Hi Therese, Others have posted about the fenugreek pilot study - see lactnet archives for the abstract; it is the only published recent or experimental study of fenugreek as a galactogogue. Other scientific study of fenugreek's actions on the body are available through a medline search of fenugreek ( see in particular the interaction of fenugreek's unique amino acid, 4-hydroxyisoleucine, with the insulin receptor when high blood sugar is present). Although there is no shortage of modern anecdotes about fenugreek's galactogogue activity ( see lactnet archives), I believe Jack Newman's descriptions of clinical use in his books are a little more weighty than mere anecdote, considering the expert source ( MD, paediatrician, well-recognized lactation expert with extensive clinical practice with breastfeeding mothers). Other detailed descriptions of clinical use by experienced and respected IBCLC clinicians are also to be found published in reliable places; many of such accounts are on the internet in their entirety. There are detailed descriptions of traditional use of fenugreek as a galactogogue in the ethnobotanical literature. Detail include plant parts and preparation, dose, route used. This literature is scientific: source information collected and evaluated by scientists using strict criteria, and published in peer-reviewed scientific journals. "Traditional" is a defined term in ethnobotany; it is obviously important to distinguish commercial hype in an advertisement from what a folk healer in the field reports to a trained ethnobotanist. Ethnobotanical information is a form of scientific evidence, not the best or highest form, that being random controlled trials (RCTs), but a valid form playing an important role in medicinal plant investigations nonetheless. RCTs are not the only form of scientific evidence nor are capable of answering all research questions. The information from expert clinical and bona fide traditional sources cannot be overlooked, whether safety or efficacy is the question. The Cochrane evaluations do not overlook these categories, btw. And on a pragmatic level, why should clinical practices that in the experience of practitioner work reliably for mothers while causing few adverse effects be automatically excluded for lack of RCTs? Or, to set the bar even higher, large-scale RCTs? As is often said, stewed prunes have not a shred of RTC-level evidence that they will relieve constipation, a status they share with a large portion of current clinical medical practices. You are neither the first nor the last to suggest fenugreek, a conservative position, and legally defensible, when new therapies are gaining acceptance. Following the established criteria for ethnobotanical evidence used to evaluate potential efficacy, fenugreek is one of many herbs who meet these criteria ( see Bingel and Farnsworth); properly conducted experimental research is very likely to validate it's ethnobotanical use. Enough information on fenugreek constituents exist to at least hazard a speculation on it's mechanisms of action. A pilot human study has now been done, and another is in progress. Numerous anecdotes show allergic response to be the most troublesome potential side effect of fenugreek, something it shares with other foods from the same plant family, most notoriously, peanuts. (Of course peanuts have shown to be much more hazardous at this point in time.) So far, allergy is only documented in mothers or direct ingesters, not infants, though the recent report of peanut allergens entering breast milk shows potential for risk to a sensitive baby. Diarrhea in mother or baby sometimes occurs, usually relieved by reducing the dose. It is not clear if this response can sometimes be allergic in nature or due to other factors; many medicinal herbs and drugs for that matter can cause diarrhea. For an allergenic mother or history of family allergy to nuts, beans, peanuts in particular, fenugreek should conservatively be avoided and a non-allergenic galactogogue be considered. There are at least 2 hospitals (California) that have a written galactogogue protocol clearly outlining when fenugreek and/or other herbal galactogogues are to be suggested. You can email me privately for contacts. Good luck with your talk - such short notice to become familiar with this plant, so just a little unfair, seems to me. Regards, Sheila Humphrey BSc RN IBCLC bucolic Marine on St. Croix, Minnesota *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html