Breastfeeding/lactation Prevention and Treatment

integrative therapies

Unclear or conflicting scientific evidence:
Asparagus: Asparagus (Asparagus officinalis) may help promote the secretion of milk in women. There is currently not enough scientific evidence to recommend asparagus during pregnancy and breastfeeding. Additional study is needed to better understand the potential galactagogue (breast milk stimulant) properties of asparagus.
Avoid if allergic or hypersensitive to asparagus or other members of the Liliaceae family. Use cautiously with edema (accumulation of fluid) caused by impaired kidney or heart function. Studies testing the safety of asparagus for pregnant or breastfeeding mothers are currently lacking in the available literature.
Coleus: Coleus has been used as a breast milk stimulant for hundreds of years, however, this traditional use has not been well documented and scientific evidence is limited. Additional study is needed to make a conclusion.
Avoid if allergic to Coleus forskohlii and related species. Use cautiously with diabetes, thyroid disorders, heart disease, asthma, low blood pressure, or if at risk of developing low blood pressure. Use cautiously with a history of bleeding, homeostatic disorders, or drug-related homeostatic problems. Use cautiously if taking asthma medications (e.g. bronchodilators), anticoagulants, anti-thrombotic agents, or anti-platelet medications. Do not use two weeks before and immediately after surgical or dental procedures that have bleeding risks. Avoid if pregnant or breastfeeding.
Fenugreek: Fenugreek has been used in Indian and Chinese medicine to help with labor and digestion. Traditionally in India, fenugreek has been used to increase milk flow. Additional study is needed to better understand the use of fenugreek as a galactagogue (breast milk stimulant).
Avoid if allergic to fenugreek or chickpeas. Stop use two weeks before and immediately after surgery/dental/diagnostic procedures with bleeding risks. Use cautiously with asthma, diabetes, or with a history of ulcers or stroke. Avoid if pregnant. Children should not take doses larger than those commonly found in foods.
Jasmine: In the Ayurvedic tradition, jasmine has been used for lactation suppression. Preliminary clinical study found that application of jasmine flowers to the breast significantly decreased prolactin levels, breast engorgement, and milk production. More higher-quality studies are needed in this area.
Use cautiously during pregnancy. Use cautiously in patients allergic to jasmine, jasmine oil, or other fragrances. Use cautiously during lactation. Avoid oral consumption of essential oils, including jasmine essential oil, as they are extremely potent and can be poisonous.
Vitamin B6: The body needs vitamin B6, or pyridoxine, to make the neurotransmitters serotonin and norepinephrine, as well as myelin. Studies evaluating pyridoxine for lactation suppression have yielded mixed results. Well-designed clinical trials are needed before a firm conclusion can be drawn.
Some individuals seem to be particularly sensitive to vitamin B6 and may have problems at lower doses. Avoid excessive dosing. Vitamin B6 is likely safe when used orally in doses not exceeding the recommended dietary allowance (RDA).
Traditional or theoretical uses lacking sufficient evidence :
Acupuncture: The practice of acupuncture originated in China 5,000 years ago. Today, it is widely used throughout the world and is one of the main pillars of Chinese medicine. Although not studied clinically, acupuncture has been traditionally used for increasing breast milk production.
Needles must be sterile in order to avoid disease transmission. Avoid with valvular heart disease, infections, bleeding disorders, medical conditions of unknown origin, or neurological disorders. Avoid if taking drugs that increase the risk of bleeding (e.g. anticoagulants). Avoid on areas that have received radiation therapy and during pregnancy. Use cautiously with pulmonary disease (e.g. asthma or emphysema). Use cautiously in elderly or medically compromised patients, diabetics, or with history of seizures. Avoid electroacupuncture with arrhythmia (irregular heartbeat) or in patients with pacemakers because therapy may interfere with the device.
Alfalfa: Although not studied clinically, alfalfa (Medicago sativa) has been traditionally used for increasing breast milk production. Alfalfa appears to be well tolerated by most individuals, although rare serious adverse effects have been reported.
Blood sugar levels may be reduced. Caution is advised in those with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a healthcare provider, and medication adjustments may be necessary. Avoid if allergic to alfalfa, clover, or grass. Avoid with a history of lupus, thyroid disease, gout, blood clots, seizures, liver disease, or kidney disease. Use cautiously with stroke, hormonal conditions (e.g. breast tenderness, breast cancer, ovarian cancer, or menstrual problems. Avoid if taking drugs that increase the risk of bleeding (e.g. aspirin, aspirin products, or warfarin) or ibuprofen. Do not use two weeks before and immediately after any surgery/dental/diagnostic procedures that may have bleeding risks. Alfalfa may be contaminated with dangerous bacteria (e.g. E. coli, salmonella, or listeria).
Bilberry: Bilberry (Vacinnium myrtillus), a close relative of blueberry, has a long history of medicinal use. Although not studied clinically, bilberry has traditionally been used for lactation suppression.
