Well said Laurie: "For example, it does not work to eat pastries all day long andthen 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!"


and Jane:  " Herbs should be considered as REAL medicine and I think the term "alternative" medicine should be discarded.   When it comes to measuring results from herbs,  one needs to consider what pathway is involved in milk production.  There is more than just prolactin involved. "


Oatmeal, fenugreek and water are not the precursors for human milk, but sometimes you'd think they were. 



Jennifer Tow, IBCLC, USA & France
Intuitive Parenting Network, LLC



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






Date:    Tue, 24 Jun 2014 09:41:04 -0500
From:    [log in to unmask]
Subject: Re: combining herbs

My personal OPINION which I try to base on as much evidence as is available, is 
that a natural precursor of an extracted supplement should be superior to the 
supplement unless one has some type of barrier to appropriate breakdown and 
absorption.  Think caffeine.  Which is better - a caffeine pill or a cup of 
coffee?   I believe research has shown that there is more to a cup of coffee 
than just caffeine.   Now, I'm not extolling the virtues of coffee, mind you, 
I’m just saying there is MORE to coffee.   IN the same way, I'm not a proponent 
of dehydrated fruits and vegetables in a capsule - eat the real thing!  There 
are reports of hypervitaminosis in children this morning from too much vitamin a 
and c in breakfast cereals.   I noted that goat's rue is possibly a precursor to 
metformin - no wonder it helps with women with insulin resistance and other 
blood sugar issues.   Herbs should be considered as REAL medicine and I think 
the term "alternative" medicine should be discarded.   When it comes to 
measuring results from herbs,  one needs to consider what pathway is involved in 
milk production.  There is more than just prolactin involved.  When you only 
measure prolactin response as your indicator of effectiveness of an herb, when 
your protocol does not control for type of pump, length of pumping, frequency of 
pumping OR breastfeeding efficiency (which can be highly subjective), how can 
you declare a particular herb as not useful?   I HAVE found herbs and 
combinations of herbs VERY effective in my 28 years of practice.  But that's 
anecdotal.     


 


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