Jennifer (and all who are following this!),
Again, interesting thought. I wanted to see what the actual definition of
"evidence-based medicine" is and it's this: "*Evidence based medicine* (EBM)
is the conscientious, explicit, judicious and reasonable use of modern, best
*evidence* in making decisions about the care of individual patients. EBM
integrates clinical experience and patient values with the best available
research information."
We were always taught as dietitians (and I know other medical fields are
taught like this and work like this, but I only want to speak from my
experience) that while nutrition research is ever-evolving we should work
with the best available evidence with a healthy dose of clinical experience
and intuition. My RD colleagues often work with off the beaten path
therapies, however, some with great success for their patients.
I'm curious about the statement that most research is "corrupted". In what
way? What about studies funded solely by universities or, in the US, the
NIH?
With regards to herbs and breastfeeding, both my new-ness and my RD hat
cause me to look objectively right now at the usage of herbs. I also am
concerned about the problem of unregulation (again, in the US) of
supplements - how do we know the fenugreek capsules actually contain
fenugreek and not, say, domperidone? None of my certifications allow me the
right to "prescribe", either.
Thanks for the discussion and I have to say I've only recently joined
LACTNET and I save almost every email that comes through. You all are such
a wealth of knowledge and I"m so happy to be here!
Theresa
On Sat, May 13, 2017 at 1:02 PM, Jennifer Tow, MA, IBCLC <
[log in to unmask]> wrote:
> Theresa,
> First, I would certainly not follow any recommendations from Hale on
> herbs, even if there was one. That is not his expertise. Frank Nice has
> more expertise in that regard.
>
> For myself, I have personally gathered resources over 30 years, because
> that's what makes the most sense to me. Hilary Jacobson's book Motherfood
> would always be my first suggestion for anyone, though.
>
> Again, if you are expected to use "evidence-based" resources, what does
> that mean? We know that upwards of 85% of all published research is
> corrupted. I would take my chances any day with herbs that have been used
> by humans for millenia with very few adverse outcomes, before any drug that
> has been manufactured for the sole purpose of making billions of dollars.
>
> It amazes me the aggressive defense I have seen of motilium for example,
> when clinical evidence suggests it damages the thyroid, yet folks are quite
> genuinely afraid of recommending foods and safe herbs. And dare to mention
> homeopathy and a witch hunt ensues. It seems to me what is needed is a
> paradigm shift toward a wellness model, because 150 years of sick care has
> left us with little more than a chronically ill population.
> Jennifer
>
> Jennifer Tow, BFA, MA, IBCLC, RLC, OMT
>
> Intuitive Parenting Network, LLC
>
> Holistic Lactation Consultant, Holistic Health Coach (focus in nutrition),
> founder Holistic Lactation Institute
>
>
> Those are great points Jennifer, and I often run into the same issues with
> my dietitian hat on. When it becomes sticky for me is, for example, in jobs
> where we have to be "evidenced-based" for liability reasons (one of my jobs
> is an online nutrition/lactation chat with moms where I often have to refer
> to an in-person LC anyway as I can't see latch!).
>
> And a follow-on question - is there a good listing of herbal and non-herbal
> galactogogues somewhere? I only find bits and pieces in various books and
> resources and would just like a nice list with recommended dosages,
> interactions, etc. I don't think Hale has a list like that, but I could be
> mistaken.
>
> Thanks!
> Theresa
>
>
> Date: Sat, 13 May 2017 10:22:11 -0400
> From: "Jennifer Tow, MA, IBCLC" <[log in to unmask]>
> Subject: Decreased supply on antibiotic
>
> What is interesting to me is the presumption that the abx or the power
> pumping are "evidence-based", while the galactagogues are not. Neither abx
> for sinus infections nor power pumping are evidence-based and I doubt much
> of anything that happened in her birth (unless it was at home) was
> evidence-based either. I see so many moms on insane pumping schedules who
> would be making a lot more milk if IBCLCs simply recommended galactagogues
> instead of, or in conjunction with, pumping. Clinical evidence is in fact
> **evidence** and many of us have decades of experience using lactogenic
> foods and galactagogues with immense success. Even more importantly,
> shouldn't IBCLCs know at least as much about increasing milk supply as
> mothers on social media do? This is one reason mothers post comments like
> "I thought you only checked latch" or far worse about the very limited
> skill set that IBCLCs are expected to have based on the IBLCE blueprint. My
> suggestion would be give her the information on the failed use of abx for
> sinus infections so she can decide if she wants to continue, suggest she
> consider immune support to help her body recover, recommend a pbx for her
> ravaged gut (and likely the baby's), review her diet (often abx cause
> stomach distress, especially w/o pbx, that cause folks to change their
> eating patterns), be sure to include lactogenic foods in her diet (we need
> carbs and electrolytes to make milk), and recommend galactagogues such as
> moringa or shatavari or an herbal combination (my preference).
> Rethinking antibiotics for sinusitis—again
> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601684/
>
> Five day vs Ten day (even if there was a reason to give them, is equally
> effective)
>
> https://www.ncbi.nlm.nih.gov/pubmed/15606217
>
>
> Jennifer Tow, BFA, MA, IBCLC, RLC, OMT
>
> Intuitive Parenting Network, LLC
>
> Holistic Lactation Consultant, Holistic Health Coach (focus in nutrition),
> founder Holistic Lactation Institute
>
>
>
>
>
> Date: Fri, 12 May 2017 15:37:44 +0000
> From: Jenny Lawlor-Nigro <[log in to unmask]>
> Subject: Decreased supply on antibiotic
>
> Hello,
>
> I know a mom who is taking Augmentin (antibiotic in the amoxicillin family)
> for a sinus infection. She is on day 3 of a 10-day regiment. Since taking
> it, she has seen her supply go way down. She was recommended several
> galactagogues from her informal network of friends but I know that they are
> not evidence-based practices for boosting supply. I was thinking power
> pumping but she says that she only gets a few drops when she pumps. Also,
> could that potentially result in an over-supply when she goes off the meds?
> Do you have any suggestions for helping to bring her supply back up?
>
> Thanks in advance!
>
> Best,
>
> Jenny Nigro
>
>
>
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--
Theresa M. Moutafis, MA, RD, LDN, CDE, IBCLC
Nutrition and Wellness Consultant
Lactation Consultant
(315) 730-1858
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