Presentation is loading. Please wait.

Presentation is loading. Please wait.

Herbs and Foods as Galactogogues Lisa Marasco, MA IBCLC © Copyright Lisa Marasco 2007.

Similar presentations


Presentation on theme: "Herbs and Foods as Galactogogues Lisa Marasco, MA IBCLC © Copyright Lisa Marasco 2007."— Presentation transcript:

1 Herbs and Foods as Galactogogues Lisa Marasco, MA IBCLC © Copyright Lisa Marasco 2007

2 Herbs: the original “medicine”

3 Current day knowledge There is little in the American literature regarding the use of herbs in general, and almost no research on herbal galactogogues at all Our basic knowledge comes from Commission E (Germany), oral & written tradition, and anecdotes

4 Many resources flawed; not all animal studies can or should be extrapolated to humans, as plant actions can vary on different animals Many report isolated in vitro study results without consideration of actual in vivo experience: thus, some herbs experienced as galactogogues may be “contra-indicated” due to theoretical concerns not proven in vivo Judging an herb by individual constituents does not take into account the possibly ameliorating effects of its other constituents

5 Herb X Example: Herb X ACTIONS Antidepressant, antihypercholesterolemic, cardiotonic, demulcent, laxative, nervine, nutritive, thymoleptic, tonic CHEMICALS & NUTRIENTS Calcium, Carbohydrates, Chlorine, Choline, Fats, Fiber, Iron, Magnesium, Manganese, Phosphorus, Potassium, Protein, Sodium, Starch, Sulfur PREPARATION & DOSAGES (3x/day) Liquid extract: 1:1 in 25% alcohol, dose ml Tincture: 1:5 in 45% alcohol, dose 1-5 ml CONTRAINDICATIONS: Celiac disease.

6 DRUG INTERACTIONS Due to the cardioactive chemicals in this herb the following drug interactions are possible: interference and/or antagonism with antiarrhythmics; antagonism of beta-adrenoceptor blocking drugs; potentiation of cardiac glycosides and increased risk of hypokalemia; when combined with depolarizing muscle relaxants there is a risk of arrhythmia; interference with nitrates and calcium-channel blockers; may increase the potential terfenadine has to cause arrhythmias. SIDE EFFECTS (Possible adverse effects and/or overdose effects) Allergic reactions. WARNING Large doses can cause headaches and diarrhea. REFERENCES 1. Weiss RF. Herbal Medicine. Gothenburg, Sweden: Ab Arcanum, 1988, OATS! herb X

7 Understanding the issues While there is some regulation of herbs, quality/potency can still vary, especially with non-standardized products. Standardized vs Non-standardized Part of plant used or % of parts in mix used (Different parts can have different effects) Freshness of herb Time on shelf (limited life) light exposure Some brands more reliable than others.Some brands more reliable than others.

8 Potential toxicities are not well understood Potential for allergic reactions often overlooked; ie, chamomile is related to ragweed, therefore not recommended to those with ragweed allergies Opinions vary between experts

9 Targeting: the unconsidered problem Targeting: the unconsidered problem We don’t know a lot about how many of the galactogogues act Little research has been done on reputed herbal galactogogues to analyze how they may work (exception: Farnsworth)Little research has been done on reputed herbal galactogogues to analyze how they may work (exception: Farnsworth) Are they boosting prolactin, or another part of the equation?Are they boosting prolactin, or another part of the equation? Inherent difficulties of researching galactogoguesInherent difficulties of researching galactogogues

10 Or are we simply guessing our target and hoping to hit the right one? Or are we simply guessing our target and hoping to hit the right one? Underlying problems may vary; does the herb even affect the problem system…

11 Potency varies by manufacturer Potency can vary by batch Experts vary on recommendations Most pkg instructions based on generic use, not lactation Little info on therapeutic dosages for lactation Titrate to needTitrate to need Dosing: No such thing as “the right amount”

12 Teas Cover to steepCover to steep Crush seedsCrush seeds Can use sweetenersCan use sweeteners Tinctures Strengths varyStrengths vary Some dosed by weight, others by standardsSome dosed by weight, others by standards Capsules Check capsule size (mg/grams); many suggested dosages do not specify mgs.Check capsule size (mg/grams); many suggested dosages do not specify mgs.

13 Best reference aid Herb ratings: A A- no safety issues identified; generally considered safe when used appropriately B B- May not be appropriate for self- use by some individuals, or may cause side-effects if misused. Seek reliable safety and dose info. C C- Moderate potential for toxicity, mainly dose related D D- Use only with supervision of knowledgeable physician E E- Avoid. Toxic plant with no justifiable medical use. By Sheila Humphrey RN IBCLC

14 Better known herbs reputed to be galactogogues

15 Anise seed (B) Pimpinella anisum NOT star anise anti-spasmodic, mildly estrogenic, expectorant, carminative, aromaticActions: anti-spasmodic, mildly estrogenic, expectorant, carminative, aromatic (Handout: Indexing Herbs by Action) May also be helpful for MERMay also be helpful for MER Parts used: seedParts used: seed “Culinary use”

16 Safety: USA: GRAS UK: General sales list Canada: approved as an OTC drug France: Traditional Medicine Germany: Comm E approved as an OTC Not for use in pregnancyNot for use in pregnancy Tea: 1-2 tsp crushed seeds in 1 c water, cover & steep 10-20min, 3-6x/day.Tea: 1-2 tsp crushed seeds in 1 c water, cover & steep 10-20min, 3-6x/day. Tincture: 3ml 2-3x/dayTincture: 3ml 2-3x/day

17 culinary use… Caraway seed (A) appetite stimulant, anti-spasmodic, expectorant, carminative, emmenagogue, astringentActions: appetite stimulant, anti-spasmodic, expectorant, carminative, emmenagogue, astringent Parts used: seedParts used: seed Has been used for infant colicHas been used for infant colic considered safe by FDASafety: considered safe by FDA Often combined with other herbsOften combined with other herbs Tea: 1-2 tsp/5oz water, steep min, 5-6x/dayTea: 1-2 tsp/5oz water, steep min, 5-6x/day Tincture: 3ml TID Tincture: 3ml TID Carum carvi

18 Coriander- Coriandrum sativum Seed of cilantro plantSeed of cilantro plant Popular galactogogue among Chinese and Indian mothersPopular galactogogue among Chinese and Indian mothers Diuretic, nutritive, anti-flatulent, anti- diabetic (mild)Diuretic, nutritive, anti-flatulent, anti- diabetic (mild) 1 heaping T seeds to 1 mug of hot water, steep min, take 3-5x per day. Can sweeten as desired.1 heaping T seeds to 1 mug of hot water, steep min, take 3-5x per day. Can sweeten as desired.

19 culinary use… Dill (A)- Anethum graveolens anti-spasmodic, diuretic, carminative, emmenagogue, anti- inflammatory, aromaticActions: anti-spasmodic, diuretic, carminative, emmenagogue, anti- inflammatory, aromatic Parts used: seedParts used: seed Used in “gripe water”Used in “gripe water” May help with MERMay help with MER Contraindicated for low sodium dietsContraindicated for low sodium diets Often combined with other herbsOften combined with other herbs

20 Dill culinary use Tea: 2 tsp/8oz water, steep min, 2-3x/dayTea: 2 tsp/8oz water, steep min, 2-3x/day Decoction: Steep ½ c dill seeds in water overnight; boil until very dark in color, strain. Drink one cup of this a day.Decoction: Steep ½ c dill seeds in water overnight; boil until very dark in color, strain. Drink one cup of this a day. 2 tsp seeds on meal2 tsp seeds on meal

21 culinary use… Fennel Seed (A) Hale L4 Foeniculum vulgare Liver, anti-spasmodic, diuretic, aromatic, estrogenic (weak)Actions: Liver, anti-spasmodic, diuretic, aromatic, estrogenic (weak) Parts used: seedParts used: seed Note: has toxic look-alike relatives!Note: has toxic look-alike relatives! For gastrointestinal disordersFor gastrointestinal disorders One source suggests may promote milk ejection; another suggest may have bust- enhancing propertiesOne source suggests may promote milk ejection; another suggest may have bust- enhancing properties Also studied for anti-hirsutism propertiesAlso studied for anti-hirsutism properties

22 Possible side effects: allergic reactions, dermatitis. Fennel oil can be toxic. Avoid.Possible side effects: allergic reactions, dermatitis. Fennel oil can be toxic. Avoid. Hale: L4 due to concerns regarding estrogenic property effects on lactationHale: L4 due to concerns regarding estrogenic property effects on lactation Safety: One European case report of 2 infants who reportedly became weak and lethargic when mom ingested 2 qts of tea daily made from fennel, licorice, galega. However, plants never ID’d.Safety: One European case report of 2 infants who reportedly became weak and lethargic when mom ingested 2 qts of tea daily made from fennel, licorice, galega. However, plants never ID’d. Not recommended during pregnancyNot recommended during pregnancy culinary use…

23 culinary use Tea: 1-3 tsp freshly crushed seeds per 8oz water, steep min, 2-6x/dayTea: 1-3 tsp freshly crushed seeds per 8oz water, steep min, 2-6x/day Tincture: 3ml X 3Tincture: 3ml X 3

24 culinary use… Fenugreek (B) Hale L3 Trigonella foenum-graecum Stimulate breast growth,digestive aid, hypoglycemic, expectorant, emmenagogue, anti- inflammatory, hypotensive, demulcent, diaphoreticActions: Stimulate breast growth, digestive aid, hypoglycemic, expectorant, emmenagogue, anti- inflammatory, hypotensive, demulcent, diaphoretic Parts used: seedParts used: seed

25 Source of iron?Source of iron? May have hypotensive and thyroid supporting propertiesMay have hypotensive and thyroid supporting properties Most studied of all lactogenic herbsMost studied of all lactogenic herbs U.S. listed GRAS (generally regarded as safe) when used in moderationU.S. listed GRAS (generally regarded as safe) when used in moderation

26 Mother’s sweat and urine usually smell like maple syrupMother’s sweat and urine usually smell like maple syrup Possible side effects: diarrhea (mother or baby), stomach upset, hypoglycemia, allergy. Could worsen asthma. Contraindicated for pregnancy. May lower cholesterol.Possible side effects: diarrhea (mother or baby), stomach upset, hypoglycemia, allergy. Could worsen asthma. Contraindicated for pregnancy. May lower cholesterol. Research Issues:Research Issues: Difficult to create placeboDifficult to create placebo Form/brand to testForm/brand to test Ethics of withholding helpEthics of withholding help

27 culinary use… Dosage: Capsules: mg caps 3-4x dayCapsules: mg caps 3-4x day Max 6gms/day (Frank Nice) BUT some people have used up to 4 qidMax 6gms/day (Frank Nice) BUT some people have used up to 4 qid Tea: 1 tsp seeds/8oz water, steepTea: 1 tsp seeds/8oz water, steep 5-10 min, x2-3. If seeds crushed, use ¼ tsp 5-10 min, x2-3. If seeds crushed, use ¼ tsp Tincture: 1-2ml TIDTincture: 1-2ml TID Often combined with Blessed ThistleOften combined with Blessed Thistle

28 Shatavari (B) Also known as “hundred husbands” Found in Africa, India, Australia, Asia Considered “the strongest” herb for female issues, is used for infertility, prevent miscarriage, increase milk supply, increase breast tissue Diuretic, nutritive, laxative. Mucilaginous. Considered “anti-oxytocic” for uterine contractions during pregnancy Asparagus racemosa

29 H.S. Puri, Rasayana: Ayurvedic herbs for Longevity & Rejuvenation “ Regularizes” menstruation, dysmenorrhea and fertility Pregnancy: “used for proper breast development, embryonic growth & to rid genital of diseases.” Powder form only first 8 mos Oil for vaginal swab 9 th mo for elasticity, “easy and painless delivery” 5-10gm asparagus powder with warm milk recommended for pregnancy/lactation

30 1-2 tsp root powder stirred into warm milk 1-2x a day1-2 tsp root powder stirred into warm milk 1-2x a day Or one capsule twice a day Or one capsule twice a day Considered safe for pregnancy and lactation Considered safe for pregnancy and lactation

31 Alfalfa (A-plant) Medicago sativa estrogenic (weak), nutritive, may stimulate appetite.Actions: estrogenic (weak), nutritive, may stimulate appetite. Parts used: leavesParts used: leaves Nutrition: High in chlorophyll beta carotene, calcium. Contains vitamins A,B1,B6,B12,C,E, K1 along with potassium, phosphorus, iron and zinc.Nutrition: High in chlorophyll beta carotene, calcium. Contains vitamins A,B1,B6,B12,C,E, K1 along with potassium, phosphorus, iron and zinc. Non-culinary herbal galactogogues

32 non-culinary Said to increase supply in cowsSaid to increase supply in cows Report of presence of “TRH-like material” which may in turn stimulate prolactin releaseReport of presence of “TRH-like material” which may in turn stimulate prolactin release Possible diuretic and pituitary function support propertiesPossible diuretic and pituitary function support properties Possible side effects: allergies, diarrhea. May lower cholesterol.Possible side effects: allergies, diarrhea. May lower cholesterol. Avoid with lupus or rheumatoid arthritis.

33 Dosages 1-2 tablets or capsules 3-4x/day1-2 tablets or capsules 3-4x/day Tea: 1-2T dried leaves/5oz water 2- 4x/dayTea: 1-2T dried leaves/5oz water 2- 4x/day Tincture: ½- 4ml 4x/dayTincture: ½- 4ml 4x/day 1T dried juice powder 2x/day1T dried juice powder 2x/day Homeopathic alfalfa: 6 tablets per day (KM)Homeopathic alfalfa: 6 tablets per day (KM) Can be combined with homeopathic Lactuca virosaCan be combined with homeopathic Lactuca virosa

34 Cnicus benedictus Cnicus benedictus Blessed Thistle (B) Hale L3 appetite stimulant and digestive aid, hormone balancer, cholagogueActions: appetite stimulant and digestive aid, hormone balancer, cholagogue Parts used: leaf, stem, flowerParts used: leaf, stem, flower Often used in conjunction with fenugreekOften used in conjunction with fenugreek Reputed to “increase the flow of milk”Reputed to “increase the flow of milk” Avoid during pregnancyAvoid during pregnancy Safety: considered nontoxicSafety: considered nontoxic

35 non-culinary Dosage: Tea 1-2 tsp crushed seeds in 5oz water (bitter) 5- 6x/dayTea 1-2 tsp crushed seeds in 5oz water (bitter) 5- 6x/day Tincture: 1-3mls 2-4x/dayTincture: 1-3mls 2-4x/day 1-3 caps ( mg) 3x/day when combined with fenugreek or up to 6g total if used alone (per Commission E)1-3 caps ( mg) 3x/day when combined with fenugreek or up to 6g total if used alone (per Commission E)

36 non-culinary Borage - Borago officinalis diuretic, expectorant, anti- inflammatory, nervine, demulcent, diaphoretic, tonic, mucilaginousActions: diuretic, expectorant, anti- inflammatory, nervine, demulcent, diaphoretic, tonic, mucilaginous Parts used: leaf, flowerParts used: leaf, flower Nutrition: potassium, calcium; oil rich in omega 3 fatty acidsNutrition: potassium, calcium; oil rich in omega 3 fatty acids

37 Oil (A) reputedly increases creaminess of milkOil (A) reputedly increases creaminess of milk 2-5ml x3 OR2-5ml x3 OR 1000mg 1-4x/day1000mg 1-4x/day Leaves (C) reputed to help milk supply, but must be used judiciously as large amounts can cause liver damageLeaves (C) reputed to help milk supply, but must be used judiciously as large amounts can cause liver damage 2 tsp dried herb x32 tsp dried herb x3

38 non-culinary Chasteberry - Vitex agnus castus (B) Hormone balancer, tonicActions: Hormone balancer, tonic Reputed to “normalize” pituitary function, used for luteal phase insufficiency (“shift” in ovarian hormones in favor of progesterone), irregular cycles, PMS. Promotes fertility. May help MER?Reputed to “normalize” pituitary function, used for luteal phase insufficiency (“shift” in ovarian hormones in favor of progesterone), irregular cycles, PMS. Promotes fertility. May help MER? Parts used: fruit