There is currently not enough scientific evidence to recommend the safe use of bilberry during pregnancy or breastfeeding, although eating bilberry fruit is believed to be safe based on its history of use as a food. Limited available study used bilberry extract to treat pregnancy-induced leg swelling (edema) and no adverse effects were reported. Avoid if allergic to plants in the Ericaceae family or to anthocyanosides (a component of bilberry). Avoid with a history of low blood pressure, heart disease, bleeding, diabetes, blood clots, or stroke. Stop use two weeks before and immediately after surgeries/dental or diagnostic procedures with bleeding risks.
Chasteberry: Chaste tree (Vitex agnus-castus) is native to the Mediterranean and Central Asia. Its berries have long been used for a variety of abnormalities including "corpus luteum deficiency," mastalgia (breast pain), and menstrual abnormalities. Although not studied clinically, chasteberry has been traditionally used for lactation. However, chasteberry is not recommended in breastfeeding women due to a lack of available scientific evidence. Chasteberry competitively binds to dopamine receptors and has been shown to affect prolactin secretion, possibly resulting in decreased breast milk production. However, some clinicians actually use low doses to stimulate milk production with some reported benefits.
Avoid if allergic or hypersensitive to members of the Vitex (Verbenaceae) family or any chasteberry components. When taken in recommended doses, chasteberry appears to be well tolerated with few side effects. Use cautiously in patients taking oral contraceptives or hormone replacement therapy. Use cautiously with dopamine agonists or antagonists. Avoid with hormone sensitive cancers or conditions (like ovarian cancer or breast cancer). Except under strict medical supervision, chasteberry should not be used in pregnancy due to potential uterine stimulatory properties. Some clinicians have used chasteberry in progesterone deficient women during their first trimester to prevent miscarriage, but it is not known if chasteberry is helpful or safe for this indication.
Dandelion: Dandelion (Taraxacum officinale) is a member of the Asteraceae/Compositae family closely related to chicory. It is a perennial herb, native to the Northern hemisphere, and found growing wild in meadows, pastures, and waste grounds of temperate zones. Although not studied clinically, dandelion has been traditionally used for breast milk stimulation.
Dandelion should be avoided by individuals with known allergy to honey, chamomile, chrysanthemums, yarrow, feverfew, or any members of the Asteraceae/Compositae plant families (ragweed, sunflower, daisies). Use cautiously with diabetes or bleeding disorders, gastroesophageal reflux disease (GERD), kidney or liver diseases, or a history of stroke or electrolyte disorders. Potassium blood levels should be monitored. Stop use two weeks before surgery/dental/diagnostic procedures with bleeding risk and do not use immediately after these procedures.
Fennel: Fennel (Foeniculum vulgare) is native to the Mediterranean region. For centuries, fennel fruits have been used as traditional herbal medicine in Europe and China. Although not studied clinically, fennel has been traditionally used as a galactagogue (breast milk stimulant).
Avoid in individuals with a known allergy or hypersensitivity to fennel or other members of the Apiaceae family including carrot, celery, and mugwort because of the chance of cross-sensitization. Oral allergy syndrome has been reported with the use of fennel in a woman. Allergic reactions affecting the skin, such as atopic dermatitis and photosensitivity, may occur in patients who consume fennel.
Guided imagery: Therapeutic guided imagery may be used to help patients relax and focus on images associated with personal issues they are confronting. Experienced guided imagery practitioners may use an interactive, objective guiding style to encourage patients to find solutions to problems by exploring their existing inner resources. Biofeedback is sometimes used with imagery to enhance meditative relaxation. Interactive guided imagery groups, classes, workshops, and seminars are available, as well as books and audiotapes. Although not studied clinically, guided imagery has been traditionally used for increasing breast milk production.
Serious adverse effects have not been reported in the available scientific literature. Theoretically, intense inward focusing may cause pre-existing psychological problems or personality disorders to surface. Guided imagery should not be relied upon as a sole therapy for potentially serious medical problems. Guided imagery is usually used as a supplemental technique to other treatments, not as a replacement.
Guided imagery techniques should not be practiced while driving or during other activity requiring strict attention. Guided imagery may trigger physical symptoms that can be brought about by stress, anxiety, or emotional upset. If practicing guided imagery produces anxiety, a qualified healthcare professional should be consulted. Similarly, people with a history of trauma or abuse should speak with a healthcare professional before using this technique.
Healing touch: Healing touch (HT) is a system of biofield- or energy-based therapy involving the practitioner's use of mental intention and the placement of hands in specific sequences either on the body or above it in the recipient's energy field. It also includes movement of the hands through the field to influence the flow or circulation of energy in a variety of ways. Although not studied clinically, healing touch has been traditionally used for promoting flow of breast milk.
HT should not be regarded as a substitute for established medical treatments. Use cautiously if pregnant or breastfeeding.
Hypnotherapy, hypnosis: Various forms of hypnosis, trance, and altered states of consciousness have played roles across cultures throughout history. Hypnosis-like practices can be traced to ancient Egypt, Babylon, Greece, Persia, Britain, Scandinavia, America, Africa, India, and China. Wong Tai, a father of Chinese medicine, made an early written reference to hypnosis in 2600 BC. In preliminary study, hypnosis has been investigated for its effects on lactation stimulation. Study results are conflicting at this time. Additional high quality clinical research is needed to make a conclusion.
