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Ryan RA, Bihuniak JD, Lyndon A, Hepworth AD. Information Seeking Behavior and Strategies to Increase Milk Supply Among Breastfeeding Mothers in the United States. Breastfeed Med 2024; 19:378-386. [PMID: 38488105 DOI: 10.1089/bfm.2024.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
Background: Some breastfeeding mothers try to increase their milk supply through pharmaceutical, dietary, and behavioral strategies that vary in effectiveness. Information seeking behaviors may influence which strategies mothers use. Objective: To describe where mothers obtain information about increasing milk supply, describe the perceived influence of each information source on decision-making about strategies for increasing milk supply, and explore associations between information sources and mothers' use of galactagogues (i.e., pharmaceutical and dietary strategies) and behavioral strategies. Methods: Women who were currently breastfeeding and living in the United States were recruited through Facebook advertisements to complete an online survey between December 2020 and February 2021. Descriptive statistics were calculated, and chi-square tests compared participants' use of galactagogues and behavioral strategies by information sources. Results: Participants were 1,351 breastfeeding mothers (81% non-Hispanic white; 47% first-time breastfeeding; 21% Special Supplemental Nutrition Program for Women, Infants, and Children participants). Nearly all participants (97%) obtained information about increasing milk supply from at least one source, most commonly lactation consultants (68%), Facebook (61%), search engines (50%), websites (47%), and nurses (41%). There was high variability in the perceived influence of each source on decision-making. Galactagogue use was higher among participants who obtained information from the internet (Yes: 68% vs. No: 43%, p < 0.000), social media (Yes: 65% vs. No: 40%, p < 0.000), family and friends (Yes: 65% vs. No: 53%, p < 0.000), and lactation consultants (Yes: 63% vs. No: 54%, p < 0.002). Behavioral strategies were more commonly reported among participants who accessed these same sources, maternal health care professionals (Yes: 98% vs. No: 91%, p < 0.000), and pediatricians (Yes: 98% vs. No: 94%, p = 0.001). Conclusion: Breastfeeding mothers commonly obtained information about increasing milk supply from a variety of sources. Information sources accessed were associated with mothers' use of galactagogues and behavioral strategies for increasing milk supply.
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Affiliation(s)
- Rachel A Ryan
- Public Health Nutrition, School of Global Public Health, New York University, New York, New York, USA
- Department of Nutrition and Food Studies, New York University, New York, New York, USA
| | - Jessica Dauz Bihuniak
- Department of Nutrition and Food Studies, New York University, New York, New York, USA
| | - Audrey Lyndon
- NYU Rory Meyers College of Nursing, New York, New York, USA
| | - Allison Doub Hepworth
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
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Zulkarnain Z, Fitriani U, Ardiyanto D, Saryanto, Wijayanti E, Triyono A, Novianto F. Galactagogue activity of poly-herbal decoction from Indonesia: a randomized open label controlled trial. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2024; 0:jcim-2020-0246. [PMID: 38644615 DOI: 10.1515/jcim-2020-0246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 04/04/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES Indonesia have several herbs empirically used as galactagogue. However there are limited clinical evidence regarding the efficacy and safety of this herbs especially poly-herb. The aim of this study was to assess the efficacy and safety of polyherbal galactagogue (PHG) consist of katuk leaves, torbangun leaves and papaya leaves compared to commercial galactagogue capsules (CGC) that contain a single plant extract, katuk leaves. METHODS This study was an open label randomized controlled trial with 120 subjects that randomly assigned into two groups, PHG and CGC. This study was conducted at the herbal medicine research house (Rumah Riset Jamu/RRJ) Hortus Medicus and 30 subsites in Central Java and Jogjakarta provinces from July to November 2018. Duration of intervention 28 days. Parameter of efficacy breast milk volume, baby weight, prolactin level and parameter of safety ALT, AST, Urea, Creatinin were performed at baseline, day 14 and 28. The symptom of side effects also recorded every week. RESULTS Breast milk volume and infant's weight increased at day-14 and 28 in both groups. However, prolactin level in both groups decreased. There were no significant differences of efficacy parameters at baseline in both groups. At three times measurement of ALT, AST, Urea and Ceratinin average levels were within the normal range. About 3-5% mothers experience higher ALT, AST and nausea that can tolerated well. No side effect was found in infants. CONCLUSIONS PHG and CGC have the equal efficacy and safety as a galactagogue. The optimal used is for 14 days.
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Affiliation(s)
- Zuraida Zulkarnain
- Center for Research and Development of Medicinal Plants and Traditional Medicine, National Institute of Health Research and Development (NIHRD), Indonesian Ministry of Health Tawangmangu, Central Java, Indonesia
| | - Ulfa Fitriani
- Center for Research and Development of Medicinal Plants and Traditional Medicine, National Institute of Health Research and Development (NIHRD), Indonesian Ministry of Health Tawangmangu, Central Java, Indonesia
| | - Danang Ardiyanto
- Center for Research and Development of Medicinal Plants and Traditional Medicine, National Institute of Health Research and Development (NIHRD), Indonesian Ministry of Health Tawangmangu, Central Java, Indonesia
| | - Saryanto
- Center for Research and Development of Medicinal Plants and Traditional Medicine, National Institute of Health Research and Development (NIHRD), Indonesian Ministry of Health Tawangmangu, Central Java, Indonesia
| | - Enggar Wijayanti
- Center for Research and Development of Medicinal Plants and Traditional Medicine, National Institute of Health Research and Development (NIHRD), Indonesian Ministry of Health Tawangmangu, Central Java, Indonesia
| | - Agus Triyono
- Center for Research and Development of Medicinal Plants and Traditional Medicine, National Institute of Health Research and Development (NIHRD), Indonesian Ministry of Health Tawangmangu, Central Java, Indonesia
| | - Fajar Novianto
- Center for Research and Development of Medicinal Plants and Traditional Medicine, National Institute of Health Research and Development (NIHRD), Indonesian Ministry of Health Tawangmangu, Central Java, Indonesia
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Elmaghraby DA, Alsalman GA, Alawadh LH, Al-Abdulqader SA, Alaithan MM, Alnuwaysir BI. Integrated traditional herbal medicine in the treatment of gastrointestinal disorder: the pattern of use and the knowledge of safety among the Eastern Region Saudi population. BMC Complement Med Ther 2023; 23:373. [PMID: 37872543 PMCID: PMC10591345 DOI: 10.1186/s12906-023-04197-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 10/04/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Herbal medicine is commonly integrated with conventional medicine in Saudi Arabia, especially for the management of digestive disorders. However, the majority of Saudis use herbal remedies without prior consultation with a physician, which raises concerns about their appropriate and safe use. The aim of this study was to assess the level of awareness among the Saudi population regarding the proper utilization and potential adverse effects of frequently used herbs for the treatment of gastrointestinal (GI) diseases. METHODS A cross-sectional survey was conducted in Saudi Arabia from January to March 2021. An electronic self-administered questionnaire was distributed. RESULTS A total of 543 participants from different age groups, educational levels, and cities across Saudi Arabia completed the study questionnaire. The most commonly used herbs at home by the participants were: myrrh, parsley, black seed, chamomile, mint, anise, clove, and green tea. 57.7% of the participants perceived herbs as safer than conventional medicines; 27.3% reported that using herbal remedies over conventional medicine was a family tradition, and 21.4% used herbs because they were cheaper than conventional medicines. CONCLUSION Herbal remedies, including myrrh, parsley, blackseed, chamomile, mint, and anise, are commonly employed for the treatment of gastrointestinal disorders in Saudi Arabia. However, the knowledge level of participants regarding potential side effects and drug-herb interactions was found to be deficient. As such, there is a pressing need for educational campaigns and community awareness programs to elucidate the proper usage of herbal remedies and to caution against their potential adverse effects.
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Affiliation(s)
- Dalia Ahmed Elmaghraby
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al Hofuf, 31982, Saudi Arabia.
| | - Ghufran Adnan Alsalman
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al Hofuf, 31982, Saudi Arabia
| | - Layla Hassan Alawadh
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al Hofuf, 31982, Saudi Arabia
| | - Sara Abdulaziz Al-Abdulqader
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al Hofuf, 31982, Saudi Arabia
| | - Malak Mohammed Alaithan
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al Hofuf, 31982, Saudi Arabia
| | - Bayan Ibrahim Alnuwaysir
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al Hofuf, 31982, Saudi Arabia
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Kwon NY, Lee HY, Hwang SI, Sung SH, Cho SJ, Yoon YJ, Park JK. Herbal Medicine for Postpartum Pain: A Systematic Review of Puerperal Wind Syndrome (Sanhupung). Healthcare (Basel) 2023; 11:2743. [PMID: 37893817 PMCID: PMC10606538 DOI: 10.3390/healthcare11202743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/27/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Mothers in the postpartum period often experience musculoskeletal disorders and pain, impacting their ability to care for themselves and their infants. Conventional treatments have limitations, prompting interest in alternative options like herbal medicine. This systematic review aimed to confirm the effectiveness and safety of herbal medicine treatment to improve maternal health in patients with postpartum pain (puerperal wind syndrome). We searched eight electronic databases for randomized controlled trials (RCTs) to evaluate the effects of herbal medicines on puerperal wind syndrome. Nine RCTs, including 652 patients, were selected. Following a meta-analysis of RCTs, both herbal medicine and combination treatments improved the visual analog scale scores, total effective rate, scores of Traditional Chinese Medicine syndromes, Oswestry Disability Index, and quality of life in patients with role-emotional puerperal wind syndrome. All adverse events were minor, and the incidence rate was not high compared with that of the control group. In conclusion, herbal medicine supports the improvement in pain, other systemic symptoms, and the quality of life of patients with puerperal wind syndrome. Moreover, no serious side effects were observed; therefore, herbal medicines appear to be safe. It can be the preferred treatment option for puerperal wind syndrome, which is currently managed symptomatically.
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Affiliation(s)
- Na-Yoen Kwon
- Department of Obstetrics and Gynecology, College of Korean Medicine, Ga-Chon University, Seongnam-si 13120, Republic of Korea;
| | - Hee-Yoon Lee
- Department of Korean Medicine Obstetrics and Gynecology, Pusan National University Korean Medicine Hospital, Yangsan-si 50612, Republic of Korea; (H.-Y.L.); (Y.-J.Y.)
- Department of Korean Medicine Obstetrics and Gynecology, School of Korean Medicine, Pusan National University, Yangsan-si 50612, Republic of Korea;
| | - Su-In Hwang
- Department of Korean Medicine Obstetrics and Gynecology, School of Korean Medicine, Pusan National University, Yangsan-si 50612, Republic of Korea;
| | - Soo-Hyun Sung
- Department of Policy Development, National Institute of Korean Medicine Development, Seoul 04554, Republic of Korea;
| | - Su-Jin Cho
- Research Institute of Nursing Science, Pusan National University, Yangsan-si 50612, Republic of Korea;
| | - Young-Jin Yoon
- Department of Korean Medicine Obstetrics and Gynecology, Pusan National University Korean Medicine Hospital, Yangsan-si 50612, Republic of Korea; (H.-Y.L.); (Y.-J.Y.)
- Department of Korean Medicine Obstetrics and Gynecology, School of Korean Medicine, Pusan National University, Yangsan-si 50612, Republic of Korea;
| | - Jang-Kyung Park
- Department of Korean Medicine Obstetrics and Gynecology, Pusan National University Korean Medicine Hospital, Yangsan-si 50612, Republic of Korea; (H.-Y.L.); (Y.-J.Y.)
- Department of Korean Medicine Obstetrics and Gynecology, School of Korean Medicine, Pusan National University, Yangsan-si 50612, Republic of Korea;
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McBride GM, Stevenson R, Zizzo G, Rumbold AR, Amir LH, Keir A, Grzeskowiak LE. Women's experiences with using domperidone as a galactagogue to increase breast milk supply: an australian cross-sectional survey. Int Breastfeed J 2023; 18:11. [PMID: 36750944 PMCID: PMC9903405 DOI: 10.1186/s13006-023-00541-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 01/07/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Domperidone is one of the most commonly utilised pharmacological galactagogues, with evidence of increasing use in clinical practice. However, the use of domperidone as a galactagogue remains controversial, with mixed evidence on safety and efficacy, leading to variable clinical practice recommendations. We sought to evaluate contemporary patterns of domperidone use and examine maternal experiences related to perceived safety and effectiveness. METHODS In 2019, we conducted an online, cross-sectional survey of Australian breastfeeding women to examine individual experiences related to domperidone use, in addition to perceptions of safety and effectiveness. RESULTS Among 1876 survey responses, 19% (n = 355) reported using domperidone. Domperidone use was significantly higher in women who were primiparous, gave birth preterm, delivered by caesarean section, had self-perceived low milk supply, and saw a lactation consultant. Nearly 20% of women commenced domperidone use in the first week postpartum (19%, n = 67). The median duration of use was six weeks (interquartile range 3-16 weeks). Maximum reported doses of domperidone used ranged from 20 mg/day to 160 mg/day. Half (n = 178, 50%) of women reported using a dose of 30 mg/day or less, 44% (n = 155) reported using a dose between 31 and 60 mg/day, and 6% (n = 22) reported using a dose greater than 61 mg/day. Nearly half of the respondents reported domperidone as 'very' or 'extremely effective' (45%, n = 161), with only 8% (n = 27) reporting it was 'not at all effective'. Almost half (n = 172, 48%) of all women using domperidone reported side effects, including weight gain (25%), headaches (17%) and dry mouth (13%). Higher doses were associated with an increased likelihood of any side effects (≤ 30 mg/day, 38%; >31-≤60 mg/day, 48%, > 61 mg/day 73%; P < 0.004), with 31 (9%) stopping domperidone because of side effects. CONCLUSION We identified widespread variation in domperidone utilisation patterns, with domperidone broadly perceived to be effective in increasing breast milk supply. Side effects associated with domperidone treatment were common, appeared to be dose-related, and were frequently associated with treatment cessation. These findings highlight the importance of improved clinical practice recommendations and generation of evidence from additional high-quality clinical trials evaluating the efficacy and safety of domperidone. More conclusive clinical trials are needed to determine the efficacy, as well as optimal dose and duration, of domperidone use.
