Role of herbal galactogogues in initiating and establishing milk secretion in lactating mothers

Dr. S. Kamala¹*, Dr. M. Gandhimathi², Dr. Jeyagowri Subash³

^1,2Professors, Rani Meyyammai College of Nursing, Annamalai University.

³Vice Principal, Rani Meyyammai College of Nursing, Annamalai University.

*Corresponding Author Email: kamalapama@yahoo.co.in

ABSTRACT:

The aim of this article is to provide guidance to healthcare personnel to understand and support the establishment of increasing maternal milk secretion among lactating mothers. The commonest reason for mothers to start supplementary feeding is inadequate milk. Herbal galactogogues help in milk production, increase milk secretion and keep in sustaining breast feeding.

INTRODUCTION:

Breast milk has been accepted as the gold standard of infant nutrition. Generally in India breast feeding culture is on the rise and the majority have the opinion that all women can breast feed and regard breast feeding as distinctive feature of a good mother, NFHS 3 showed that the initiation of breast feeding within one hour was only 24.5% while the exclusive breast feeding rates of children under six months was only 46.4%¹. Although breast milk has been linked to many positive health outcomes, widespread adoption of exclusive breast feeding has been challenging.

Worldwide, maternal perception of insufficient milk production is the most common reason reported by mothers for early cessation of breast feeding(30% to 80%)². Many authors have reported that the main reason for difficulty in initiating breast feeding was the belief that just mother’s milk is not sufficient. For those mothers in whom milk production has declined and is not responding to non-pharmacologic measures the use of galactogogues is often considered as best option.

Galactogogues

Galactogogues otherwise termed as lactogogues are the substances which assist in the initiation, continuation and augmentation of maternal milk synthesis. Currently medicinal galactogogues have potential adverse side effects. Usually galactogogues either herbs or drugs are recommended as a last resort and current research about all galactogogues is relatively inconclusive.

Commonly used pharmacological galactogogues are metaclopromide and domperdon. The main drawback of using these medicinal galactogogues is there are no strong empirical evidences with regard to their efficacy in initiating lactation and also the side effects of these drugs are not carefully assessed and examined. These drugs are not used in many countries or approved by regulatory mechanism³.

Herbal galactogogues

In India and many other non western cultures, lactating mothers are provided with traditional herbal foods which initiate milk secretion. Traditionally, lactating mothers are given complete rest, with well balanced traditional foods which include one or many galactogogues¹

Commonly used herbal galactogogues are fenugreek, goat’s rue, milk thisle, oats, dandelions, millet, seaweed, anise, basial, blessed thisle, fennel sheeds, marsh mallows and many others. The action of many herbs are not known and many herbs are not scientifically evaluated, but the usage suggest safety and possible efficacy. Galactogogues should be recommended to the mothers once the non pharmacologic measures fail to initiate or produce adequate milk supply³.

Recommendations for herbal galactogogues

Women experiencing difficulties in milk production which is evidenced by inadequate breast milk production and baby is not gaining weight usually start supplementary feeds

The following points to be kept in mind while prescribing herbal galactogogues

Evaluate why baby is not getting enough milk

· Take history and observe the breast feeding pattern

· Check progress in the weight of the baby

· Use non-pharmacologic measures like skin to skin contact, self breast massage, relaxation techniques, rooming in, demand feeding etc.

· Give information regarding smell, taste and how the herbal galactogogues is to be taken (e.g before food, with food, after food, etc)

· Prescribe galactogogues at the lowest possible doses. Screen the mothers for any allergies to the prescribed herbal galactogogues Obtain informed consent before using any galactogogues.⁴

Foods:

Foods which are commonly used to increase breast milk secretion include dandelion greens, asparagus, green peas, carrots, sweet potatoes, peas and water cress, parseley, etc⁵.

Herbs	Doses	Side effects
fenugreek (Trigonella foenum graceum)	Used as a tea of ¼ tsp seeds steeped in 80z of water for 10 minutes (3 to 4 times daily) alternatively 1-4 capsules can be consumed 580-610mgm	nausea in mother, diarrhoea in baby, lower blood sugar in some cases, increased perspiration, allergy and exacerbation of asthma
Garlic (Alli sativa bulbus)	1/4 tsp of seeds steeped in 8 oz of water for 10 mts strain and drink 1 cup, 3 times in a day (4-9 gm capsule daily	may decrease feeding time if garlic odor is unacceptable by the infant
goat’s rue (galega officinais)	Used as tea 1 tsp dried leaves steeped in 8 oz of water for 10 mts (2-3 times daily)	hypoglycemic agent, allergic reaction to baby)
Borage leaves, flowers (Borogo officinalis)	used as salad ½ cup at each feeding, eat flowers in salad	mild laxative, not to be used in pregnancy
milk thistle (cardui marial herbs)	12-15 gm daily	laxative effect and mild allergy
fennel and barley water (foenicum vulgere and hordeum genus)	Prepare barley water by soaking barley ½ cup in cold water or boil for by 20 mts. Mix barley water with one teaspoon fennel seeds and steep for 30 mts (3 to 4 times daily)
Dried borage leaves raspberry leaves Blessed thisle, Anise, cumin, fennel, caraway, coriander seeds, Galactogogues (brews) (one tea spoonful of any of these seeds)	Place leaves in a half gallon jar and fill with boiling water. Cap tightly and steep overnight. Strain out herbs and refrigerate before nursing the baby, boil it and add any of the aromatic seeds, let it cool and drink 3 to 4 times daily – ½ cup
Other common teas or infusions comfrey, red cloves

SUMMARY:

Breast milk has unparalleled benefits and its superiority is incomparable. Health personnel should take all the efforts to assist mothers in the initiation and establishment of breast feeding. Herbal galactogogues should be prescribed with appropriate caution. Though they are used widely and considered safe and efficacious, there is insufficient evidence of efficacy and safety. The mothers and newborns are to be followed up carefully for any allergic reaction following herbal therapy.

REFERENCES:

1. ABM clinical protocol, use of galactogogus in initiating rate of maternal milk secretion, Breast Feeding Medicine, 2011: vol 6(1) : 41-45

2. Lewis JA. Maternal perceptions of insufficient milk supply in breast feeding. Am. J. Maternal. C Nursing. 2009, 34: 264

3. McCuffin M. Hobbsc, Upton R, et al. American Herbal products associations. Botanical Safety Hand book, CRC press, Bocarolton, Fc 1997.

4. Grabay MD, Galactogogues, Medications that induce lactation, Hum Lact, 2002; 18: 274-279.

5. Swaflord S Berens P. Effect of fenugreek on breast milk volume (abstract), ABM News Views, 2000; 6(3): 21.

Received on 20.04.2015 Modified on 11.05.2015

Int. J. Nur. Edu. and Research 3(3):July-Sept., 2015; Page 335-336

DOI: 10.5958/2454-2660.2015.00019.8