39 Sometimes used for PCOSSometimes used for PCOS Reputed to “modulate” Prolactin levelsReputed to “modulate” Prolactin levels 1943 Study found increase in milk1943 Study found increase in milk production in 80% of 125 patients. production in 80% of 125 patients controlled trial of 817 patients claimed that avg milk production 3X that of controls1957 controlled trial of 817 patients claimed that avg milk production 3X that of controls

40 Conflicting info: “May bring on milk flow “May bring on milk flow early” if used in pregnancy. early” if used in pregnancy. hypoprolactinemic agent, hypoprolactinemic agent, suppressed lactation in rats suppressed lactation in rats In men, small dose In men, small dose (120mg/day) increased PRL (120mg/day) increased PRL while large dose (500mg) while large dose (500mg) inhibited it. inhibited it. May take time for effects May take time for effects to kick in? to kick in?

41 May interfere with ReglanMay interfere with Reglan Tea: 1 tspripe berries infused in 8oz water min; drink 3x/day (bitter)Tea: 1 tsp ripe berries infused in 8oz water min; drink 3x/day (bitter) Capsules: 2-“00” per day or 30-40mg/day (Humphrey)Capsules: 2-“00” per day or 30-40mg/day (Humphrey) Tincture: 1ml x3 or up to 5mls daily (1:5 conc)Tincture: 1ml x3 or up to 5mls daily (1:5 conc)

42 non-culinary Goat’s Rue (B) – Galega Officinalis stimulate breast growth;milk; diuretic; hypoglycemic; emmenagogue; diaphoretic;Actions: stimulate breast growth; milk; diuretic; hypoglycemic; emmenagogue; diaphoretic; Parts used: dried aerial partsParts used: dried aerial parts upon which phenformin was basedContains galegin, upon which phenformin was based

43 Reputation for causing breast growthReputation for causing breast growth French dairy farmers noted 35-50% increase in output of milk in their herdsFrench dairy farmers noted 35-50% increase in output of milk in their herds Popular among French nursing mothersPopular among French nursing mothers Controversy: toxicity in sheepControversy: toxicity in sheep No reports of problems in human use Peripheral Receptor Sensitizer?Peripheral Receptor Sensitizer?

44 Goat’s Rue Dosage: No consensus, but consider taking with food Tea: 1 tsp leaves/5-8oz water,Tea: 1 tsp leaves/5-8oz water, steep min, 3-5x/day steep min, 3-5x/day Tincture:Tincture: 2.5ml X 4 (Wise Woman Herbal)2.5ml X 4 (Wise Woman Herbal) 3-4ml x 4 (Mechell Turner)3-4ml x 4 (Mechell Turner) 1-2ml x3 (MotherLove)1-2ml x3 (MotherLove) 1 tsp in 8oz water TID (LowDog)1 tsp in 8oz water TID (LowDog) Capsule: 1 cap 4x/day (Motherlove)Capsule: 1 cap 4x/day (Motherlove)

45 non-culinary Ixbut - Euphorbia lancifolia (C) From Ix (woman) and but (increase in flow or volume)From Ix (woman) and but (increase in flow or volume) Ancient Mayan galactogogue used when milk supply insufficient.Ancient Mayan galactogogue used when milk supply insufficient. Popular back in the 1940’s, still occasionally used by rural women in Guatemala. Also found in SE Mexico, rural women in Guatemala. Also found in SE Mexico, Belice, El Salvador and Honduras. Belice, El Salvador and Honduras. “Said to double the quantity of milk given by cows that “Said to double the quantity of milk given by cows that eat it.“ High amounts appeared to cause decrease after eat it.“ High amounts appeared to cause decrease after several days……. Moderation important? several days……. Moderation important?

46 ixbut Claimed “to cause milk to flow after it has ceased normally, or even in women who have not given birth to a child……. That aged grandmothers, after taking Ixbut, have been able to suckle newly born infants through withered breasts….” Aerial parts used– leaves and branchlets Typical “dose” tea made from 5 leaves or sections Typical “dose” tea made from 5 leaves or sections of stem (~ 5gms) and 1 cup of water, 3x/day of stem (~ 5gms) and 1 cup of water, 3x/day Dehydrated leaves high in calcium? Pozo 1949 study: no changes in breast volume or milk composition noted, only milk volume. milk composition noted, only milk volume. Galactagogue properties appear higher in November before plant blossomed Euphorbia family (esp. hirta) has many reputed galactagogues, galactagogues, but toxicity concerns have precluded common use

47 Althaea officinalis Marshmallow root (A) diuretic; expectorant; anti-inflammatory; demulcent; mucilaginousActions: diuretic; expectorant; anti-inflammatory; demulcent; mucilaginous Parts used: root and leafParts used: root and leaf Nutrition: calciumNutrition: calcium Galactogogue effect not direct, perhapssynergistic;one herbalist uses it “when baby isn’t gaining weight well”Galactogogue effect not direct, perhaps synergistic; one herbalist uses it “when baby isn’t gaining weight well” May help counteract loose bowel effects of alfalfa, fenugreek, blessed thMay help counteract loose bowel effects of alfalfa, fenugreek, blessed th

48 Tea: 1T root powder/ 5oz water, let stand 30 min; drink immediately.Tea: 1T root powder/ 5oz water, let stand 30 min; drink immediately. Tincture: 1-4 ml 3x/dayTincture: 1-4 ml 3x/day Capsules: up to 4 caps 3x dailyCapsules: up to 4 caps 3x daily

49 Silybum marianum Milk Thistle (A) Liver, demulcent; cholagogueActions: Liver, demulcent; cholagogue Contains silibinin, silydianin, silychristinContains silibinin, silydianin, silychristin Parts used: seeds or leavesParts used: seeds or leaves Mechell Turner says leaves are used for milk supply Possible side effects: mild laxative effect, diarrhea, mild allergen.Possible side effects: mild laxative effect, diarrhea, mild allergen.

50 Milk thistle Tea: 1 tsp freshly crushed seeds in 5oz water, steep min. 5- 6x/dayTea: 1 tsp freshly crushed seeds in 5oz water, steep min. 5- 6x/day Tincture: 3-5ml 3x/dayTincture: 3-5ml 3x/day Capsules: two 500mg 3x/dayCapsules: two 500mg 3x/day

51 Urtica dioica, urens Nettle (A) astringent, diuretic, tonic, hypotensive.Actions: astringent, diuretic, tonic, hypotensive. Parts used: aerial partsParts used: aerial parts For gastrointestinal disordersFor gastrointestinal disorders High in chlorophyll; also Vit C, ironHigh in chlorophyll; also Vit C, iron Possible side or overdose effects: gastritis, edema, burning sensation of skinPossible side or overdose effects: gastritis, edema, burning sensation of skin

52 Tea: 2-3 tsp herb in 1c water; steep 10 min, 2-3x/dayTea: 2-3 tsp herb in 1c water; steep 10 min, 2-3x/day Leaf Tincture 2.5-5ml 3x/dayLeaf Tincture 2.5-5ml 3x/day Capsules: mg 3x/dayCapsules: mg 3x/day

53 non-culinary Red Clover (B) Trifolium pratense Actions: anti-spasmodic; expectorant; estrogenic (weak) stomachic; cholagogueActions: anti-spasmodic; expectorant; estrogenic (weak) stomachic; cholagogue Parts used: flower headParts used: flower head Use in pregnancy considered controversialUse in pregnancy considered controversial Use non-fermented onlyUse non-fermented only

54 Dosage Tea: 1-3 tsp herb in 5oz water; 3x/dayTea: 1-3 tsp herb in 5oz water; 3x/day Tincture: 2-6 ml 3x/dayTincture: 2-6 ml 3x/day

55 non-culinary Red Raspberry (A) Rubus idaeus Astringent, tonic, parturientAstringent, tonic, parturient Parts used: leaves, fruitParts used: leaves, fruit Nutrition: vitamin A, B complex, C, E, calcium and iron, phosphorous, potassium.Nutrition: vitamin A, B complex, C, E, calcium and iron, phosphorous, potassium. Galactogogue effect uncertain; one source says it is believed to lower supply long term, but may help if used short term (<1wk)Galactogogue effect uncertain; one source says it is believed to lower supply long term, but may help if used short term (<1wk) Other sources say it “increases the flow” and “enriches” the milk, use tea to aid milk ejection Other sources say it “increases the flow” and “enriches” the milk, use tea to aid milk ejection Tea: 1 tsp leaves/5oz water, steep 5-10 min, 2-4x/day Tea: 1 tsp leaves/5oz water, steep 5-10 min, 2-4x/day Tincture: 3-4mls 3x/day Tincture: 3-4mls 3x/day Capsules: 3-300mg caps 3x/day Capsules: 3-300mg caps 3x/day

56 Historical use includes for treatment of “underdeveloped breasts,” “a galactia;” “increased lactation;” “breast enlargement.”Historical use includes for treatment of “underdeveloped breasts,” “a galactia;” “increased lactation;” “breast enlargement.” Parts used: fruitParts used: fruit Nutrition: The leaves have a very high content of vitamin A as well as moderate amounts of vitamin D, vitamin C, various B vitamins, iron, silicon, magnesium, zinc, and manganese.Nutrition: The leaves have a very high content of vitamin A as well as moderate amounts of vitamin D, vitamin C, various B vitamins, iron, silicon, magnesium, zinc, and manganese. Saw Palmetto (A) Serenoa repens

57 Dosage (general) 320mg daily320mg daily tinc: 1-2ml 3x/daytinc: 1-2ml 3x/day tea: ½-1 tsp berries in 1c water, simmer 5 min, drink 3x/daytea: ½-1 tsp berries in 1c water, simmer 5 min, drink 3x/day

58 non-culinary Vervain : Verbena officinalis (B) Actions: nervine, anti-spasmodic, diaphoretic, hypotensive, hepaticActions: nervine, anti-spasmodic, diaphoretic, hypotensive, hepatic Reputedly oxytocic and uterotonicReputedly oxytocic and uterotonic Parts used: aerial partsParts used: aerial parts More often found in combinationsMore often found in combinations Dosage:Dosage: Considered safe in appropriate dosages; not for pregnancyConsidered safe in appropriate dosages; not for pregnancy Tea: 1 tsp per 5oz water steep min, drink 3x/dayTea: 1 tsp per 5oz water steep min, drink 3x/day European Infusion: 30-60g herb in 1 qt boiling water; steep minEuropean Infusion: 30-60g herb in 1 qt boiling water; steep min Tincture: 2-4ml 3x/dayTincture: 2-4ml 3x/day

59 Others on the horizon Ashwagandha (C) Black Cohosh (B) hypotensive Chickweed (A) thyroid, ovarian cysts Dandelion (A) diuretic Hops (A) diuretic; bust enhancement? Licorice (B) another aromatic herb Oat Straw (A) iron; diuretic; pituitary Handouts: Herbs by family, Herbs by similar action

60 Commercially available herbal galactogogue tinctures More Milk, More Milk Plus (Motherlove Herbal): Blessed Thistle, Nettle, Fennel; plus adds Fenugreek. MM+ now 1:3, or also in glycerin form. More Milk Special Blend (Motherlove Herbal): adds goat’s rue to More Milk Plus (1:5)More Milk Special Blend (Motherlove Herbal): adds goat’s rue to More Milk Plus (1:5) More Milk Two (Motherlove Herbal) : Raspberry leaf, Nettle, Alfalfa. Considered safe for use during pregnancy.