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Affiliation(s)
- Grace M. McBride
- grid.1010.00000 0004 1936 7304Adelaide Medical School, Robinson Research Institute, University of Adelaide , Adelaide, Australia ,grid.430453.50000 0004 0565 2606SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Robyn Stevenson
- grid.1010.00000 0004 1936 7304Adelaide Medical School, Robinson Research Institute, University of Adelaide , Adelaide, Australia
| | - Gabbie Zizzo
- grid.1010.00000 0004 1936 7304Adelaide Medical School, Robinson Research Institute, University of Adelaide , Adelaide, Australia
| | - Alice R. Rumbold
- grid.1010.00000 0004 1936 7304Adelaide Medical School, Robinson Research Institute, University of Adelaide , Adelaide, Australia ,grid.430453.50000 0004 0565 2606SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Lisa H. Amir
- grid.1018.80000 0001 2342 0938Judith Lumley Centre, La Trobe University, Melbourne, Australia ,grid.416259.d0000 0004 0386 2271Breastfeeding Service, Royal Women’s Hospital, Parkville, Australia
| | - Amy Keir
- grid.1010.00000 0004 1936 7304Adelaide Medical School, Robinson Research Institute, University of Adelaide , Adelaide, Australia ,grid.430453.50000 0004 0565 2606SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Luke E. Grzeskowiak
- grid.1010.00000 0004 1936 7304Adelaide Medical School, Robinson Research Institute, University of Adelaide , Adelaide, Australia ,grid.430453.50000 0004 0565 2606SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia ,grid.467022.50000 0004 0540 1022SA Pharmacy, SA Health, Adelaide, Australia ,grid.1014.40000 0004 0367 2697College of Medicine and Public, Flinders Health and Medical Research Institute Flinders University, GPO Box 2100, SA 5001 Adelaide, Australia
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Alqathama A, Alhomoud F, Alsadiq Y, Almehmadi A, Fallatah W, Alharbi O, Abdulhakim B, Alsubhi R, Alluqmani R. Complementary and alternative medicine from the perspective of pregnant and lactating women. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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McBride GM, Stevenson R, Zizzo G, Rumbold AR, Amir LH, Keir AK, Grzeskowiak LE. Knowledge of Galactagogue Use During Breastfeeding in Australia: A Cross Sectional Online Survey. J Hum Lact 2022; 38:740-748. [PMID: 35236166 DOI: 10.1177/08903344221077131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Galactagogues have been used for centuries to induce, maintain, or increase a mother's milk supply. Recently, there has been an apparent increase in utilization and promotion of galactagogues, largely in the absence of data regarding their efficacy and safety. However, there is limited contemporary evidence about knowledge of these substances in the community or how and where individuals seek information. RESEARCH AIM To evaluate knowledge about galactagogue use during breastfeeding among birth parents, including recognition of specific substances, perceptions of safety, and common information sources. METHOD An online, prospective, cross-sectional survey of Australian birthing parents (N = 2055) who were currently breastfeeding or had previously breastfed their infants was conducted from September to December 2019. The survey included questions about recognition of galactagogues, perceptions of safety, and information-seeking behaviors. RESULTS Among participants, 47% (n = 882) were primiparous and 65% (n = 1,219) were currently breastfeeding. The most recognized galactagogues included lactation cookies (89%; n = 1,828), brewer's yeast (79%; n = 1,629), fenugreek (74%; n = 1,519), and domperidone (69%; n = 1,420). Respondents cited the internet (52%; n = 1,066), lactation support providers (46%; n = 951), midwives (42%; n = 873), general practitioners (39%; n = 802), and social media (35%; n = 714) as common information sources. Lactation support providers and breastfeeding helplines were commonly rated as helpful; whereas, general practitioners and community pharmacists were often rated as unhelpful. While most participants perceived galactagogues to be safe, herbal or dietary galactagogues were perceived to be safer than pharmaceutical galactagogues. CONCLUSIONS Our Australian community survey of individuals with current or previous breastfeeding experience identified widespread recognition of galactagogue use, with participants reporting a broad range of information-seeking behaviors and generally perceiving galactagogues as being safe to use.
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Affiliation(s)
- Grace McKenzie McBride
- Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Robyn Stevenson
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Gabriella Zizzo
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Alice R Rumbold
- Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Robinson Research Institute, University of Adelaide, Adelaide, Australia.,SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Lisa H Amir
- Judith Lumley Centre, La Trobe University, Bundoora, Australia.,Breastfeeding Service, Royal Women's Hospital, Parkville, Australia
| | - Amy K Keir
- Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Robinson Research Institute, University of Adelaide, Adelaide, Australia.,SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Luke Edward Grzeskowiak
- Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Robinson Research Institute, University of Adelaide, Adelaide, Australia.,SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia.,SA Pharmacy, SA Health, Adelaide, Australia.,Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
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Lawal U, Mohammed RT, Gidado SM, Kankara SS. Ethnobotanical survey and nutritional composition of medicinal plants used for traditional galactagogue practice in Katsina state, Nigeria. ADVANCES IN TRADITIONAL MEDICINE 2022. [DOI: 10.1007/s13596-022-00667-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Tan ML, Foong SC, Foong WC, Ho JJ. Use of Galactagogues in a Multi-Ethnic Community in Southeast Asia: A Descriptive Study. Int J Womens Health 2022; 14:1395-1404. [PMID: 36172202 PMCID: PMC9512541 DOI: 10.2147/ijwh.s366288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 08/15/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose Galactagogues are substances that increase breast-milk production. They can be medication, herbs or food. Use of galactagogues may be different among the major ethnic groups in Malaysia. The primary objective of this cross-sectional study is to determine the prevalence of galactagogues use among breastfeeding mothers in a multi-ethnic community. Patients and Methods Self-administered questionnaires were distributed between November 2016 and January 2017 to mothers attending the health clinics and private hospital paediatric clinics in Penang, Malaysia, whose infants were below 6 months of age. The questionnaire enquired about use of galactagogues, types of galactagogue used, perceived effectiveness and sources of information. It also asked mothers about what they would do to increase milk supply. Results We analyzed 322 out of 530 questionnaires distributed where 76% of mothers reported use of galactagogues; most of which were food-based: dates (66%), oats (58%) and soya bean (56%). Each major ethnic group had a different preference for galactagogues: Malays (dates), Chinese (soya bean) and Indians (oats). Only one mother used pharmacological galactagogues alone. Galactagogues were perceived to be effective by 65% of mothers who used them. Multivariate analysis showed that use of galactagogues was not related to ethnicity, education, work, perception of milk supply or use of formula milk. The most common source of information on galactagogues came from family and friends. Conclusion Use of galactagogues is common in our population, especially food-based ones, and the choice of galactagogues differs by ethnicity. Future studies on efficacy and safety galactagogues should be focused these commonly used ones. There is also a need for qualitative studies to improve our understanding of why they are widely used in this region.
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Affiliation(s)
- May Loong Tan
- Department of Pediatrics, RCSI & UCD Malaysia Campus, George Town, Penang, Malaysia
| | - Siew Cheng Foong
- Department of Pediatrics, RCSI & UCD Malaysia Campus, George Town, Penang, Malaysia
| | - Wai Cheng Foong
- Department of Pediatrics, RCSI & UCD Malaysia Campus, George Town, Penang, Malaysia
| | - Jacqueline J Ho
- Department of Pediatrics, RCSI & UCD Malaysia Campus, George Town, Penang, Malaysia
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Millinga VP, Im HB, Hwang JH, Choi SJ, Han D. Use of Herbal Medicines Among Breastfeeding Mothers in Tanzania: A Cross-Sectional Study. Front Pharmacol 2022; 13:751129. [PMID: 35571105 PMCID: PMC9096166 DOI: 10.3389/fphar.2022.751129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background: There are limited data on the use of herbal medicines (HM) among breastfeeding mothers, despite the fact that knowledge of the possible benefits or harms of HM use has a direct relationship with the health of infants, especially in resource-limited countries. The study aims to determine the prevalence and factors associated with HM use among breastfeeding mothers in Tanzania. Methods: The study followed a cross-sectional design using a structured survey questionnaire. Survey participants were recruited from the reproductive and child health clinic at Uhuru health center in Morogoro, Tanzania. The survey instrument comprised of 34 questions, including demographic information, the pattern of HM use during breastfeeding, and women's perceptions of HM. Chi-square test and logistic regression were used for data analysis using SPSS ver. 24.0. Results: The majority of the respondents (53.8%) used HM during breastfeeding. The most commonly used HM was black pepper (Piper nigrum L.; 80.0%), followed by pumpkin seeds (Cucurbita pepo L.; 18.0%). About one-third (27.5%) of HM users discussed their use with their healthcare providers. In addition, higher education levels and low breastmilk supply were identified as potential predictors of HM use. Conclusion: The practice of HM use among breastfeeding mothers in Tanzania is popular to ease breastfeeding difficulties. However, the issue of the safety or effectiveness of HM is still an unknown agenda. This awakens the need to evaluate HM's safety, efficacy, and quality through pharmacological studies for scientific evidence. Lastly, a clinical guideline should be developed in healthcare settings to promote open dialogues between the healthcare providers and mothers to ensure the safe use of HM.
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Affiliation(s)
| | - Hyea Bin Im
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, South Korea.,Institute of Health Services Management, Hanyang University, Seoul, South Korea
| | - Jung Hye Hwang
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, South Korea.,Institute of Health Services Management, Hanyang University, Seoul, South Korea.,Department of Obstetrics and Gynecology, College of Medicine, Hanyang University, Seoul, South Korea
| | - Soo Jeung Choi
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, South Korea.,Institute of Health Services Management, Hanyang University, Seoul, South Korea
| | - Dongwoon Han
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, South Korea.,Institute of Health Services Management, Hanyang University, Seoul, South Korea.,Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea
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Molavi Vardanjani H, Salehi Z, Alembizar F, Cramer H, Pasalar M. Prevalence and the Determinants of Traditional, Complementary, and Integrative Medicine Use Among Breastfeeding Mothers: A Cross-Sectional Study. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:67-76. [PMID: 35085020 DOI: 10.1089/jicm.2021.0270] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objectives: Breastfeeding is highly important for a child's health, and the widespread use of herbal medicines as galactagogues has been reported. The present study was conducted to evaluate the use of traditional, complementary, and integrative medicine (TCIM) and its determinants among breastfeeding mothers in Shiraz, Iran. Design: Cross-sectional study. Setting/Location: Neonatal clinics affiliated to Shiraz University of Medical Sciences. Subjects: Mothers elder than 18 years old. Interventions: Nothing. Outcome Measures: Prevalence and of the use of TCIM products and its associated factors. Methods: In this cross-sectional study, mothers older than 18 years who referred to neonatal clinics affiliated to Shiraz University of Medical Sciences were enrolled. Using a structured interview, the authors explored the prevalence and of the use of TCIM products and its associated factors. Results: Of 625 mothers who were approached, 483 agreed to participate (response rate: 77.3%). The average age was 27.3 ± 5.9 years. The prevalence of using TCIM products during current breastfeeding was 97.1%. There were 168 working mothers (44.9%); 163 mothers (34.1%) complaining of postpartum breastfeeding problems, and 327 mothers (68%) had no history of breastfeeding. Recommendations of medical staff or relatives were the most frequent reasons for the consumption of TCIM products (64.9%). Only 27% of mothers disclosed the use of TCIM products to their doctor or health care provider, although 62% of mothers were asked about the use of such products. Notably, 438 mothers (95.8%) considered TCIM to increase their milk. Based on multivariable logistic regression, literacy and past use of TCIM galactagogues were independently associated with TCIM products use. Conclusions: The use of TCIM galactagogues is highly common among breastfeeding mothers in south of Iran, showing a diverse range of determinants. It is necessary to evaluate the safety and efficacy of common herbal galactagogues, and evidence-based studies must be designed to achieve standardized complementary medicine approaches in this regard.
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Affiliation(s)
- Hossein Molavi Vardanjani
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Salehi
- Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Faranak Alembizar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Mehdi Pasalar
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Essence of Parsiyan Wisdom Institute, Traditional Medicine and Medicinal Plant Incubator, Shiraz University of Medical Sciences, Shiraz, Iran
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12
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Chang D, Bhuyan D, Dissanayake I, Jaye K. Traditional and complementary medicine in Australia: Clinical practice, research, education, and regulation. Int J Ayurveda Res 2022. [DOI: 10.4103/ijar.ijar_4_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Barnes LAJ, Rolfe MI, Barclay L, McCaffery K, Aslani P. Demographics, health literacy and health locus of control beliefs of Australian women who take complementary medicine products during pregnancy and breastfeeding: A cross-sectional, online, national survey. Health Expect 2021; 25:667-683. [PMID: 34951097 PMCID: PMC8957740 DOI: 10.1111/hex.13414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 11/28/2022] Open
Abstract
Background Pregnant and breastfeeding women's use of complementary medicine products (CMPs) is common, and possibly associated with autonomous health care behaviours. However, the health literacy levels and health locus of control (HLOC) beliefs of women who use CMPs in pregnancy and lactation have not been previously assessed in a large Australian sample. Aim The aim of this study is to determine the health literacy levels and HLOC beliefs of women who use CMPs in pregnancy and lactation and determine the types of CMPs used. Methods A cross‐sectional, national, online survey of Australian pregnant or breastfeeding women aged 18 years and older, and currently using CMPs was conducted. Results A total of 810 completed surveys (354 pregnant and 456 breastfeeding women) were analysed. Most had adequate functional health literacy levels (93.3%). Health care practitioners (HCPs) HLOC mean scores were the highest for the sample, followed by Internal HLOC beliefs mean scores. Almost all (n = 809) took at least one dietary supplement, the most popular being pregnancy and breastfeeding multivitamins, iron supplements and probiotics. Use was generally in line with clinical recommendations, except for low rates of iodine supplementation. Herbal medicine use was lower for the total sample (57.3%, n = 464), but significantly higher (p < .0001) for the breastfeeding cohort, with consumers taking one to four herbal medicines each. The most popular herbs were raspberry leaf, ginger, peppermint and chamomile (pregnant respondents) and chamomile, ginger and fenugreek (breastfeeding respondents). Conclusions Respondents were health literate, with high scores for Internal and HCP HLOC scales, suggesting that they are likely to demonstrate self‐efficacy, positive health behaviours and work well in partnership with HCPs. HCPs can facilitate discussions with pregnant and breastfeeding women using CMPs, while considering women's health literacy levels, health beliefs and goals.
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Affiliation(s)
- Larisa A J Barnes
- Faculty of Medicine and Health, School of Pharmacy and University Centre for Rural Health, The University of Sydney, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University Centre for Rural Health and School of Public Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Margaret I Rolfe
- Faculty of Medicine and Health, University Centre for Rural Health and School of Public Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Lesley Barclay
- Faculty of Medicine and Health, University Centre for Rural Health and School of Public Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Kirsten McCaffery
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Parisa Aslani
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
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Zizzo G, Rumbold AR, Grzeskowiak LE. "Fear of stopping" vs "wanting to get off the medication": exploring women's experiences of using domperidone as a galactagogue - a qualitative study. Int Breastfeed J 2021; 16:92. [PMID: 34886887 PMCID: PMC8656031 DOI: 10.1186/s13006-021-00438-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 11/16/2021] [Indexed: 11/10/2022] Open
Abstract
Background Domperidone is the most frequently prescribed medicine used to increase breast milk supply. There is considerable controversy surrounding the use of domperidone in lactation, due to limited evidence about efficacy and concerns about rare but life-threatening side-effects. Despite this, in many high-income settings such as Australia, use of domperidone among breastfeeding mothers appears to be increasing. The aim of this paper was to explore women’s experiences of using domperidone during breastfeeding. Methods Semi-structured interviews were conducted in 2019 with 15 women in Australia who reported using domperidone as a galactagogue during breastfeeding. Interviews were recorded, transcribed and analysed thematically. Results Women reported a wide variety of practices concerning the timing of initiation of domperidone use, including prophylactic use, as well as the dose and duration of use. Prolonged periods of use and unsupervised dosing were commonly reported, these practices were sometimes associated with a fear of the consequences of stopping, insufficient provision of information about the drug or feeling dismissed by health professionals. Some women indicated that when doctors refused to prescribe domperidone they responded by doctor shopping and seeking anecdotal information about benefits and risks online, leading to unsupervised practices. Women often reported high expectations surrounding the effectiveness of domperidone, and most used the medication in conjunction with food/herbal galactagogues and non-galactagogue support. Positive outcomes following domperidone use included having greater confidence in breastfeeding and pride at achieving breastfeeding goals. Conclusions This study identified a variety of practices concerning domperidone use, including potentially unsafe practices, linked in some cases to inconsistent advice from health professionals and a reliance on online, anecdotal information sources. These findings emphasise the urgent need for development of clinical practice guidelines and a greater focus on translating existing evidence concerning domperidone into clinical practice, including clinical support that is tailored to women’s needs.
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Affiliation(s)
- Gabriella Zizzo
- Faculty of Health and Medical Science, The University of Adelaide, Adelaide, Australia
| | - Alice R Rumbold
- Faculty of Health and Medical Science, The University of Adelaide, Adelaide, Australia.,SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Luke E Grzeskowiak
- Faculty of Health and Medical Science, The University of Adelaide, Adelaide, Australia. .,SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia. .,Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia. .,SA Pharmacy, SA Health, Adelaide, Australia.
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15
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Sibeko L, Johns T, Cordeiro LS. Traditional plant use during lactation and postpartum recovery: Infant development and maternal health roles. JOURNAL OF ETHNOPHARMACOLOGY 2021; 279:114377. [PMID: 34192598 DOI: 10.1016/j.jep.2021.114377] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/11/2021] [Accepted: 06/25/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Evidence of phytochemical roles in infant development and maternal recovery offers insights into beneficial functions of traditional plant use during lactation and the postpartum period. Ethnopharmacological research has relevance to global priorities on maternal and child health, to understanding origins and determinants of human self-medication, and for reconciling traditional postpartum practices and mainstream healthcare. AIM OF THE STUDY Present emerging evidence, within evolutionary and socio-cultural contexts, on the role of maternal consumption on transfer of phytochemicals into breast milk with impacts on maternal and child health, and on infant development. Establish current state of knowledge and an ethnopharmacological research agenda that is attentive to cross-cultural and regional differences in postpartum plant use. MATERIALS AND METHODS An extensive literature review using Medline, Scopus, and Web of Science focused on traditional and contemporary use and socio-cultural context, as well as physiological, pharmacological, toxicological, and behavioral activities of plants used medicinally by women during postpartum recovery and lactation. RESULTS The most widely reported postpartum plants show antimicrobial, anti-inflammatory, immunological, and neurophysiological activities, with low toxicity. Phytochemicals transfer from maternal consumption into breast milk in physiological concentrations, while animal studies demonstrate immunomodulation and other actions of medicinal plants during lactation. Reporting on the use and diverse traditional knowledge of women about plants during the postpartum period is obscured by the marginal place of obstetric issues and by gender biases in ethnobotanical research. In many contemporary contexts use is prejudiced by precautionary risk warnings in health literature and practice that confound lactation with pregnancy. CONCLUSIONS Although systematic investigation of postpartum plant use is lacking, known pharmacological activities support potential benefits on infant development and maternal health with immediate and long-term consequences in relation to allergic, inflammatory, autoimmune, and other diseases. An ethnopharmacological agenda focused on the perinatal period requires directed methodologies and a regional approach in relation to culturally-specific knowledge and practices, traditional plant use, and local health needs. Testing the hypothesis that phytochemicals transferred from medicinal plants into breast milk impact the human immune system and other aspects of infant development requires extended analysis of phytochemicals in human milk and infant lumen and plasma, as well as effects on gastrointestinal and milk microbiome.
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Affiliation(s)
- Lindiwe Sibeko
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, 01003, USA.
| | - Timothy Johns
- School of Human Nutrition, McGill University, Ste. Anne de Bellevue, QC, H9X 3V9, Canada.
| | - Lorraine S Cordeiro
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, 01003, USA.
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16
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Lenells M, Andersson E, Gustafsson A, Wells M, Dennis CL, Wilson E. Breastfeeding interventions for preventing postpartum depression. Hippokratia 2021. [DOI: 10.1002/14651858.cd014833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Mikaela Lenells
- Women's and Children's Health; Karolinska Institutet; Stockholm Sweden
| | - Ewa Andersson
- Women's and Children's Health; Karolinska Institutet; Stockholm Sweden
| | - Anna Gustafsson
- Clinical Science, Intervention and Technology, Division of Paediatrics; Karolinska Institutet; Stokholm Sweden
- Department of Neonatology; Karolinska University Hospital; Stockholm Sweden
| | - Michael Wells
- Women's and Children's Health; Karolinska Institutet; Stockholm Sweden
| | - Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing; University of Toronto; Toronto Canada
| | - Emilija Wilson
- Women's and Children's Health; Karolinska Institutet; Stockholm Sweden
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Sevrin T, Sirvins C, David A, Aguesse A, Gandon A, Castellano B, Darmaun D, Boquien CY, Alexandre-Gouabau MC. Dietary Arginine Supplementation during Gestation and Lactation Increases Milk Yield and Mammary Lipogenesis in Rats. J Nutr 2021; 151:2188-2198. [PMID: 34091672 DOI: 10.1093/jn/nxab152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/29/2021] [Accepted: 04/26/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Arginine, an essential amino acid during the reproductive period, has been shown to enhance lactation performances in livestock. Whether it could help mothers with breastfeeding difficulties is not known. OBJECTIVES This study aimed to determine whether dietary arginine supplementation would enhance milk production in rat dams nursing large 12-pup litters and, if so, what mechanisms are involved. METHODS In 3 series of experiments, differing in dam killing timing, 59 primiparous, pregnant Sprague-Dawley rats (mean ± SD weight: 254 ± 24.7 g) were randomly assigned to receive either 1) an AIN-93G diet supplemented with l-arginine at 2.0% (ARG diet), through lactation and gestation (AGL group); 2) a control AIN-93G diet including at 3.5% an isonitrogenous mix of amino acids that are not essential for lactation (MA diet), during gestation and lactation (MA group); or 3) the MA diet during gestation and the ARG diet during lactation (AL group). Milk flow was measured using deuterated water enrichment between days 11 and 18. Plasma hormones and mammary expression of genes involved in lactation were measured using ELISA and qRT-PCR, respectively, at lactation days 12, 18, or 21 in the 3 experiments. Data were analyzed by ANOVA. RESULTS Dam food intake, pup weight gain, milk flow normalized to dam weight, and milk fat concentration were 17%, 9%, 20%, and 20% greater in the AGL group than in the MA group, respectively (P < 0.05). Genes involved in lipogenesis and lipid regulation were overexpressed ≤2.76-fold in the mammary gland of AGL dams compared with MA dams (P < 0.05) and plasma leptin concentration was 39% higher (P = 0.008). Milk flow and composition and mammary gene expression of the AL group did not differ from those of the MA group, whereas milk fat concentration and flow were 26% and 37% lower than in the AGL group, respectively. CONCLUSIONS Arginine supplementation during gestation and lactation enhances milk flow and mammary lipogenesis in rats nursing large litters.
