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Background: Expensive lactation cookies (LCs) are marketed as milk boosters; however, their effectiveness remains unknown., Objectives: The objective of this study was to evaluate the effectiveness of the 1-mo daily intake of LCs on changes in objective and subjective milk production and breastfeeding self-efficacy., Methods: This is a 1-mo, randomized controlled trial among 18-45-y-old exclusively lactating parents of healthy, term, 2-mo-old infants living in the United States from March to December 2021. Participants (n = 176) were randomly assigned to eat daily 56.5 g of either LCs with "galactagogues" (oatmeal, brewer's yeast, flax seeds, and fenugreek) or conventional cookies containing similar weight, calories, and presentation but lacking galactagogues. The primary outcome was baseline-to-1-mo changes in human milk production rate (HMPR), measured with a validated milk expression protocol. Secondary outcomes included changes in perceived insufficient milk (PIM) and lactation self-efficacy scores., Results: Among 176 randomly assigned participants (age: 31.3 ± 5.8 y; 71.0% self-identified as White, 15.3% Hispanic/Latin, 6.3% Black, and 4.0% Asian), 90 participants (51.1%) completed endline HMPR measures and 129 (73.3%) completed secondary outcomes. Imputed models showed a mean increase in HMPR of 5.8 ± 15.7 mL/h in control participants and 5.5 ± 17.6 mL/h in the LC participants after 1 mo of daily intake of the cookie. No significant differences were observed with adjusted linear mixed models on the multiply imputed data comparing baseline-to-endline changes in HMPR, PIM, or breastfeeding self-efficacy: mean (SE) difference-in-differences for HMPR, -0.33 (4.97), P = 0.948; PIM scores (range: 5-50), -0.52 (1.83), P = 0.775; and self-efficacy scores (range: 14-70), 0.31 (2.23), P = 0.888, respectively., Conclusions: This study found no evidence for the effect of consuming LCs on HMPR, PIM, or breastfeeding self-efficacy in exclusively breastfeeding parents with an overall adequate perceived milk supply. Recommendations to consume LCs for increasing objective or subjective milk supply may deliver false hope and unnecessary financial costs at a vulnerable time., Trial Registration Number: This trial was registered at clinicaltrials.gov as NCT04805008., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Perceived insufficient milk supply is common among postpartum women and is a major reason for early weaning. Studies indicate a significantly higher incidence of insufficient milk supply in women who undergo cesarean section as compared with women who undergo vaginal delivery. Purpose: This study was designed to determine perceived milk supply in postpartum women who underwent a planned cesarean section, as well as related factors. Methods: Authors employed a descriptive correlational study design. Factors associated with milk supply perception in postpartum women (at 3 days postpartum) were collected from 141 postpartum women who planned to undergo cesarean section at a regional teaching hospital in northern Taiwan. A demographic data sheet, the Birth Practice Inventory, a visual pain analog scale, and the Hill and Humenick Lactation Scale were used to identify factors affecting the perceived milk supply of participants. Results: The study used multiple linear regression to identify significant predictors of milk supply perception. Four factors, including parity, type of anesthesia, time to initial breastfeeding, and use of formula, explained 23.1% of total variance among participants. Women who experienced epidural patient-controlled analgesia, those with delayed initial breastfeeding or lower breastfeeding frequency, and those who used formula supplementation earned relatively lower perceived milk supply scores. Conclusions/Implications for Practice: Study results indicate that medical staff should encourage postpartum women to commence breastfeeding, based on infant need, as early as possible and reduce formula use to increase breastfeeding frequency. Shifting to nonnarcotic analgesic medications from epidural patient-controlled analgesia as early as possible is also recommended to increase breastfeeding success. [ABSTRACT FROM AUTHOR]