Postpartum hypogalactia is a common clinical problem that affects maternal and infant health and the continuation of breastfeeding. This review narrows the topic to traditional Chinese medicine formulas for postpartum hypogalactia and summarizes evidence from clinical application, mechanistic studies, and unresolved research issues. Current formula-based interventions are mainly applied to qi-blood deficiency, liver-qi stagnation, and phlegm-dampness obstruction patterns. Representative prescriptions include Shenqi Cuiru decoction, Cuiru decoction, Buxue Shengru granules, Liqi Jiedu Tongru decoction, and Cangfu Daotan pills. These formulas may improve milk volume, breast fullness, serum prolactin, and breastfeeding outcomes. Modern studies suggest that the lactogenic effects are associated with regulation of the hypothalamus-pituitary-mammary axis, correction of estrogen-progesterone imbalance, activation of JAK2/STAT5, PI3K/Akt/mTOR, and Wnt/β-catenin signalling pathways, attenuation of inflammatory responses, and promotion of mammary tissue repair. However, existing studies still have problems such as non-uniform syndrome diagnosis and inclusion/exclusion criteria, high heterogeneity of outcome indicators, insufficient high-quality randomized controlled trials, and limited elucidation of the material basis and targeted mechanisms of compound formulas. Future research should focus on constructing standardized clinical evaluation systems, strengthening evidence-based designs, combining network pharmacology with multi-omics to elucidate key active components and mechanisms of compound formulas, and promoting the development of standardized formulations. This review may provide references for clinical syndrome differentiation and treatment of postpartum hypogalactia and secondary development of traditional Chinese medicine compound formulas.

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