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Affiliation(s)
- Thomas Sevrin
- Laboratoire FRANCE Bébé Nutrition, Laval, France
- UMR 1280-Pathophysiology of Nutritional Adaptations (PhAN), Nantes University, INRAE, IMAD, CRNH-Ouest, Nantes, France
| | - Charlène Sirvins
- UMR 1280-Pathophysiology of Nutritional Adaptations (PhAN), Nantes University, INRAE, IMAD, CRNH-Ouest, Nantes, France
| | - Agnès David
- UMR 1280-Pathophysiology of Nutritional Adaptations (PhAN), Nantes University, INRAE, IMAD, CRNH-Ouest, Nantes, France
| | - Audrey Aguesse
- UMR 1280-Pathophysiology of Nutritional Adaptations (PhAN), Nantes University, INRAE, IMAD, CRNH-Ouest, Nantes, France
| | - Alexis Gandon
- UMR 1280-Pathophysiology of Nutritional Adaptations (PhAN), Nantes University, INRAE, IMAD, CRNH-Ouest, Nantes, France
| | - Blandine Castellano
- UMR 1280-Pathophysiology of Nutritional Adaptations (PhAN), Nantes University, INRAE, IMAD, CRNH-Ouest, Nantes, France
| | - Dominique Darmaun
- UMR 1280-Pathophysiology of Nutritional Adaptations (PhAN), Nantes University, INRAE, IMAD, CRNH-Ouest, Nantes, France
- University Hospital of Nantes, Nantes, France
| | - Clair-Yves Boquien
- UMR 1280-Pathophysiology of Nutritional Adaptations (PhAN), Nantes University, INRAE, IMAD, CRNH-Ouest, Nantes, France
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Mukonowenzou NC, Adeshina KA, Donaldson J, Ibrahim KG, Usman D, Erlwanger KH. Medicinal Plants, Phytochemicals, and Their Impacts on the Maturation of the Gastrointestinal Tract. Front Physiol 2021; 12:684464. [PMID: 34393812 PMCID: PMC8363294 DOI: 10.3389/fphys.2021.684464] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/29/2021] [Indexed: 12/24/2022] Open
Abstract
The gastrointestinal tract (GIT) is the first point of contact for ingested substances and thus represents a direct interface with the external environment. Apart from food processing, this interface plays a significant role in immunity and contributes to the wellbeing of individuals through the brain-gut-microbiota axis. The transition of life from the in utero environment, to suckling and subsequent weaning has to be matched by phased development and maturation of the GIT; from an amniotic fluid occupancy during gestation, to the milk in the suckling state and ultimately solid food ingestion at weaning. This phased maturation of the GIT can be affected by intrinsic and extrinsic factors, including diet. Despite the increasing dietary inclusion of medicinal plants and phytochemicals for health benefits, a dearth of studies addresses their impact on gut maturation. In this review we focus on some recent findings mainly on the positive impact of medicinal plants and phytochemicals in inducing precocious maturation of the GIT, not only in humans but in pertinent animals. We also discuss Paneth cells as mediators and potential markers of GIT maturation.
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Affiliation(s)
| | - Kehinde Ahmad Adeshina
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Sokoto, Nigeria
- Centre for Advanced Medical Research and Training, Usmanu Danfodiyo University, Sokoto, Sokoto, Nigeria
| | - Janine Donaldson
- Faculty of Health Sciences, School of Physiology, University of the Witwatersrand, Johannesburg, Johannesburg, South Africa
| | - Kasimu Ghandi Ibrahim
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Sokoto, Nigeria
- Centre for Advanced Medical Research and Training, Usmanu Danfodiyo University, Sokoto, Sokoto, Nigeria
| | - Dawoud Usman
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Sokoto, Nigeria
- Centre for Advanced Medical Research and Training, Usmanu Danfodiyo University, Sokoto, Sokoto, Nigeria
| | - Kennedy Honey Erlwanger
- Faculty of Health Sciences, School of Physiology, University of the Witwatersrand, Johannesburg, Johannesburg, South Africa
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McBride GM, Stevenson R, Zizzo G, Rumbold AR, Amir LH, Keir AK, Grzeskowiak LE. Use and experiences of galactagogues while breastfeeding among Australian women. PLoS One 2021; 16:e0254049. [PMID: 34197558 PMCID: PMC8248610 DOI: 10.1371/journal.pone.0254049] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/19/2021] [Indexed: 02/05/2023] Open
Abstract
Background Galactagogues are substances thought to increase breast milk production, however evidence to support their efficacy and safety remain limited. We undertook a survey among Australian women to examine patterns of use of galactagogues and perceptions regarding their safety and effectiveness. Methods An online, cross-sectional survey was distributed between September and December 2019 via national breastfeeding and preterm birth support organisations, and networks of several research institutions in Australia. Women were eligible to participate if they lived in Australia and were currently/previously breastfeeding. The survey included questions about galactagogue use (including duration and timing), side effects and perceived effectiveness (on a scale of 1 [Not at all effective] to 5 [Extremely effective]). Results Among 1876 respondents, 1120 (60%) reported using one or more galactagogues. Women were 31.5 ± 4.8 years (mean ± standard deviation) at their most recent birth. Sixty-five percent of women were currently breastfeeding at the time of the survey. The most commonly reported galactagogues included lactation cookies (47%), brewer’s yeast (32%), fenugreek (22%) and domperidone (19%). The mean duration of use for each galactagogue ranged from 2 to 20 weeks. Approximately 1 in 6 women reported commencing galactagogues within the first week postpartum. Most women reported receiving recommendations to use herbal/dietary galactagogues from the internet (38%) or friends (25%), whereas pharmaceutical galactagogues were most commonly prescribed by General Practitioners (72%). The perceived effectiveness varied greatly across galactagogues. Perceived effectiveness was highest for domperidone (mean rating of 3.3 compared with 2.0 to 3.0 among other galactagogues). Over 23% of domperidone users reported experiencing multiple side effects, compared to an average of 3% of women taking herbal galactagogues. Conclusions This survey demonstrates that galactagogues use is common in Australia. Further research is needed to generate robust evidence about galactagogues’ efficacy and safety to support evidence-based strategies and improve breastfeeding outcomes.
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Affiliation(s)
- Grace M. McBride
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
- The Robinson Research Institute, University of Adelaide, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Robyn Stevenson
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Gabriella Zizzo
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Alice R. Rumbold
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
- The Robinson Research Institute, University of Adelaide, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Lisa H. Amir
- Judith Lumley Centre, La Trobe University, Melbourne, Australia
- Breastfeeding Service, Royal Women’s Hospital, Parkville, Australia
| | - Amy K. Keir
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
- The Robinson Research Institute, University of Adelaide, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Luke E. Grzeskowiak
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
- The Robinson Research Institute, University of Adelaide, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
- SA Pharmacy, SA Health, Adelaide, Australia
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
- * E-mail:
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20
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Chao J, Ko CY, Lin CY, Tomoji M, Huang CH, Chiang HC, Yang JJ, Huang SS, Su SY. Ethnobotanical Survey of Natural Galactagogues Prescribed in Traditional Chinese Medicine Pharmacies in Taiwan. Front Pharmacol 2021; 11:625869. [PMID: 33679390 PMCID: PMC7928277 DOI: 10.3389/fphar.2020.625869] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/23/2020] [Indexed: 01/14/2023] Open
Abstract
Natural medicinal materials have been used to promote breast milk secretion. Here, we investigated the natural medicinal materials prescribed in traditional Chinese medicine (TCM) pharmacies across Taiwan to induce lactation. We collected medicinal materials from 87 TCM pharmacies, identified them in the prescriptions, and analyzed their drug contents. We examined their botanical origins, biological classifications, traditional usage, and modern pharmacological properties. We used the TCM Inheritance Support System to identify core medicinal materials in galactogenous prescriptions. We collected 81 medicinal materials from 90 galactogenous prescriptions. Leguminosae accounted for 12%, whereas Apiaceae accounted for 7% of all materials examined. The primary medicinal plant parts used were roots and seeds. Nineteen frequently used medicinal materials had a relative frequency of citation of greater than or equal to 0.2. According to their efficacy, 58% were warm, 54% were sweet, and 63% were tonifying; 74% of the frequently used medicinal materials have been showed efficacy against breast cancer. The primary core medicinal material was Angelica sinensis (Oliv.) Diels, whereas the secondary core medicinal materials were Tetrapanax papyrifer (Hook.) K. Koch and Hedysarum polybotrys Hand.-Mazz. Most galactogenous prescriptions consisted of multiple materials from Leguminosae and Apiaceae. The mechanisms underlying galactogenous efficacy warrant further investigations.
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Affiliation(s)
- Jung Chao
- Department of Chinese Pharmaceutical Sciences and Chinese Medicine Resources, Chinese Medicine Research Center, China Medical University, Taichung, Taiwan
| | - Chien-Yu Ko
- School of Pharmacy, China Medical University, Taichung, Taiwan
| | - Chin-Yu Lin
- Institute of New Drug Development, China Medical University, Taichung, Taiwan.,Tsuzuki Institute for Traditional Medicine, China Medical University, Taichung, Taiwan
| | - Maeda Tomoji
- Department of Pharmaceutical Sciences, Nihon Pharmaceutical University, Saitama, Japan.,Tsuzuki Institute for Traditional Medicine, China Medical University, Taichung, Taiwan
| | | | - Hung-Che Chiang
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Jeng-Jer Yang
- Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Shyh-Shyun Huang
- School of Pharmacy, China Medical University, Taichung, Taiwan.,Department of Food Nutrition and Health Biotechnology, Asia University, Taichung, Taiwan
| | - Shan-Yu Su
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
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21
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Udoudo DA, Pitter C, Agu CF. The Use of Herbal Remedies Among Breastfeeding Mothers: A Cross-Sectional Study Among Women Visiting Public Health Facilities in Kingston and St. Andrew, Jamaica. INTERNATIONAL JOURNAL OF CHILDBIRTH 2021. [DOI: 10.1891/ijcbirth-d-20-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUNDThe use of herbal remedies is increasing among Jamaican women especially during pregnancy and breastfeeding even though there is no sufficient evidence on the safety of herbal remedies used during breastfeeding. The aim of this study was to determine the prevalence, commonly used herbal remedies and factors contributing to the use of herbal remedies among breastfeeding women. This research was guided by the Health Belief Model.METHODSA quantitative cross-sectional study was conducted using a structured and validated questionnaire. A consecutive sampling was used to achieve a sample size of 240 breastfeeding mothers across three Health Centers. Ethical considerations were followed. Data was analyzed using SPSS version 22.0.RESULTSThere was a 100% response rate with 56% of respondents who used herbal remedies while breastfeeding. Additionally, 43% chose garlic as their preferred herbal remedy while 16% used fever grass and 18% preferred ginger as their commonly used herb. The analysis revealed that 58% of the respondents used herbal remedies as supplements. It was also found that 13% used herbs to increase their breast milk supply while 12.9% used herbal remedies to treat illnesses. In addition, 10% used herbal remedies to prevent illness and 7% used herbal remedies for other reasons.CONCLUSIONThe use of herbal remedies is prevalent among breastfeeding women in public health facilities in Jamaica. Although few respondents use herbal remedies to promote lactation, most women use herbs for various reasons other than to increase their breast milk supply.
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Kaygusuz M, Gümüştakım RŞ, Kuş C, İpek S, Tok A. TCM use in pregnant women and nursing mothers: A study from Turkey. Complement Ther Clin Pract 2020; 42:101300. [PMID: 33412511 DOI: 10.1016/j.ctcp.2020.101300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/26/2020] [Accepted: 12/23/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND This study aimed to specify the frequency of traditional and complementary medicine (TCM) usage and the most commonly used methods by the pregnant. MATERIALS AND METHODS The cross-sectional and definitive study included 212 pregnant and 152 nursing women who applied to obstetric, pediatrics, and family practice polyclinics. FINDINGS Of the pregnant women, 38.7% applied to the TCM method during pregnancy, and of the nursing women, 63.2% during nursing. The most commonly used herbal products were mint, thyme and linden by the pregnant women while anise and mint were most commonly used by nursing.Women commonly used TCM methods to increase breast milk and for upper respiratory tract infection's symptoms. CONCLUSIONS Every health personnel who provides pregnancy care should be aware of the latest data published on the usage of TCM in the literature and educate patients about the usage of TCM which may have negative outcomes.
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Affiliation(s)
| | - Raziye Şule Gümüştakım
- Kahramanmaraş Sütçü İmam University Faculty of Medicine Family Medicine Department, Kahramanmaraş, Turkey.
| | - Celal Kuş
- Kahramanmaraş Sütçü İmam University Faculty of Medicine Family Medicine Department, Kahramanmaraş, Turkey.
| | - Sevcan İpek
- Kahramanmaraş Sütçü İmam University Faculty of Medicine Pediatrics Department, Kahramanmaraş, Turkey.
| | - Abdullah Tok
- Kahramanmaraş Sütçü İmam University Faculty of Medicine Obstetrics and Gynecology Department, Kahramanmaraş, Turkey.
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Ağagündüz D. Determination of the total antioxidant and oxidant status of some galactagogue and herbal teas. FOOD SCIENCE AND HUMAN WELLNESS 2020. [DOI: 10.1016/j.fshw.2020.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Sevrin T, Boquien CY, Gandon A, Grit I, de Coppet P, Darmaun D, Alexandre-Gouabau MC. Fenugreek Stimulates the Expression of Genes Involved in Milk Synthesis and Milk Flow through Modulation of Insulin/GH/IGF-1 Axis and Oxytocin Secretion. Genes (Basel) 2020; 11:E1208. [PMID: 33081164 PMCID: PMC7602737 DOI: 10.3390/genes11101208] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/06/2020] [Accepted: 10/13/2020] [Indexed: 12/12/2022] Open
Abstract
We previously demonstrated galactagogue effect of fenugreek in a rat model of lactation challenge, foreshadowing its use in women's breastfeeding management. To assess longitudinal molecular mechanisms involved in milk synthesis/secretion in dams submitted to fenugreek supplementation, inguinal mammary, pituitary glands and plasma were isolated in forty-three rats nursing large 12 pups-litters and assigned to either a control (CTL) or a fenugreek-supplemented (FEN) diet during lactation. RT-PCR were performed at days 12 and 18 of lactation (L12 and L18) and the first day of involution (Inv1) to measure the relative expression of genes related to both milk synthesis and its regulation in the mammary gland and lactogenic hormones in the pituitary gland. Plasma hormone concentrations were measured by ELISA. FEN diet induced 2- to 3-times higher fold change in relative expression of several genes related to macronutrient synthesis (Fasn, Acaca, Fabp3, B4galt1, Lalba and Csn2) and energy metabolism (Cpt1a, Acads) and in IGF-1 receptor in mammary gland, mainly at L12. Pituitary oxytocin expression and plasma insulin concentration (+77.1%) were also significantly increased. Altogether, these findings suggest fenugreek might extend duration of peak milk synthesis through modulation of the insulin/GH/IGF-1 axis and increase milk ejection by activation of oxytocin secretion.
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Affiliation(s)
- Thomas Sevrin
- FRANCE Bébé Nutrition (FBN) Laboratory, 53000 Laval, France;
- Mixed Research Unit 1280 Pathophysiology of Nutritional adaptations (UMR 1280 PhAN) Nantes University, Research Center in Human Nutrition-West (CRNH-O), Institute of Digestive Tract Diseases (IMAD), French National Research Institute for Agriculture, Food and Environment (INRAE), F-44000 Nantes, France; (C.-Y.B.); (A.G.); (I.G.); (P.d.C.); (D.D.)
| | - Clair-Yves Boquien
- Mixed Research Unit 1280 Pathophysiology of Nutritional adaptations (UMR 1280 PhAN) Nantes University, Research Center in Human Nutrition-West (CRNH-O), Institute of Digestive Tract Diseases (IMAD), French National Research Institute for Agriculture, Food and Environment (INRAE), F-44000 Nantes, France; (C.-Y.B.); (A.G.); (I.G.); (P.d.C.); (D.D.)
| | - Alexis Gandon
- Mixed Research Unit 1280 Pathophysiology of Nutritional adaptations (UMR 1280 PhAN) Nantes University, Research Center in Human Nutrition-West (CRNH-O), Institute of Digestive Tract Diseases (IMAD), French National Research Institute for Agriculture, Food and Environment (INRAE), F-44000 Nantes, France; (C.-Y.B.); (A.G.); (I.G.); (P.d.C.); (D.D.)
| | - Isabelle Grit
- Mixed Research Unit 1280 Pathophysiology of Nutritional adaptations (UMR 1280 PhAN) Nantes University, Research Center in Human Nutrition-West (CRNH-O), Institute of Digestive Tract Diseases (IMAD), French National Research Institute for Agriculture, Food and Environment (INRAE), F-44000 Nantes, France; (C.-Y.B.); (A.G.); (I.G.); (P.d.C.); (D.D.)
| | - Pierre de Coppet
- Mixed Research Unit 1280 Pathophysiology of Nutritional adaptations (UMR 1280 PhAN) Nantes University, Research Center in Human Nutrition-West (CRNH-O), Institute of Digestive Tract Diseases (IMAD), French National Research Institute for Agriculture, Food and Environment (INRAE), F-44000 Nantes, France; (C.-Y.B.); (A.G.); (I.G.); (P.d.C.); (D.D.)
| | - Dominique Darmaun
- Mixed Research Unit 1280 Pathophysiology of Nutritional adaptations (UMR 1280 PhAN) Nantes University, Research Center in Human Nutrition-West (CRNH-O), Institute of Digestive Tract Diseases (IMAD), French National Research Institute for Agriculture, Food and Environment (INRAE), F-44000 Nantes, France; (C.-Y.B.); (A.G.); (I.G.); (P.d.C.); (D.D.)
- Nantes University Hospital (CHU) Nantes, F-44000 Nantes, France
| | - Marie-Cécile Alexandre-Gouabau
- Mixed Research Unit 1280 Pathophysiology of Nutritional adaptations (UMR 1280 PhAN) Nantes University, Research Center in Human Nutrition-West (CRNH-O), Institute of Digestive Tract Diseases (IMAD), French National Research Institute for Agriculture, Food and Environment (INRAE), F-44000 Nantes, France; (C.-Y.B.); (A.G.); (I.G.); (P.d.C.); (D.D.)
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Brushett S, Sinha T, Reijneveld SA, de Kroon MLA, Zhernakova A. The Effects of Urbanization on the Infant Gut Microbiota and Health Outcomes. Front Pediatr 2020; 8:408. [PMID: 32903831 PMCID: PMC7438894 DOI: 10.3389/fped.2020.00408] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/12/2020] [Indexed: 12/14/2022] Open
Abstract
Humans and their gut microbiota have co-evolved over thousands of years, resulting in the establishment of a complex host-microbiota ecosystem. Early life environmental factors, such as delivery mode, nutrition, and medication use, have been shown to substantially affect both host-microbiota interactions and health outcomes. However, the effects of urbanization (characterized by the spectrum of rural and urban populations) on these early life events have been overlooked. A deeper understanding of the relationship between urbanization and microbiota development will allow for the identification of novel biological and social approaches that can be implemented to prevent and treat disease and promote maternal and infant/child health. The aim of this narrative review is to summarize how factors associated with urbanization differentially impact delivery mode, nutrition, and medication use, and how these changes subsequently affect the gut microbiota and health outcomes of infants. This narrative review also describes the important evidence gaps associated with these relationships and recommends actions that can be taken to improve the health of mothers and infants worldwide.
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Affiliation(s)
- Siobhan Brushett
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Trishla Sinha
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Marlou L. A. de Kroon
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Alexandra Zhernakova
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Nik Yusof Fuad NF, Ching SM, Awg Dzulkarnain DH, Cheong AT, Zakaria ZA. Complementary alternative medicine use among postpartum mothers in a primary care setting: a cross-sectional study in Malaysia. BMC Complement Med Ther 2020; 20:197. [PMID: 32586306 PMCID: PMC7318471 DOI: 10.1186/s12906-020-02984-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 06/08/2020] [Indexed: 11/30/2022] Open
Abstract
Background Complementary alternative medicine (CAM) is widely used among postpartum mothers to maintain their well-being. This study aims to determine the prevalence and factors associated with CAM use among postpartum mothers in a primary-care clinic in Malaysia. Methods This is a cross-sectional study of 725 postpartum mothers, aged 18 and above, attending a primary-care clinic. The systematic sampling method was used to recruit patients through a structured, self-administered questionnaire. Data analysis was conducted using SPSS version 23. Multiple logistic regression was used to identify the predictors of CAM use among postpartum mothers. Results The prevalence of CAM use among postpartum mothers was 85.5%. Manipulative body therapies, including massage, reflexology, hot stone compression and body wrapping were the most widely used methods of CAM (84.1%) among postpartum mothers, followed by biological-based therapies (33.1%). More than half of the respondents (52.1%) opted to use CAM, as they had observed good results from other CAM users. However, our study showed that 57.1% of mothers who consumed herbal medicine reported neonatal jaundice in their newborn. The median of the expenditure on CAM usage was 250 Malaysian Ringgits, or USD 61.3 per month. According to multiple logistic regression analyses, being Muslim (OR = 5.258, 95% CI: 2.952–9.368), being Malay (OR = 4.414, 95% CI: 1.18–16.56), having a higher educational level (OR = 2.561, 95% CI: 1.587–4.133) and having delivered via spontaneous vaginal delivery (OR: 5.660, 95% CI: 3.454–9.276) had a significantly positive association with CAM use among postpartum mothers. Conclusions The prevalence of CAM use was high (8 out of 10) among postpartum mothers. Postpartum mothers who are Malay, Muslim, have a higher educational level and who have had spontaneous vaginal delivery tended to use CAM more. Manipulative body therapies, including massage, reflexology, hot stone compression and body wrapping, were the most widely used forms of CAM, followed by biological-based therapies. More than half of the mothers who consumed herbal medicine reported neonatal jaundice in their newborn. Thus, education to increase awareness regarding the consumption of herbs is urgently required in this country.
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Affiliation(s)
- Nik Farah Nik Yusof Fuad
- Klinik Kesihatan AU2 Keramat, Ministry of Health Malaysia, Taman Sri Keramat, Jalan AU2, Putrajaya, 54200, Selangor, Malaysia
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia. .,Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, 43400, Malaysia.
| | | | - Ai Theng Cheong
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia
| | - Zainul Amiruddin Zakaria
- Department of Biomedical Science Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Malaysia
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Dib S, Wells JCK, Fewtrell M. A within-subject comparison of different relaxation therapies in eliciting physiological and psychological changes in young women. PeerJ 2020; 8:e9217. [PMID: 32509467 PMCID: PMC7247525 DOI: 10.7717/peerj.9217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 04/28/2020] [Indexed: 12/04/2022] Open
Abstract
Background Stress reactivity can be different in women compared to men, which might consequently influence disease risk.Stress in women may also generate adverse physiological effects on their offspring during pregnancy or lactation. The objective of this study was to compare the effects of different relaxation interventions on physiological outcomes and perceived relaxation in healthy young women, to assist in identifying the most appropriate intervention(s) for use in a subsequent trial for mothers who deliver prematurely. Methods A within-subject study was conducted in 17 women of reproductive age comparing five different relaxation interventions (guided-imagery meditation audio (GIM), music listening (ML), relaxation lighting (RL), GIM+RL, ML+RL), with control (silence/sitting), assigned in random order over a 3–6 week period. Subjective feelings of relaxation (10-point scale), heart rate (HR), systolic and diastolic blood pressure (SBP, DBP), and fingertip temperature (FT) were measured before and after each technique Results All interventions significantly increased perceived relaxation and FT, while music also significantly reduced SBP (p < 0.05). Compared to control, HR significantly decreased following GIM (mean difference = 3.2 bpm, p < 0.05), and FT increased (mean difference = 2.2 °C, p < 0.05) and SBP decreased (mean difference = 3.3 mmHg, p < 0.01) following ML. GIM + RL followed by GIM were the most preferred interventions. Conclusions Based on preference, simplicity, and the physiological and psychological effects, GIM and ML were identified as the most effective tools for reducing stress and improving relaxation. These techniques warrant further research in larger samples and other populations.
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Affiliation(s)
- Sarah Dib
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Jonathan C K Wells
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Mary Fewtrell
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
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Ceulemans M, Fortuin M, Van Calsteren K, Allegaert K, Foulon V. Prevalence and characteristics of pregnancy- and lactation-related calls to the National Poison Centre in Belgium: A retrospective analysis of calls from 2012 to 2017. J Eval Clin Pract 2020; 26:911-917. [PMID: 31298801 DOI: 10.1111/jep.13228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/17/2019] [Accepted: 06/20/2019] [Indexed: 12/23/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVE In the absence of a Teratology Information Service in Belgium, the National Poison Centre might act as a substitute centre for answering pregnancy- and lactation-related questions regarding medication use. The aim of this study was to define the prevalence and characteristics of pregnancy- and lactation-related calls to the National Poison Centre in Belgium, as well as the type of health products involved during these calls. METHOD A retrospective, descriptive study on pregnancy- and lactation-related calls involving health products received by the Belgian Poison Centre between January 2012 and December 2017 was performed. Health products were categorized as registered medicines or non-registered health products; medicines were further classified according to the Anatomical Therapeutic Chemical classification system. RESULTS The Poison Centre annually received about 361 calls related to pregnancy and lactation. Pregnant and lactating women mainly called the Poison Centre themselves in case of exposure, while relatives were the predominant type of caller when preventive information was requested. The Poison Centre was mostly contacted for information about medicines and especially for preventive questions during lactation. Many questions involved over-the-counter medicines such as paracetamol and ibuprofen. Given the safety issues related to some involved products (eg, ibuprofen, zolpidem, benzodiazepines, and pseudoephedrine), seeking for advice was justified. CONCLUSIONS The Belgian Poison Centre received almost daily calls from patients and health care professionals on medication exposure during pregnancy and lactation. These findings underline the importance of evidence-based counselling of pregnant and lactating women and should encourage health care professionals to engage themselves more actively when counselling on the rational use of medicines during pregnancy and lactation. The findings also contribute to the ongoing discussion to establish a Teratology Information Service in Belgium.
