Who will ever fund the studies -- Be it herbals or CST?
I agree that utilizing meds/herbs/CST puts a provider in a difficult position, especially when they have been trained in Western Medicine and devoted to evidence-based practice, as I have.
As a licensed nurse practitioner, I am always wondering what I would tell a judge/jury about why I recommended/ prescribed a certain drug/herb/treatment, when there were no double-blinded randomized controlled trials to back me up.
That said, I believe that sometimes, through the trial and error/wisdom of trusted colleagues, and our own personal experiences, we must move beyond our evidence-based knowledge to enable us to make judicious, individualized, recommendations for our clients.
There are so many examples of this in Medicine: as an OB nurse, the first ones that come to mind are terbutaline and Mag Sulfate for preterm labor. Both off-label, but used extensively because 'they work'.
I asked Dr Ghaheri (an ENT in Portland OR who performs laser frenotomies) how he justifies his recommendation forCST to his clients when it isn't a proven treatment for certain sucking problems: he simply said " because it works" .
Enough said
Melinda Harris Moulton ARNP
Olympia WA
Sent from my iPad
> On Jun 24, 2014, at 8:56 AM, Laurie Wheeler <[log in to unmask]> wrote:
>
> Hi Michelle,
>
> You asked, "My understanding is that ABM does not recommend usage of things
> like fenugreek and Mother's Milk Tea. How does recommending these items
> conflict with our charge to practice evidence-based medicine?"
>
> Here is my understanding of the issue. According to evidence reviewed by
> ABM, and you can read their policy or position statement on use of
> galactagogues, there was not clear evidence of benefit to using
> galactagogues (herbs included here). Of course, clinicians still do it, and
> in some case studies, benefit is seen. It may be hard to tell if the
> galactagogue did the trick, because most clinicians would also fix the
> latch, increase frequency of milk removal, etc.
>
> Jennifer Tow, for example, is one of our lactnetters who uses and sees
> results through herbals. Hi, Jennifer, correct me if I am wrong. I greatly
> respect her philosophy and knowledge and clinical experience. My
> understanding is that Jennifer does a complete and extensive nutritional
> evaluation. She does not, as many moms or clinicians would do, simply add
> fenugreek to whatever the mom is already doing. The herbs are used
> nutritionally, as foods, and then other pro-inflammatory foods are
> eliminated. For example, it does not work to eat pastries all day long and
> then pop a capsule of fenugreek 4x per day. Any of us who improve our
> nutrition dramatically, something most of us should do, would find our
> bodies working so much better and many disease processes reversed!
>
> To me, that is what the gist of the ABM position is: herbal supplements
> (especially capsules and pills) are not a "magic bullet." I hope this
> explanation helps. It is just my personal understanding and opinion.
>
> Laurie Wheeler RN MN IBCLC
> rural MISSISSIPPI USA
>
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