61 Mother’s Lactaflow (Wise Woman Herbals) Fennel Blessed thistle Fenugreek Goat’s rue Suggested dosage drops 3-4x per day other combinations…

62 Commercial Tinctures…. Make Milk (Laura Nevada Lactation): Fenugreek, Blessed Thistle, Borage, Goat’s Rue M&B-A: (Pure Herbs) Marshmallow root, Fenugreek, Blessed Thistle, Universal ER, Plaintain, Fennel

63 Nursing Mother’s Blend (Kerry’s Herbals) Fenugreek Blessed Thistle Goat's Rue Alfalfa Anise Abundant Milk Tincture (Growing Life) Blessed thistleBlessed thistle FennelFennel FenugreekFenugreek PeppermintPeppermint Lemon grassLemon grass

64 Commercial tinctures Ancient One’s formula (B&BR): Anise, Dill, Fennel, Fenugreek. Made of kitchen-familiar herbs only, for those not comfortable with the unknown. LC’s proprietary blend (B&BR): Blessed Thistle, Fenugreek. Most commonly demanded herbs. Milk In Formula (B&BR): Blessed Thistle, Borage, Fenugreek, Goat’s Rue, Red Raspberry. When nothing else seems to be working.

65 Commercial tinctures Mega Milk FormulaMega Milk Formula (B&BR): Blessed Thistle, Borage, Red Raspberry. For those who don’t want fenugreek. Anti-Puffy FormulaAnti-Puffy Formula (B&BR): Dandelion, Cornsilk. For postpartum edema. Let-down FormulaLet-down Formula (B&BR): Black Cohosh, Motherwort, Schizandra berries. Can also get with added fenugreek. When MER seems to be the problem, not available milk

66 Combination Galactogogues in Capsules More Milk Plus Fenugreek, blessed thistle, nettle, fennel Dosage: 1 capsule QID or 2 caps TID if >175lbs or not working well after 48 hrs

67 “Lactation Blend” ( Vitanica** ) Fennel Seed mg Nettles Leaf mg Blessed Thistle mg Vervain mg Hops mg Oat Straw mg Raspberry Leaf mg Goat's Rue aerial parts mg Chaste tree berry mg Fenugreek Seed mg Milk Thistle Seed mg Borage Seed Oil mg Borage Flower & Top mg TOTAL mg per capsule 590 mg Recommended dosage 1-2 caps per day *Recommended dosage 1-2 caps per day **formulated by Dr. Tori Hudson, Naturopath **formulated by Dr. Tori Hudson, Naturopath capsules…

68 Baby Me Now Lactation Ease (Solaray) Fenugreek, fennel, nettle Mfr reputation?????

69 Nonichai Noni (leaves) Cardamom (seed) Marshmallow herb (root) Fennel (seed) Fenugreek (seed) Dosage: 2 capsules per day ??????

70 Gactogogue Teas Mother’s Milk Tea (Traditional Medicinals): Fennel, Anise, Coriander, Spearmint, Lemongrass, Lemon verbena, Althea root, Blessed thistle, Fenugreek. –Milder than tinctures, usually taken as 1-4 cups a day. Katherine Shealy finds 8 cups a day very effective. –Tasty iced tea version: 6 bags MMT + 4 bags Celestial Seasonings Wild Berry Zinger to make 3 qts tea; place in water bottles and sip throughout day.

71 Weleda Nursing Tea (Swiss) Swiss Formula: Nettle, Aniseed, Caraway and Fennel U.S. Formula: Fenugreek Seed, Anise Seed, Fennel Seed, Caraway Seed, Lemon Verbena Leaves. Combine one level 5ml teaspoon to 1 cup of cold water and bring to the boil. Simmer for one minute, steep 5 minutes.Directions 1: Combine one level 5ml teaspoon to 1 cup of cold water and bring to the boil. Simmer for one minute, steep 5 minutes. Directions 2: 1 tea bag to a cup of boiling water, cover and steep 5 minutes.Directions 2: 1 tea bag to a cup of boiling water, cover and steep 5 minutes. Drink 3 cups a day or as directed by your naturopath.Drink 3 cups a day or as directed by your naturopath. swiss U.S.

72 Fennel, fenugreek, anise, chamomile, lavendar Directions:pour 8 oz boiling water over one tea bag and steep for 5 to 10 minutes. Gently squeeze each tea bag to fully release the active ingredients. Drink 2 cups daily to maintain milk production or 1 cup every 3 hours to stimulate milk flow.Directions: pour 8 oz boiling water over one tea bag and steep for 5 to 10 minutes. Gently squeeze each tea bag to fully release the active ingredients. Drink 2 cups daily to maintain milk production or 1 cup every 3 hours to stimulate milk flow. Yogi Tea – Woman’s Nursing Mom

73 other combinations…. Abundant Milk Tea (Growing Life) Blessed thistle, fennel, fenugreek, peppermint, lemon grass

74 “Lactare” from India Asparagus RacemosusAsparagus Racemosus (Shatavari) 200mg Withania SomniferaWithania Somnifera (Ashwagandha) 100mg Glycyrrhiza glabraGlycyrrhiza glabra (European Licorice) 50mg FenugreekFenugreek 50mg Allium sativumAllium sativum (garlic) 20 mg Directions: 2 caps TID for first 14 days after delivery or as neededDirections: 2 caps TID for first 14 days after delivery or as needed Studies cited showing Lactare increases prolactin, milk production, creaminess of milk

75 Homeopathics Based on the Law of Similars, or “like treats like.” Counter-intuitive to western thought. Classical approach takes in-depth consititutional history and chooses one remedy onlyClassical approach takes in-depth consititutional history and chooses one remedy only Remedies are diluted until no measurable amount of source remains; can be found in 6x, 12x, 6c, 12c, 30c, 200c, L and M dilution/ potencies; typically used short term, ~ 3 days The greater the dilution, the more potent it is consideredThe greater the dilution, the more potent it is considered Best results when prescribed by practitioner rather than self-diagnosis

76 Advice from herbalist Mechell Turner, IBCLC: Do not touch the pills or tablets (remedy is on the outside of the pellet) Put the dose—usually 1 tablet or drop—into the lid of the bottle, or even a clean paper cup. (Often placed under tongue for quick absorption)Put the dose—usually 1 tablet or drop—into the lid of the bottle, or even a clean paper cup. (Often placed under tongue for quick absorption) Take the remedy only for the symptoms. If symptoms get worse, stop the dosage.If symptoms get worse, stop the dosage. Administer less frequently as symptoms improve. Usually do not take medicine for longer than 3 days.Usually do not take medicine for longer than 3 days. For emergencies use the 30C every 30 minutes to 1 hour for up to 10 doses. Then see above rule. Take the smallest dose for the shortest period of time.Take the smallest dose for the shortest period of time.

77 Homeopathics more commonly used for low milk supply….. *Urtica urens Considered a good galactogogue for general use. May be useful when there is a total absence of milk or when milk supply is slow to establish without an obvious cause. May be appropriate when hemorrhage or anemia precede low milk supply. *Lactuca virosa Considered a strong galactogogue overall, good for general use Suggested dosage 4 (30c) pellets QID or 2 (30c or 200c) BIDSuggested dosage 4 (30c) pellets QID or 2 (30c or 200c) BID

78 *Ignatia Often used for sudden loss of milk related to shock and grief. “I haven't seen this do much on it's own. However, when it's combined with a mild galactagogue like nettle I've seen amazing results.” -Jay Gordon’s website Suggested dosage: 2 (6x) tablets TID (KM)Suggested dosage: 2 (6x) tablets TID (KM)

79 Ricinus communis Hemorrhage or anemia preceding low milk supply Galega When anemia or poor nutrition are also variables Helonias (False Unicorn) When caused by extreme maternal exhaustion (super mom syndrome)

80 Dulcamara Traditionally used when sudden loss of milk occurs after exposure to cold and damp; may be helpful when low milk supply follows milk stasis (ie, engorgement). Agnus Castus When low milk supply is accompanied by depression. (Note: Patricia Hatherly believes this depression could possibly be related to hormones from retained placental products, the latter of which suppress lactation.)

81 Causticum Short-term exhaustion leading to drop in milk supply, ie mother up all night with baby. Most appropriate with personality that resists rather than “rolls with the punches.” Calcarea carbonica May be useful when breasts are engorged and milk is not flowing, or when low supply occurs with breast infection that is associated with engorgement. May possibly have application for milk supply when thyroid function is low.

82 Silicea Low milk supply related to poor maternal diet/extreme dieting. May also be appropriate when supply problems preceded by boggy uterus after childbirth, possible retained placental products, or inflamed breast infection Rescue Remedy When the milk is present but not flowing and mother is stressed from pain, fear of pain, etc. Use 4 drops sublingually before nursing or pumpingto facilitate milk ejection.Use 4 drops sublingually before nursing or pumping to facilitate milk ejection. Rescue Remedy can have a slight sedative effect, so use caution.

83 Selecting galactogogues A good maternal health history is important, including any medical conditions, allergies, history of depression, current medications What is the root of the problem? Is there a lactogenic medication or herb that seems to target this issue?

84 For example: (not exhaustive) Thyroid support:Thyroid support: dandelion, chickweed, nettle, vervain High Iron:High Iron: alfalfa, dandelion, fenugreek, nettle, red raspberry leaf, Pituitary support: alfalfa, chasteberry, Diuretic properties:Diuretic properties: alfalfa, blessed thistle, borage, coriander, dandelion, dill, fennel seed, goat’s rue, marshmallow, nettle, Milk ejection:Milk ejection: anise?, chasteberry?, dill, fennel seed?, red raspberry leaf? Anti-hypertensive: fenugreek, nettle, vervain Nervine:Nervine: anise, borage, fennel seed, vervain

85 What is mother’s comfort and philosophy regarding medications or herbs? Are there institutional or HCP restrictions on what can be used? Must work carefully within framework of mother’s HCPs Look for reputable manufacturers or herbalists Rotating herbs may work better for long- term dependence

