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 *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome