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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