86 Case Studies Case 1: Two babies, two different results Primary supply failure (but >50%) with baby #1 Did research, then used herbs for #2: During pregnancy: drank mix of Handfuls of Red Raspberry Leaf & Nettle Slightly less Alfalfa and Red Clover Blossom Heaping handful of the mixture to 1qt of boiling water steeped overnight (drank iced) Postpartum Adjustments: Added hops, blessed thistle, marshmallow root, fenugreek and goat’s rue powder (1 tsp ea/qt) Drank 1qt per day ~anecdotal~

87 Case 2: Break through experience Primigravida age 33 presented at 8 days pp. due to no BMs in 72 hrs, “brick dust” urine Baby born at home, 8#2, now 7#00.5. Mother feeding almost constantly. Family staunch vegans, opposed to commercial formulas Mildly hypoplastic type 2 breasts spaced ” apart mild pregnancy changes only. More palpable gland in L vs R Veining moderate Areolae very large Milk in day 4 ( by color change)

88 Additional maternal hx: erratic cycles from age 13 with menorrhagia; placed on BCPs during 20’s. Cycles improved 2 yrs ago after starting vegan diet Infant Assessment: good suck, tone, alertness Feeding observation: latched fairly well Intake 8ccs L and 2ccs R Post pumping yielded 20ccs total; good MER Initial lactation dx: infant lack of weight gain secondary to poor supply due to inadequate glandular tissue.

89 Initial Care Plan: Demand feed, breast compressions Pump min after feeds Supplement with 1.5-2oz EBM & AIM Alternate MM+ and Goat’s Rue per mfr’s instructions Follow-up 1 (4 days later) Baby’s wt 7#5.3 up ~5oz/4 days Test feed 10ccs R, 4ccs L, (double before) Pumped 18 ccs after feed (same) Agreed to continue current plan

90 F/U 2 (1 wk, age 19 days) Baby 7#12.5, up 7oz/7days Baby taking about 2oz suppl. per feed for 14oz AIM + 7oz EBM per day Test intake 8ccs R 9ccs L; switched to football, got 28ccs more = 45ccs total Mom reports taking both herbs 8-10x/dayMom reports taking both herbs 8-10x/day Baby breastfeeds 30 min total Pumping 6-7x/day, 20-35ccs ea Continue plan

91 F/U 3 (1 wk, age ~1mo) Baby wt 8#3, up 6.5oz/7days Mom still pumping 1oz each time, baby also getting additional 2- 3oz/supplement Mom now alternating herbs, total of 8x/day; if supply felt low, she took them together Test feed: baby sleepy & passive, 12ccs R only.

92 F/U 4 (2 wks, age 6 wks) Baby wt 8#15.9 up 13oz/14 days 104ccs!Test feed: 24ccs R and 80ccs L = 104ccs! AIM down Mom taking herbs 10-12x/day + MM tea Mom also reported some vaginal bleeding

93 F/U 5 (7wks) Baby wt 9#5, up 5.5oz/8 days Mom reports avg 6oz AIM per day Mom reports periodic bleeding past month, passing of clots 75ccsTest intake: 45ccs R and 30ccs L = 75ccs Suggest monitoring timing of supplements vs “periods” F/U 6 (8wks) Baby wt 9#12.3 up 7oz/6 days Mom stopped pumping 52ccsTest feed 24ccs R and 28ccs L = 52ccs Mom had not used GR for 2 days 4oz AIM past 2 days vs 2-3 3oz bottles

94 F/U 7 (10 wks) 10#4.3 up 8oz/15 daysBaby wt 10#4.3 up 8oz/15 days Mom reports using 3oz supplement in evening only; baby sleeping more and eating less at night Stooling every 3-5 days, but large 102 ccsTest feed: 62ccs R 40ccs L = 102 ccs F/U 8 (~ 12 wks) 10#14.5 oz up 10oz/12 daysBaby wt 10#14.5 oz up 10oz/12 days Mom reports supplement at 3-6oz 72 ccsTest feed: 38ccs R and 34ccs L= 72 ccs Baby eventually rejected supplements; gain average.5oz/day. Solids started late due to paternal preference. New 7 mos;New 7 mos; baby #1 breastfed 6 mos into new pregnancy

95 Baby eventually rejected supplements; gain average.5oz/day. Solids started late due to paternal preference. New 7 mos;New 7 mos; baby #1 breastfed 6 mos into new pregnancy

96 At 5 mos: transferred 100ccs, but wt gain not quite.5oz/day

97 Interesting stuffInteresting stuff Mom got tired of doing herbs all the time, so decided to try domperidone instead. At first this seemed to work, but then supply dropped and breasts “deflated,” so she added Goat’s Rue back and took them concurrently. Later on, she ran out of the Goat’s Rue for a few days and found that her breast seem to “deflate” again. She quickly got more and things returned to normal Supply was ~95% overallSupply was ~95% overall Baby #3……..Baby #3……..

98 Web Resources KellyMom.com- ml ml LowMilkSupply.org galactagogues.shtmlhttp://lowmilksupply.org/increasingmilk- galactagogues.shtml Birth and Breastfeeding: Mongraphs by D. Hoffman, Herbal Materia Medica: Longwood herbal task force: Saw palmetto: Napralert: MOBI: Breastfeeding & herbs discussion group: Breastfeeding & herbs discussion group:


Download ppt "Herbs and Foods as Galactogogues Lisa Marasco, MA IBCLC © Copyright Lisa Marasco 2007."

Similar presentations


Ads by Google