It is estimated that about 15% of breastfeeding women in the United States have used herbs for breastfeeding. (1,7) It is not surprising that this number is so high since both herbal therapy and breastfeeding are becoming more popular. Women are the primary users of herbs and they are once again gaining confidence in nature's pharmacopeia. They are sharing their knowledge because they have witnessed successful results. Women naturally begin to increase their herbal use during pregnancy as they become aware that they can no longer use harmful over-the-counter and prescription medicines. The use of herbal remedies during breastfeeding is a natural progression of their relationship with herbs. They may use herbs for a number of reasons:

• As an alternative to harmful over-the-counter and prescription medicines.
• To increase or decrease milk supply.
• To help heal their own bodies after pregnancy.

The most common use of herbs within this population is to increase milk supply. These herbs are known as GALACTAGOGUES. In a global review, researchers documented over 400 plant species that have been used to promote milk supply. Some are applied topically, but many are taken internally.(2) It is clear that although their use is widespread, the usefulness of these herbs is unproven in a clinical or laboratory setting. (3)

This is a great pity that the herbal use by midwifes have not been published. Despite the lack of science, it is clear that many women believe that they need galactagogue herbs to help them during breastfeeding. There may be physical reasons for lack of milk, but many women take them because they are uncertain that they have a sufficient milk supply.(4) Social and psychological factors also strongly influence a mother's ability to nurse. Other common causes of insufficient milk production include diabetes, hypothyroidism, obesity, ovarian cysts, and polycystic ovarian syndrome (PCOS).

A dwindling milk supply may be assisted by a sufficient water intake, rest and a well-balanced diet in most cases. Sometimes, a little extra help is needed and that is where herbs come in. These herbs may be useful

1. Fennel seed
2. Fenugreek seed

Whatever your opinion regarding herbal safety, it is likely that you have an even stronger belief regarding a mother's use of herbs while breastfeeding.

When a woman is breastfeeding, many substances that enter her body can also travel through her breast milk to her child. Therefore, like many synthetic drugs, many herbs are not suitable for nursing mothers. All the products manufactured by Oregon's Wild Harvest will show a pregnancy and nursing warning if they are not suitable for pregnancy and/or nursing women.

We have adopted three levels of warnings depending on the data available to us:

1. If an herb has proven to have adverse affects (or is extremely likely) the bottle will state "do not use if nursing".
2. If the safety is unknown the bottle will state "Not recommended for use while nursing, until further research verifies no contraindications".
3. If there is a long history of use and/or some preliminary scientific data we will not apply a warning.

It is important to consider also that anyone can have an allergic reaction to any herb, and it is recommended that the mother begins any herbal regimen very conservatively before taking a full dose. It is true that some herbs do contain constituents that have to be respected and used moderately, but compared to drugs their use is synonymous with having an accident with a bicycle as opposed to a Mack truck (which represents most synthetic drugs). I believe that the pesticides and contaminants in certain herbs pose a greater potential danger to the nursing infant. This is especially true of pesticides.

A national survey of over 1400 nursing women revealed that milk samples had detectable levels of dieldrin, and breakdown products of heptachlor and chlordane in 83%, 61%, and 74% of the women respectively. Most of the studies concerning a spectrum of pesticides document that pesticides continue to be present in the milk of nearly all nursing mothers. (6)

Many of the commercial pesticides are attracted to fat and can be stored for long periods of time in the mother's fat. However a lot of these fat cells are broken down during lactation as the body produces milk. With this release of fat comes the release of the attached pesticides. The fat solubility of these dangerous chemicals also enables them to readily transfer into the mother's milk.

Infants (and children) are very vulnerable to pesticides for three reasons:

1. Their body weight is so much smaller than that of an adult and so the exposure to a pesticide is exaggerated in their small bodies.
2. They have not developed an intact "blood brain barrier," a special protective feature of the human brain. Thus infants may be particularly vulnerable to exposure to neurotoxic pesticides.
3. The very young infant cannot metabolize toxins well. The major routes for elimination of pesticides are through the kidneys and the liver which do not have full function at a young age.

A similar argument can be used for heavy metals and other contaminants. These are reasons why it is important to purchase premium quality organic herbs that are being screened for harmful contaminants.

FENNEL

Fennel has been used as a galactagogue for a very long time. It has been shown to increase milk production in goats. (8)

Fennel has an added benefit in that it may help relieve colic in infants, when combined with other herbs. This has been shown in animal and human studies. The fact that the herb can be given to colicky babies shows that fennel does not pose a safety issue. (9-10)

FENUGREEK

Fenugreek appears to be the herb used most often today as a galactagogue. Most of the increased popularity is due to anecdotal accounts such as the personal account of a lactation consultant. (11)

Although further research is warranted a small study showed that the use of fenugreek significantly increased volume of breast milk. (12) The negative effects are minor such as the resulting maple syrup smell in the mother and the infant. Fenugreek can cause mild stomach upset stomach and diarrhea. Occasionally the baby may have symptoms of an oversupply of milk where the infant gets too much foremilk. This may cause fussiness, gas and green watery stools which are classic symptoms of overabundant milk supply.

References

(1) Use of Herbal Products in Pregnancy, Breastfeeding, and Childhood Workshop. The National Children's Study, December 16, 2003. www.nationalchildrensstudy.
(2) Bingel AS, Farnsworth NR. Higher plants as potential sources of galactagogues. Econ Med Plant Res 1991:1-54.
(3) Humphrey SI, McKenna DJ. Herbs and breastfeeding. Breastfeeding Abstracts 1997:11-2.
(4) Humphrey S. Sage advice on herbs and breastfeeding. Leaven 1998:43-7.
(5) Ayers JF. The use of alternative therapies in the support of breastfeeding. J Human Lactation 2000:52-6
(6) http://eap.mcgill.ca/MagRack/JPR/JPR_07.htm
(7) Kathy Abascal, Eric Yarnell. Alternative and Complementary Therapies. December 1, 2008, 14(6): 288-294.

(8) Wynn SG, Fougere BJ. Veterinary Herbal Medicine. St. Louis: Mosby Elsevier, 2007.
(9) Savino F, Capasso R, Palumeri E, et al. Advances on the effects of the compounds of a phytotherapy agent (ColiMil) on upper gastrointestinal transit in mice [in Italian]. Minerva Pediatrica 2008;60:285-290.
(10) Savino F, Cresi F, Castagno E, et al. A randomized double-blind placebocontrolled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officinalis (ColiMil) in the treatment of breastfed colicky infants. Phytother Res 2005;19:335-340.

(11) Jensen, R (1992). Fenugreek, Overlooked but not Forgotten. UCLA Lactation Alumni Newsletter 1,2-3 http://www.breastfeedingonline.com/fenugreekoverlooked.shtml
(12) Swafford S, Berens B. Effect of fenugreek on breast milk production. ABM News and Views 2000;6(3): Annual meeting abstracts Sept 11-13, 2000

This product is not intended to diagnose, treat, cure or prevent any disease. The Contraindications and Potential Drug Interactions information provided on this website is not intended to be all-inclusive. A health care professional should be consulted regarding the use of herbal products. Always keep your Doctor or other healthcare professional informed about the herbal and other dietary supplement products that you are taking.