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Affiliation(s)
- Michael Ceulemans
- Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, Leuven, Belgium
| | - Marijke Fortuin
- Hospitaal Centrum van de basis Koningin Astrid, National Poison Centre, Brussel, Belgium
| | - Kristel Van Calsteren
- Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, Leuven, Belgium.,Department of Development and Regeneration, Women and Child, KU Leuven, Leuven, Belgium
| | - Karel Allegaert
- Department of Development and Regeneration, Woman and Child, KU Leuven, Leuven, Belgium.,Department of Pediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Veerle Foulon
- Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, Leuven, Belgium
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Zheng T, Chen W, Hu H, Wang Y, Harnett JE, Ung COL. The prevalence, perceptions and behaviors associated with traditional/complementary medicine use by breastfeeding women living in Macau: a cross-sectional survey study. BMC Complement Med Ther 2020; 20:122. [PMID: 32316951 PMCID: PMC7175520 DOI: 10.1186/s12906-020-02921-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 04/07/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There is a long history of traditional/complementary medicine (T/CM) use by women during lactation. While it is important to evaluate such use within a scientific paradigm to ensure efficacy and safety, knowledge about the prevalence and characteristics of T/CM use during lactation is limited. This study aimed to generate preliminary data on the prevalence, perceptions and behaviors related to T/CM use by women living in Macau during lactation. METHODS Between April to June 2018, women aged 18 years or above who had breastfed within the previous 12 months were invited to complete a questionnaire which asked about their perceptions and behaviors related to the use of T/CM while breastfeeding. Chi-square analysis and logistic regressions were used to conduct data analysis. RESULTS A total of 500 women completed the survey with 62.6% (95% CI 58.37-66.83) reporting use of at least 1 T/CM while breastfeeding. Of these 48.9% (95% CI 44.67 to 53.13) believed T/CM were safe to take during lactation and 55.6% (95% CI 51.37 to 59.83) suggested there were inadequate resources to assist making an informed decision. Working status, monthly family income and the presence of a breastfeeding-related health problems were associated with T/CM use (all p < 0.05). The most commonly used T/CM were Tetrapanax papyriferus, lecithin, Vaccaria segetalis, docosahexaenoic acid and Trigonella foenum-graecum commonly referred to as Fenugreek. The most common reasons for using T/CM were "to unblock milk ducts", "to increase milk supply" and "to improve baby development". Women were recommended to use T/CM from multiple sources; 15.0% from health personnel (HP) only, 40.0% received recommendations from non-HP only; and 42.2% from both. CONCLUSIONS The use of T/CM by women during lactation is common in Macau. The current support and resources available to women during the breastfeeding period to make informed decisions about T/CM use is not standardized nor integrated. The gaps identified in this study provide an opportunity to develop resources and a more defined role for HPs to ensure the appropriate and safe use of T/CM in this population.
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Affiliation(s)
- Tingyun Zheng
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau SAR, China
| | - Weijie Chen
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau SAR, China
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau SAR, China
| | - Yitao Wang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau SAR, China
| | - Joanna E. Harnett
- The University of Sydney School of Pharmacy, The Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau SAR, China
- The University of Sydney School of Pharmacy, The Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Eid AM, Jaradat N. Public Knowledge, Attitude, and Practice on Herbal Remedies Used During Pregnancy and Lactation in West Bank Palestine. Front Pharmacol 2020; 11:46. [PMID: 32116721 PMCID: PMC7034419 DOI: 10.3389/fphar.2020.00046] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 01/14/2020] [Indexed: 12/23/2022] Open
Abstract
The use of herbal products by pregnant and lactating mothers without awareness of their harmful effects may expose both mother and fetus or infant to great dangers, such as abortion, premature delivery, uterine bleeding, and physical and mental retardation of the fetus. Thus, the aim of this study was to investigate the extent to which herbal product treatment is used and the reason for which such products are used and to ensure that these reasons are correct. An ethnopharmacological survey (cross-sectional observational design study) using a pre-piloted questionnaire was undertaken on herbal products used by pregnant and lactating women in the West Bank area of Palestine. A questionnaire was distributed to 350 pregnant and lactating women. The informed consent forms, ethics, and aims of the present study were reviewed and approved by the Institutional Review Board (IRB) at An-Najah National University. To identify the most important species used, the use value (UV) index was employed, while the SPSS program was used to analyze the data. Collected data revealed that 13 medicinal plants are utilized, while 12 plants are not used during pregnancy. Moreover, 15 plants are utilized and 9 plants are not used during lactation for treating and dealing with various problems. The most commonly used plants belonged to 14 families, including Lamiaceae, Apiaceae, Leguminosae, and Rubiaceae. The plants most used during pregnancy were sage (Salvia fruticosa), anise (Pimpinella anisum), and peppermint (Mentha × piperita). Castor (Ricinus communis) oil, ginger (Zingiber officinale), saffron (Crocus sativus), and senna (Senna alexandrina) mostly were not used by pregnant women. Moreover, cinnamon (Cinnamomum verum), anise (P. anisum), peppermint (M. piperita), and sage (S. fruticosa) were mostly used during lactation. Castor (R. communis) oil, ginger (Z. officinale), garlic (Allium sativum), and aloe (Aloe vera) mostly were not used during lactation. This study is of great importance in order to decrease the possibility of endangering the lives of fetuses and infants. A combined effort among researchers, scientists, lactating women, and pregnant women may help in changing wrong uses and thoughts about medicinal plants and help to improve the overall health of both mother and fetus.
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Affiliation(s)
- Ahmad M Eid
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Nidal Jaradat
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Barnes LA, Barclay L, McCaffery K, Aslani P. Complementary medicine products: Information sources, perceived benefits and maternal health literacy. Women Birth 2019; 32:493-520. [DOI: 10.1016/j.wombi.2018.11.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 11/15/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
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Barnes LAJ, Barclay L, McCaffery K, Aslani P. Women's health literacy and the complex decision-making process to use complementary medicine products in pregnancy and lactation. Health Expect 2019; 22:1013-1027. [PMID: 31116500 PMCID: PMC6803395 DOI: 10.1111/hex.12910] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 03/27/2019] [Accepted: 04/22/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Little is known about women's decision-making processes regarding using complementary medicine products (CMPs) during pregnancy or lactation. OBJECTIVES To explore the decision-making processes of women choosing to use CMPs in pregnancy and lactation; and to investigate how women's health literacy influences their decisions. DESIGN, SETTING AND PARTICIPANTS In-depth interviews and focus group discussions were held with twenty-five pregnant and/or breastfeeding women. Data were analysed using thematic analysis. RESULTS Key to women's decision making was the desire to establish a CMPs safety and to receive information from a trustworthy source, preferably their most trusted health-care practitioner. Women wanted positive therapeutic relationships with health-care practitioners and to be highly involved in the decisions they made for the health of themselves and their children. Two overarching components of the decision-making process were identified: (a) women's information needs and (b) a preference for CMP use. Women collated and assessed information from other health-care practitioners, other mothers and published research during their decision-making processes. They showed a strong preference for CMP use to support their pregnancy and breastfeeding health, and that of their unborn and breastfeeding babies. DISCUSSION AND CONCLUSIONS Complex decision-making processes to use CMPs in pregnancy and lactation were identified. The participants showed high levels of communicative and critical health literacy skills in their decision-making processes. These skills supported women's complex decision-making processes.
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Affiliation(s)
- Larisa A. J. Barnes
- School of PharmacyThe University of SydneySydneyNew South WalesAustralia
- University Centre for Rural HealthThe University of SydneyLismoreNew South WalesAustralia
| | - Lesley Barclay
- University Centre for Rural HealthThe University of SydneyLismoreNew South WalesAustralia
- School of Public HealthThe University of SydneySydneyNew South WalesAustralia
| | - Kirsten McCaffery
- School of Public HealthThe University of SydneySydneyNew South WalesAustralia
| | - Parisa Aslani
- School of PharmacyThe University of SydneySydneyNew South WalesAustralia
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Barnes LAJ, Barclay L, McCaffery K, Aslani P. Factors influencing women's decision-making regarding complementary medicine product use in pregnancy and lactation. BMC Pregnancy Childbirth 2019; 19:280. [PMID: 31390996 PMCID: PMC6686446 DOI: 10.1186/s12884-019-2396-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 07/02/2019] [Indexed: 12/20/2022] Open
Abstract
Background The prevalence of complementary medicine product (CMP) use by pregnant or breastfeeding Australian mothers is high, however, there is limited data on factors influencing women’s decision-making to use CMPs. This study explored and described the factors influencing women’s decisions take a CMP when pregnant or breastfeeding. Methods Qualitative in-depth interviews and focus group discussions were held with 25 pregnant and/or breastfeeding women who currently used CMPs. Participants’ health literacy was assessed using a validated single-item health literacy screening question and the Newest Vital Sign. Interview and focus group discussions were audio-recorded, transcribed verbatim and thematically analysed. Results Participants were a homogenous group. Most had higher education, medium to high incomes and high health literacy skills. They actively sought information from multiple sources and used a reiterative collation and assessment process. Their decision-making to take or not to take CMPs was informed by the need to establish the safety of the CMPs, as well as possible benefits or harms to their baby’s or their own health that could result from taking a CMP. Their specific information needs included the desire to access comprehensive, consistent, clear, easy to understand, and evidence-based information. Women preferred to access information from reputable sources, namely, their trusted health care practitioners, and information linked to government or hospital websites and published research. A lack of comprehensive, clear, consistent, or evidence-based information often led to decisions not to take a CMP, as they felt unable to adequately establish its safety or benefits. Conversely, when the participants felt the CMPs information they collected was good quality and from reputable sources, it reassured them of the safety of the CMP in pregnancy and/or breastfeeding. If this confirmed a clear benefit to their baby or themselves, they were more likely to decide to take a CMP. Conclusions The participants’ demographic profile confirms previous research concerning Australian women who use CMPs during pregnancy and lactation. Participants’ high health literacy skills led them to engage in a reiterative, information-seeking and analysis process fuelled by the need to find clear information before making the decision to take, or not to take, a CMP. Electronic supplementary material The online version of this article (10.1186/s12884-019-2396-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Larisa Ariadne Justine Barnes
- The University of Sydney, School of Pharmacy and University Centre for Rural Health, Faculty of Medicine and Health, PO Box 3074, Lismore, NSW, 2480, Australia.
| | - Lesley Barclay
- The University of Sydney, University Centre for Rural Health and Sydney School of Public Health, Faculty of Medicine and Health, Edward Ford Building (A27), Sydney, NSW, 2006, Australia
| | - Kirsten McCaffery
- The University of Sydney, Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, Edward Ford Building (A27), Sydney, NSW, 2006, Australia
| | - Parisa Aslani
- The University of Sydney, School of Pharmacy, Faculty of Medicine and Health, Rm N502, Pharmacy & Bank Building (A15), Science Rd, Camperdown, NSW, 2006, Australia
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The Sex-Gender Effects in the Road to Tailored Botanicals. Nutrients 2019; 11:nu11071637. [PMID: 31319627 PMCID: PMC6682902 DOI: 10.3390/nu11071637] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/10/2019] [Accepted: 07/10/2019] [Indexed: 12/17/2022] Open
Abstract
Phenols are a wide family of phytochemicals that are characterized by large chemical diversity and are considered to bioactive molecules of foods, beverages, and botanicals. Although they have a multitude of biological actions, their beneficial effects are rarely evidenced in clinical research with high scientific rigor. This may occur due to the presence of numerous confounders, such as the modulation of phenol bioavailability, which can be regulated by microbiota, age, sex-gender. Sex-gender is an important determinant of health and well-being, and has an impact on environmental and occupational risks, access to health care, disease prevalence, and treatment outcomes. In addition, xenobiotic responses may be strongly influenced by sex-gender. This review describes how sex–gender differentially influences the activities of phenols also in some critical periods of women life such as pregnancy and lactation, considering also the sex of fetuses and infants. Thus, sex–gender is a variable that must be carefully considered and should be used to propose directions for future research on the road to tailored medicine and nutrition.
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Barnes LAJ, Barclay L, McCaffery K, Aslani P. Complementary medicine products information-seeking by pregnant and breastfeeding women in Australia. Midwifery 2019; 77:60-70. [PMID: 31255910 DOI: 10.1016/j.midw.2019.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 06/04/2019] [Accepted: 06/20/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Complementary medicine product use in pregnancy and lactation is common but little is known about women's health literacy and information-seeking regarding this. The objectives of this study were to identify and explore pregnant or breastfeeding women's sources of, and rationale for seeking complementary medicine products information, the types of information sought, and how women felt their health care practitioners can help them receive information that meets their needs. DESIGN A qualitative research design consisting of in-depth interviews and focus group discussions was conducted. Data were thematically analysed. Participants also completed two validated health literacy screening tools. SETTING Communities in regional and metropolitan settings in Sydney and Northern New South Wales, and South-East Queensland, Australia. PARTICIPANTS Twenty-five women (n = 7 pregnant, n = 17 breastfeeding, n = 1 both pregnant and breastfeeding) who currently used complementary medicine products participated. Eleven women were pregnant with or breastfeeding their first child; 14 had between one and four older children. FINDINGS Twenty-four participants had high health literacy according to the validated screening tools. Around half of the participants had used complementary medicine products for most of their lives and 17 had used complementary medicine products to resolve or manage complex health conditions in adulthood or childhood. Women sought complementary medicine products information from three main sources. 1) Practical and safety information on complementary medicine products was sought from health care practitioners and published research; 2) health care practitioners were also sources of information on reasons for complementary medicine products recommendations and physiological actions; and 3) sharing experiences of complementary medicine products use with other mothers appeared to help women understand what to expect when taking complementary medicine products, support social-emotional wellbeing and encourage participants to look after their own health. Participants strongly expressed the desire for their mainstream biomedical health care practitioners to be more informed in, and open to, complementary medicine product use in pregnancy and breastfeeding. KEY CONCLUSIONS Participants' high health literacy skills may have influenced them to seek comprehensive information on complementary medicine products from a variety of professional and lay sources. Their use of complementary medicine products in pregnancy and breastfeeding was a natural consequence from previous positive experiences with complementary medicine products and/or therapies. IMPLICATIONS FOR PRACTICE Maternity care practitioners can positively enhance their interactions with pregnant or breastfeeding women who use complementary medicine products by respectfully discussing use within the context of these women's values and health goals, and by furthering their own education in complementary medicine products' safety, efficacy and indications in pregnancy and breastfeeding.
