>>i searched the archives but did not find this info. An OB doc called
me today for a mother who has experienced low milk supply in 2 prev.
lactations. she is now pregnant (don't have the details of gest. age etc
but no pertinent history and normal breasts per doc) and the doc
wondered if there was a med to be taken now during pregnancy that could
possibly enhance mom's milk supply with the upcoming lactation. <<

Laurie,
First, do make sure that there really is no pertinent
health/reproductive history; what we consider important and what other
HCPs consider important can be two different things.

This is an area that has intrigued me greatly. The herbs that I know of
that seem to have a reputation for enhancing or increasing breast tissue
include fenugreek, goat's rue and saw palmetto, with the latter two
having the greater reputation. Fenugreek, unfortunately, is considered
contraindicated for pregnancy due to the possibility of causing
contractions. My research on goat's rue to date has not come up with any
definitive contraindications, and when I conferred with Frank Nice, he
also had the same gut feeling, but commented on the fact that there is
no hard scientific evidence to back this up at this time.

With the available information on hand, I have had two women (both under
the supervision of their midwife) try goat's rue during pregnancy. The
first woman started it late, around 36 wks, and was sporadic; there was
no change or improvement. The second woman started it in her last
trimester but was not always entirely faithful, either; she also did not
find any change or improvement. There is so much that we don't yet know
as to what amount might be needed and/or when it might need to be
started IF it is going to be effective. This is definitely in infant
trial state.

Saw palmetto is mostly known for male prostate issues, but it also has
the reputation of increasing breast tissue (think herbal "breast
enhancers;" they may actually have some merit)and for combatting
hirsutism, the latter of which ironically arises from too many
androgens. I do not yet have enough information about its possible use
during pregnancy for breast growth; below is info I obtained from Frank
Nice, who commented: "Saw palmetto is not specifically contraindicated
in pregnancy or lactation, but it is not generally used by women."

        Studies conducted at the U of Milan and the U of Pavia
demonstrated the liposterolic extract has no teratogenic effects when
given at doses up to 600 mg/Kg in rats and rabbits. Bombardelli E,
Morrazzoni P.  Serenoa Repens (Bartram) JK Small.  Fitoterapia 1997,
68(2): 99-114.

        Pregnant rats given saw palmetto fruits as 50% of their diets
had suckling rats with depressed growth, but the dams did not seem to be
affected.
Feurt SD, Fox LE.

        A note on the effects of feeding saw palmetto berries to rats.
Serenoa repens (Bartram) Small J Am Pharm Assoc Sci Ed 1954; 43(10):
636-639.


Another herb I've wondered about for pregnancy is Vitex: though one
study showed that it reduced prolactin levels [in men], there is another
report of use in pregnancy. Sheila Humphrey, IBCLC, commented: "It is
interesting that the researchers sought to overcome the perceived "slow
onset" of activity of Vitex by having pregnant staff members start
taking Vitex while pregnant.  They noted that the women started
producing milk prematurely, and despite the fact that it was a
reversible effect, they could not be persuaded to continue taking the
Vitex.  This bit of investigation still shows up in the recommendation
to not take Vitex after the first trimester as it may bring in milk
prematurely ( Madaus Co. literature)."

Something else worth considering: progesterone cream applied topically
to the breast. Natural is considered a better choice than synthetic. I
have not had anyone try this, but we do know that progesterone plays an
important role in breast growth during pregnancy. Dr. Katarina Dalton
has long been a huge advocate of progesterone therapy for several female
complaints, and there are some anecdotes claiming that progesterone
cream use "from the middle of pregnancy on" helped with breastfeeding.
BTW, I have been told that red raspberry leaf may help stimulate the
production of progesterone, but I have not verified this claim.

~Lisa Marasco

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