Use cautiously with mental illnesses, such as psychosis, schizophrenia, manic depression, multiple personality disorders, or dissociative disorders. Use cautiously with seizure disorders.
Milk thistle: Milk thistle (Silybum marianum) has been used medicinally for over 2,000 years, most commonly for the treatment of liver and gallbladder disorders. A flavonoid complex called silymarin can be extracted from the seeds of milk thistle, and is believed to be the biologically active component. The terms "milk thistle" and "silymarin" are often used interchangeably. Milk thistle has been used historically to improve breast milk flow, and brief studies of milk thistle in pregnant women reported no side effects. However, there is not enough scientific evidence to support the safe use of milk thistle for lactation stimulation during pregnancy or breastfeeding at this time.
Use cautiously if allergic to plants in the aster family (Compositea or Asteraceae), daisies, artichoke, common thistle, or kiwi. Use cautiously with diabetes. Avoid if pregnant or breastfeeding.
Physical therapy: Although not studied clinically, physical therapy has been traditionally used for promoting flow of breast milk. Physical therapy has been used in pregnancy, specifically to treat women with pelvic girdle pain during pregnancy and at three, six, and 12 months postpartum.
Reports of major adverse effects are lacking in the available literature, but caution is advised nonetheless. All therapies during pregnancy and breastfeeding should be discussed with a licensed obstetrician/gynecologist before initiation. Based on the available literature, physical therapy appears generally safe when practiced by a qualified physical therapist; however, complications are possible. Persistent pain and fractures of unknown origin have been reported. Physical therapy may increase the duration of pain or cause limitation of motion. Pain and anxiety may occur during the rehabilitation of patients with burns. Both morning stiffness and bone erosion have been reported in the physical therapy literature, although causality is unclear. Erectile dysfunction has also been reported.
Raspberry: Raspberry (Rubus idaeus) is cultivated and grows wild throughout temperate climates, including North America and Europe. For several centuries, midwives have used raspberry leaf to stimulate and ease labor. Although not studied clinically, raspberry has been traditionally used as a galactagogue (breast milk stimulant).
Raspberry leaf may induce labor. However, a clinical trial using raspberry leaf tablets reported no adverse effects. More study is needed in this area before a recommendation can be made. Avoid if allergic or hypersensitive to raspberry (Rubus idaeus), its constituents, or any members of the Rosaceae family. Use cautiously with asthma or if taking Clotrimoxazole, antibiotics (especially clarithromycin), antispasmodic agents or muscle relaxants, diuretics, salicylates, or laxatives, sedatives or operating heavy machinery. Cyclosporiasis associated with contaminated fresh raspberries has been reported. Always thoroughly wash raspberries before ingestion.
Relaxation therapy: Relaxation techniques include behavioral therapeutic approaches that differ widely in philosophy, methodology, and practice. The primary goal is usually non-directed relaxation. Most techniques share the components of repetitive focus (on a word, sound, prayer phrase, body sensation, or muscular activity), adoption of a passive attitude towards intruding thoughts, and return to the focus. Although not studied clinically, relaxation therapy has been traditionally used for increasing breast milk production.
Avoid with psychiatric disorders such as schizophrenia/psychosis. Jacobson relaxation (flexing specific muscles, holding that position, and then relaxing the muscles) should be used cautiously with illnesses, such as heart disease, high blood pressure, or musculoskeletal injury. Relaxation therapy is not recommended as the sole treatment approach for potentially serious medical conditions and should not delay the time to diagnosis or treatment with more proven techniques.
Therapeutic touch: The way therapeutic touch (TT) may affect the body is unknown. It is theorized that TT affects patients through the connection of energy fields within and outside of the body. Energy is thought to stimulate internal mechanisms to treat physical symptoms. The autonomic nervous system is felt to be particularly sensitive to TT, followed by the lymphatic, circulatory, and musculoskeletal systems. Female endocrine disorders are believed to be more sensitive than those affecting males. In preliminary study, therapeutic touch has been investigated for its effects on promoting flow of breast milk. Study results are conflicting at this time. Additional high-quality clinical research is needed to make a conclusion.
Therapeutic touch is believed to be safe for most people. Therapeutic touch should not be used for potentially serious conditions in place of more proven therapies. Avoid with fever or inflammation, and on body areas with cancer.
Turmeric: Although not studied clinically, turmeric has been traditionally used for increasing breast milk production (lactation stimulant). Clinical research is needed in this area to make a conclusion.
Historically, turmeric (Curcuma longa) has been considered safe when used as a spice in foods during pregnancy and breastfeeding. However, turmeric has been found to cause uterine stimulation and to stimulate menstrual flow, and caution is therefore warranted during pregnancy. Animal studies have not found turmeric taken by mouth to cause abnormal fetal development. Avoid if allergic or hypersensitive to turmeric (curcumin), yellow food colorings, or plants belonging to the Curcuma and Zingiberaceae (ginger) families. Use cautiously with a history of bleeding disorders, immune system deficiencies, liver disease, or gallstones. Use cautiously if taking anticoagulants.