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Affiliation(s)
- Larisa A J Barnes
- Faculty of Medicine and Health, The University of Sydney School of Pharmacy, Pharmacy & Bank Building (A15), Science Rd, The University of Sydney NSW 2006, Australia; The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore NSW 2480, Australia.
| | - Lesley Barclay
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore NSW 2480, Australia; Faculty of Medicine and Health, The University of Sydney School of Public Health, Edward Ford Building (A27), NSW 2006, Australia.
| | - Kirsten McCaffery
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Edward Ford Building (A27), NSW 2006, Australia.
| | - Parisa Aslani
- Faculty of Medicine and Health, The University of Sydney School of Pharmacy, Pharmacy & Bank Building (A15), Science Rd, The University of Sydney NSW 2006, Australia.
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Wagner CL, Boan AD, Marzolf A, Finch CW, Morella K, Guille C, Gardner Z, Marriott BP. The Safety of Mother's Milk® Tea: Results of a Randomized Double-Blind, Controlled Study in Fully Breastfeeding Mothers and Their Infants. J Hum Lact 2019; 35:248-260. [PMID: 30005170 DOI: 10.1177/0890334418787474] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Various natural products are reported to improve maternal milk supply yet are not necessarily safe for infants. Researchers have not systematically studied galactagogue teas for safety. RESEARCH AIM This study evaluates the safety of a galactagogue tea in breastfeeding women and their infants, assessing short- and long-term adverse effects. METHODS Healthy, exclusively/fully breastfeeding women ( N = 60) with no milk insufficiency were randomized into (1) an all-natural tea containing fruits of bitter fennel, anise, and coriander; fenugreek seed; and other herbs (Mother's Milk® herbal tea; test) group or (2) a lemon verbena leaf (placebo) group. Maternal diaries captured self-reported maternal and infant adverse effects, tea consumed, and perceived infant satisfaction. Maternal quality of life and psychological state were assessed at baseline and 2 and 4 weeks. Poststudy calls assessed adverse effects through the infants' age of 12 months. RESULTS No adverse effects attributable to the interventions were reported at any time point. No differences were found between test and placebo groups in sociodemographic characteristics, maternal or infant adverse symptoms, quality of life, breastfeeding self-efficacy, maternal psychological measures, infant growth, and infant satisfaction (all p >.05). CONCLUSIONS This double-blind, randomized controlled trial (RCT) of an herbal galactagogue versus placebo among healthy, exclusively/fully breastfeeding mothers and infants found no adverse events associated with the test tea across the 30-day study or the first year of their infant's life. This composite tea appears to present no safety risk for mothers or their young babies.
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Affiliation(s)
- Carol L Wagner
- 1 Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Andrea D Boan
- 1 Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Alicia Marzolf
- 2 Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Carolyn W Finch
- 1 Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Kristen Morella
- 3 Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Connie Guille
- 4 Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Zoe Gardner
- 5 Traditional Medicinals, Sebastopol, CA, USA
| | - Bernadette P Marriott
- 2 Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.,4 Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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Zheng T, Yao D, Chen W, Hu H, Ung COL, Harnett JE. Healthcare providers' role regarding the safe and appropriate use of herbal products by breastfeeding mothers: A systematic literature review. Complement Ther Clin Pract 2019; 35:131-147. [DOI: 10.1016/j.ctcp.2019.01.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 01/08/2019] [Accepted: 01/22/2019] [Indexed: 12/18/2022]
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Bryant AG, Bauer AE, Muddana A, Wouk K, Chetwynd E, Yourkavitch J, Stuebe AM. The Lactational Effects of Contraceptive Hormones: an Evaluation (LECHE) Study. Contraception 2019; 100:48-53. [PMID: 30898657 DOI: 10.1016/j.contraception.2019.03.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 03/07/2019] [Accepted: 03/08/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To estimate the proportion of women for whom use of hormonal contraception was associated with reporting a decreased breast milk supply. STUDY DESIGN The Lactational Effects of Contraceptive Hormones: an Evaluation ("LECHE") Study was an anonymous, internet-based, exploratory, cross-sectional survey of postpartum women using approximately 70 questions. Women were eligible to participate in the survey if they were 18 years or older, had a singleton infant between 3 and 9 months of age, had breastfed this infant for any amount of time and could read English. The survey included questions about breastfeeding, reproductive health, demographic characteristics and the timing of postpartum events. RESULTS A total of 3971 participants clicked on the survey. Our final study population included 2922 participants. Overall, 1201 (41%) reported having had milk supply concerns at some point in the first 12 weeks postpartum. The median time from birth until milk supply concerns was 3 weeks (IQR 1-7). Eight hundred fifty-two women (29%) started hormonal contraception in the first 12 weeks postpartum. Fifteen percent (127/852) of women reported new or additional milk supply concerns after starting hormonal contraception. Reported milk supply concerns were higher for women who used hormonal contraception than those who did not (44% vs. 40%; p=.05) Adjusted hazard ratios (HRs) assessing the association between contraceptive use and time to milk supply concerns were not statistically significant (HR 1.18, 95% confidence interval 0.94-1.47 for any type of hormonal contraception). CONCLUSIONS This study found a slightly increased proportion of reported milk supply concerns among women who started hormonal contraception. IMPLICATIONS It is important for caregivers in the postpartum period to recognize the potential for multiple factors, including initiation of hormonal contraception, to affect breastfeeding. Patient-centered counseling can help elicit women's values and preferences regarding breastfeeding and pregnancy prevention.
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Affiliation(s)
- Amy G Bryant
- University of North Carolina School of Medicine, Department of Obstetrics and Gynecology, Division of Family Planning, Gillings School of Public Health Department of Maternal and Child Health.
| | - Anna E Bauer
- University of North Carolina School of Medicine, Department of Psychiatry, UNC Center for Women's Mood Disorders
| | - Anitha Muddana
- University of North Carolina School of Medicine, Department of Obstetrics and Gynecology, North Carolina Womens Hospital, Department of Lactation
| | - Kathryn Wouk
- University of North Carolina Gillings School of Global Public Health, Maternal and Child Health Department, Carolina Global Breastfeeding Institute
| | - Ellen Chetwynd
- North Carolina State University, College of Agriculture and Life Sciences, Food, Bioprocessing & Nutrition Sciences
| | - Jennifer Yourkavitch
- University of North Carolina Gillings School of Global Public Health, Maternal and Child Health Department
| | - Alison M Stuebe
- University of North Carolina School of Medicine, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Carolina Global Breastfeeding Institute, Gillings School of Public Health
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James PB, Kaikai AI, Bah AJ, Steel A, Wardle J. Herbal medicine use during breastfeeding: a cross-sectional study among mothers visiting public health facilities in the Western area of Sierra Leone. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:66. [PMID: 30876454 PMCID: PMC6420723 DOI: 10.1186/s12906-019-2479-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 03/11/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND The use of medications, including herbal medicines during breastfeeding is always a concern among women. Currently, there is no published evidence on whether Sierra Leonean women use herbal medicine during breastfeeding. This study investigates the prevalence, correlates and pattern of herbal medicine use during breastfeeding. METHODOLOGY We conducted a cross-sectional study among 378 current breastfeeding mothers visiting public healthcare facilities within the Western area of Sierra Leone. Descriptive statistics and logistic regression analysis were used for data analysis. RESULTS Over a third of mothers (n = 140, 37.0%) used herbal medicine during breastfeeding. However, very few herbal medicine users (2.1%, n = 3) used herbal medicine to augment breastfeeding. Dietary changes were the most common method used to increase breast milk supply (93.9%, n = 355) with cassava leaves sauce and tubers being the most common dietary addition. Mothers with children more than six months old were more likely to use herbal medicine than mothers with younger children (OR:1.8; CI:1.13-2.85,p = 0.013). Among herbal medicine users, only 11.4% (n = 16) disclosed their herbal medicine use to their conventional healthcare providers. CONCLUSION The use of herbal medicine among breastfeeding mothers attending public health facilities in the Western area of Sierra Leone is common. Whilst this use is not usually specific to increasing breast milk supply, our study indicates that herbal medicines may be used to 'cleanse' initial breast milk.
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Affiliation(s)
- Peter Bai James
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007 Australia
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Angela Isata Kaikai
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007 Australia
- Endeavour College of Natural Health, 269 Wickham St, Fortitude Valley, QLD 4006 Australia
| | - Jon Wardle
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007 Australia
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Morns M, Bowman D, Steel A. Breastfeeding difficulties: The role of integrative medicine (IM) in breastfeeding support. ADVANCES IN INTEGRATIVE MEDICINE 2019. [DOI: 10.1016/j.aimed.2018.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gan WC, Smith L, Luca EJ, Harnett JE. The prevalence and characteristics of complementary medicine use by Australian and American adults living with gastrointestinal disorders: A systematic review. Complement Ther Med 2018; 41:52-60. [DOI: 10.1016/j.ctim.2018.08.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/31/2018] [Accepted: 08/31/2018] [Indexed: 02/06/2023] Open
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Bettiol A, Lombardi N, Marconi E, Crescioli G, Bonaiuti R, Maggini V, Gallo E, Mugelli A, Firenzuoli F, Ravaldi C, Vannacci A. The use of complementary and alternative medicines during breastfeeding: results from the Herbal supplements in Breastfeeding InvesTigation (HaBIT) study. Br J Clin Pharmacol 2018; 84:2040-2047. [PMID: 29768673 DOI: 10.1111/bcp.13639] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/02/2018] [Accepted: 05/05/2018] [Indexed: 11/30/2022] Open
Abstract
AIMS The use of complementary and alternative medicines (CAMs) during breastfeeding is increasing, mainly because of their presumed greater safety compared with conventional medications. However, CAMs can cause serious adverse effects, and there is limited high-quality evidence supporting their use during lactation. In Italy, specific investigations on the attitude of lactating women towards CAMs are lacking. The Herbal supplements in Breastfeeding InvesTigation (HaBIT) study aimed to explore attitudes to and knowledge on CAMs among lactating women. METHODS A web-based survey was conducted over a 6-year period among lactating women resident in Tuscany, Italy. Data on lactating behaviour, CAMs use during pregnancy or breastfeeding, and women's knowledge about the efficacy and safety of CAMs were collected. RESULTS A total of 388 lactating women answered the questionnaire. The majority of them were primiparae, with a high educational level. Of these, 204 women declared themselves to have used CAMs during breastfeeding. Moreover, 61% and 48% of subjects reported also using CAMs before and during pregnancy, respectively. A significant proportion of subjects were unable to identify correctly the types of CAMs they were using. Seventy-three per cent of women were convinced that CAMs were equally safe or safer than conventional medications; nevertheless, 65% of women admitted to have no scientific information about the potential risks of CAMs, and 14 CAMs users reported that they had experienced side effects. CONCLUSIONS These results demonstrate the need for healthcare providers to increase the awareness of breastfeeding women about CAMs. Further research is needed to support the evidence base for nonpharmaceutical approaches for symptom control during breastfeeding.
