Ginekol Pol 2021;92:118-2533751522 PubMed
10. Cragg A, Levene I, Darabi S, et al. Herbal galactagogues to improve breastmilk production and lactation in mothers of preterm babies: A systematic review of clinical trials. Eur J Clin Nutr 202541350450 PubMed
11. Brodribb W. ABM Clinical Protocol #9: Use of galactogogues in initiating or augmenting maternal milk production, second revision 2018. Breastfeed Med 2018;13:307-1429902083 PubMed
12. Breastfeeding challenges: ACOG Committee Opinion, Number 820. Obstet Gynecol 2021;137:e42-e5333481531 PubMed