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Affiliation(s)
- Alessandra Bettiol
- Department of Neurosciences, Psychology, Drug Research and Child Health Section of Pharmacology and Toxicology, University of Florence; Tuscan Regional Centre of Pharmacovigilance and Phytovigilance, Florence, Italy
| | - Niccolò Lombardi
- Department of Neurosciences, Psychology, Drug Research and Child Health Section of Pharmacology and Toxicology, University of Florence; Tuscan Regional Centre of Pharmacovigilance and Phytovigilance, Florence, Italy
| | - Ettore Marconi
- Department of Neurosciences, Psychology, Drug Research and Child Health Section of Pharmacology and Toxicology, University of Florence; Tuscan Regional Centre of Pharmacovigilance and Phytovigilance, Florence, Italy
| | - Giada Crescioli
- Department of Neurosciences, Psychology, Drug Research and Child Health Section of Pharmacology and Toxicology, University of Florence; Tuscan Regional Centre of Pharmacovigilance and Phytovigilance, Florence, Italy
| | - Roberto Bonaiuti
- Department of Neurosciences, Psychology, Drug Research and Child Health Section of Pharmacology and Toxicology, University of Florence; Tuscan Regional Centre of Pharmacovigilance and Phytovigilance, Florence, Italy
| | - Valentina Maggini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Center for Integrative Medicine, Careggi University Hospital, University of Florence, Florence, Italy
| | - Eugenia Gallo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Center for Integrative Medicine, Careggi University Hospital, University of Florence, Florence, Italy
| | - Alessandro Mugelli
- Department of Neurosciences, Psychology, Drug Research and Child Health Section of Pharmacology and Toxicology, University of Florence; Tuscan Regional Centre of Pharmacovigilance and Phytovigilance, Florence, Italy
| | - Fabio Firenzuoli
- Center for Integrative Medicine, Careggi University Hospital, University of Florence, Florence, Italy
| | - Claudia Ravaldi
- CiaoLapo Onlus, Charity for Healthy Pregnancy, Stillbirth and Perinatal Grief Support, Prato, Italy
| | - Alfredo Vannacci
- Department of Neurosciences, Psychology, Drug Research and Child Health Section of Pharmacology and Toxicology, University of Florence; Tuscan Regional Centre of Pharmacovigilance and Phytovigilance, Florence, Italy.,CiaoLapo Onlus, Charity for Healthy Pregnancy, Stillbirth and Perinatal Grief Support, Prato, Italy
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Schürger N, Klein E, Hapfelmeier A, Kiechle M, Paepke D. Demand for integrative medicine among women in pregnancy and childbed: a German survey on patients' needs. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:187. [PMID: 29907100 PMCID: PMC6003184 DOI: 10.1186/s12906-018-2249-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 06/06/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Although integrative medicine is gaining increasing attention and is claiming more and more its place in modern health care, it still plays a marginal role in conventional maternity care. The present study aims to examine the patterns of Complementary and Alternative Medicine (CAM) use and the demand for integrative therapies, including CAM, relaxation therapies, nutritional counseling, and psychological assistance, among women in pregnancy and childbed. METHODS The survey was conducted from April 2017 to July 2017 by means of a pseudo-anonymous 38-item questionnaire at the Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University of Munich. Eligible participants were women hospitalized due to pregnancy related complications and women in childbed. Descriptive statistics were generated to determine patterns of CAM use and demand for integrative therapeutic approaches. Univariate analysis was used to detect associations between patients' characteristics and their interest in the different integrative therapies. Furthermore, binary logistic regression was used to estimate the odds ratio of demand for CAM. RESULTS A total of 394 out of 503 patients participated in the survey (78%). 60% declared using CAM in general, 45% specifically in relation to their pregnancy or childbed. Most commonly used modalities were vitamins (31% of all patients), yoga (24%), and herbal supplements (23%). Most popular sources of recommendation of CAM use were midwives and gynecologists. Integrative therapy options patients would have wanted alongside conventional maternity care were CAM (64%), relaxation therapies (44%), dietary counseling (28%), and psychological counseling (15%). Furthermore, associations between patients' sociodemographic characteristics and their demand for integrative therapies were identified. CONCLUSIONS The results of this study demonstrate that there is a considerable demand for integrative medicine and widespread use of CAM among women during pregnancy and childbed in Germany. Maternity health care providers should be aware of these findings in order to be able to better address patients' needs and wishes. Our study findings should be interpreted with regard to patients in an hospital setting.
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Sim TF, Hattingh HL, Sherriff J, Tee LB. The use of non-prescription medicines during lactation: A qualitative study of community pharmacists' attitudes and perspectives. Res Social Adm Pharm 2018. [DOI: 10.1016/j.sapharm.2017.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wang S, Zhang C, Li C, Li D, He P, Su Z, Li Y, Ding Y, Lu A. Efficacy of Chinese herbal medicine Zengru Gao to promote breastfeeding: a multicenter randomized controlled trial. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:53. [PMID: 29409494 PMCID: PMC5801806 DOI: 10.1186/s12906-018-2121-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 01/30/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Breastfeeding is recommended worldwide but not fully practiced. The first week after childbirth is regarded as a critical period for increasing breast milk production. The aim of the study was to investigate whether Chinese herbal medicine Zengru Gao would result in more women breastfeeding in the first week after childbirth. METHODS A multicenter randomized controlled trial was conducted of 588 mothers considering breastfeeding in China. Among the mothers of the intervention group, the intervention included Chinese herbal medicine Zengru Gao; among those of the control group, it did not. Primary outcomes were the percentages of fully and partially breastfeeding mothers. Secondary outcome was baby's daily formula intake. RESULTS At 3 d and 7 d after delivery, significant differences were found in favour of Zengru Gao group on the percentage of full/ partial breastfeeding (Z = - 3.0037, p = 0.0027). At day 7, the percentage of full/ partial breastfeeding of the active group increased to 71.48%/20.70% versus 58.67%/30.26% in the control group, the differences remained significant (Z = - 3.0037, p = 0.0027). No statistically significant differences were detected on primary measures at 1 d. While intake of formula differed between groups at 1 d and 3 d, this difference did not achieve statistical significance, but this difference was apparent by 7 d (55.45 ± 115.39 ml/day vs 90.66 ± 153.89 ml/day). CONCLUSION In conclusion, Chinese Herbal medicine Zengru Gao enhanced breastfeeding success during one week postpartum. The approach is acceptable to participants and merits further evaluation. TRIAL REGISTRATION ChiCTR-IPR-15007376 , December 11, 2015.
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McClatchey AK, Shield A, Cheong LH, Ferguson SL, Cooper GM, Kyle GJ. Why does the need for medication become a barrier to breastfeeding? A narrative review. Women Birth 2017; 31:362-366. [PMID: 29258800 DOI: 10.1016/j.wombi.2017.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 10/16/2017] [Accepted: 12/04/2017] [Indexed: 10/18/2022]
Abstract
PROBLEM The need for medication during lactation can contribute to the early cessation of breastfeeding. BACKGROUND Breastfeeding women may require medication for acute or chronic health conditions. For some women this need for medication can become a barrier to breastfeeding; this is despite the fact that the majority of medications are considered to be compatible with lactation. AIM This narrative review aims to investigate factors relating to medicines safety that could contribute to medication unnecessarily becoming a barrier to breastfeeding. METHODS A selective literature search using PubMed, Scopus and Google Scholar was conducted over a 6-month period using the search terms "breastfeeding", "lactation", "medication" and "information". Articles were assessed to identify whether they addressed the impact of medication use on the decision to breastfeed. FINDINGS Fifty six articles were identified as having appropriate discussion about decision making for the safe use of medication during lactation. Themes identified included variable and conflicting safety advice for medicines; difficulty interpreting risks associated with medicine use; societal pressures faced by the breastfeeding woman; and the varied knowledge and training of health professionals involved in the care of breastfeeding women. CONCLUSION Poor quality of information about medicine safety during lactation can contribute to confusion in giving recommendations. This confusion can result in early cessation of breastfeeding or insufficient health care for the breastfeeding woman.
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Affiliation(s)
- Alyson K McClatchey
- Discipline of Pharmacy, University of Canberra, University Drive, Bruce, ACT, 2617, Australia.
| | - Alison Shield
- Discipline of Pharmacy, University of Canberra, University Drive, Bruce, ACT, 2617, Australia
| | - Lynn H Cheong
- Discipline of Pharmacy, University of Canberra, University Drive, Bruce, ACT, 2617, Australia
| | - Sally L Ferguson
- Faculty of Health, University of Canberra, University Drive, Bruce, ACT, 2617, Australia
| | - Gabrielle M Cooper
- Discipline of Pharmacy, University of Canberra, University Drive, Bruce, ACT, 2617, Australia
| | - Gregory J Kyle
- Discipline of Pharmacy, Queensland University of Technology, 2 George St, Brisbane, QLD, 4000, Australia
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Towards the implementation of breastfeeding-related health services in community pharmacies: Pharmacists' perspectives. Res Social Adm Pharm 2017; 13:980-988. [DOI: 10.1016/j.sapharm.2017.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 03/07/2017] [Accepted: 03/10/2017] [Indexed: 11/22/2022]
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Kabiri M, Kamalinejad M, Sohrabvand F, Bioos S, Babaeian M. Management of Breast Milk Oversupply in Traditional Persian Medicine. J Evid Based Complementary Altern Med 2017; 22:1044-1050. [PMID: 28817945 PMCID: PMC5871304 DOI: 10.1177/2156587217722474] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Comprehensive explanation about milk oversupply is not available in the current literature because few studies have been done on this topic. In traditional Persian medicine, milk oversupply and its management have been described. The aim of this study was to investigate milk oversupply from the perspective of medieval Persian practitioners. In this study, some main medical resources of traditional Persian medicine such as Al-Havi and the Canon of Medicine were studied to extract valuable information about milk oversupply. Etiology of milk overproduction according to traditional Persian medicine is based on humors theory and cannot be easily compared with current medical concepts. Diet modifications and natural remedies have been applied for managing this condition but the majority of traditional Persian medicine interventions for reducing milk oversupply have not been scientifically investigated in modern medicine. The knowledge of milk oversupply in traditional Persian medicine may be helpful to conduct further related studies.
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Affiliation(s)
- Marya Kabiri
- 1 Department of Traditional Medicine, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Kamalinejad
- 2 School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farnaz Sohrabvand
- 3 Vali-e-Asr Hospital, Emam Khomeini Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Soodabeh Bioos
- 1 Department of Traditional Medicine, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Babaeian
- 2 School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ung COL, Harnett J, Hu H. Key stakeholder perspectives on the barriers and solutions to pharmacy practice towards complementary medicines: an Australian experience. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:394. [PMID: 28793918 PMCID: PMC5550952 DOI: 10.1186/s12906-017-1899-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 08/01/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND Although pharmacists are entrusted to play a role in ensuring the safe and appropriate use of all medicines, in general, the inclusion of complementary medicines (CMs) into their professional practice has not been observed. The purpose of this study was to explore the perceptions and opinions of pharmacists and 8 key stakeholder leaders regarding the barriers that hinder pharmacists from providing care related to the use of CMs by patients/consumers and to identify solutions that would support pharmacists' in extending their role in this area. METHODS Semi-structured key informant interviews were conducted with 2 practicing pharmacists, 1 pharmacy owner, 1 key representative of a pharmacist professional organization, 1 key representative of a consumer advocacy group, 1 key representative of a medical professional organization, 1 key representative from a complementary medicine practitioner professional organization, 1 leader within a pharmacy school, 2 senior staff from a regulatory authority, and 1 key representative of the complementary medicine industry in Australia. RESULTS A total of 9 barriers were identified in this study. Barriers including a lack of CMs knowledge, doubts about the evidence-base, a lack of research skills and access to reliable and reputable information dominated the discussions. A total of 7 solutions were proposed. Of those, the integration of CMs curricula into under-graduate and professional pharmacy education, and defining a clearer role for pharmacists' standard of practice were considered the most important. Apposing opinions about the role of naturopaths in pharmacies were identified.. CONCLUSION It is anticipated that pharmacists will be required to formalise a role in ensuring the safe and appropriate use of complementary medicines to fulfil their professional and ethical responsibilities. However, pharmacists in general are not ready to take up this extended role. Individual key stakeholder groups have considered the existing barriers and have proposed solutions that are isolated measures. To facilitate further developments related to CMs and the professional practice of pharmacy, collaborative efforts between key stakeholders are needed to strategically plan and execute an extended role in a unified manner.
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Affiliation(s)
- Carolina Oi Lam Ung
- State Key Lab of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Room 2057, N22 Research Building, Macao, China
| | - Joanna Harnett
- Faulty of Pharmacy, The University of Sydney, A15 - Pharmacy And Bank Building, Sydney, NSW Australia
| | - Hao Hu
- State Key Lab of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Room 2057, N22 Research Building, Macao, China
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Bazzano AN, Cenac L, Brandt AJ, Barnett J, Thibeau S, Theall KP. Maternal experiences with and sources of information on galactagogues to support lactation: a cross-sectional study. Int J Womens Health 2017; 9:105-113. [PMID: 28280392 PMCID: PMC5338995 DOI: 10.2147/ijwh.s128517] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
An increase in the marketing and use of herbal galactagogues among breastfeeding mothers in the US has raised the issue of how best to provide support and information on the use of these products, particularly in light of limited availability of certified lactation counselors and continued suboptimal rates of breastfeeding globally. Currently, no cross-sectional data are available on the experiences and attitudes of mothers regarding the use of herbal and pharmaceutical galactagogues for lactation in the US. The findings of an online survey of 188 breastfeeding mothers on experiences with and sources of information on galactagogues are presented. Most mothers (76%) reported that while breastfeeding, they felt as though they were not making enough milk to meet the needs of their child, and yet 54% also indicated that they had not supplemented with formula. A large proportion of respondents reported utilizing galactagogues to increase lactation and finding them useful. The results indicated that most women learned about galactagogues from the Internet or by word of mouth through friends. Lactation consultants were the third-most reported sources of information on these products. While many respondents reported perceiving galactagogues as innocuous, more evidence on safety and efficacy is needed to support women properly who seek out and use them. Large-scale studies of the prevalence of galactagogue use in the US and rigorous evaluation of use globally are needed to ensure that mothers who choose to breastfeed may safely avail themselves of all options when counseling support is insufficient.
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Affiliation(s)
- Alessandra N Bazzano
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Lauren Cenac
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Amelia J Brandt
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | | | | | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
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