RESUMO
BACKGROUND: Domperidone is a commonly prescribed galactagogue used off-label for lactation insufficiency. Prescriber unfamiliarity or safety concerns can lead to therapeutic delay and potential early breastfeeding discontinuation. To facilitate access, the study site pharmacy department developed a Structured Administration and Supply Arrangement (SASA) for International Board-Certified Lactation Consultants (IBCLC) to screen and initiate domperidone using a checklist. MATERIAL: To validate a domperidone screening tool via analysis of its use and compliance, together with a staff satisfaction survey. METHODS: Records were extracted from the REDCap® database for women with documented domperidone supply between 06/05/2022 and 27/01/2023 and reviewed with medical records. A staff survey was distributed assessing compliance and attitudes towards the SASA. RESULTS: Records of supply revealed that 34% (17/50) of patients were referred to a physician, revealing a discrepancy between database documentation and checklists, as no referrals were documented. Overall staff satisfaction with the SASA was rated 4.6 out of 5. 77.7% (7/9) felt confident counselling and supplying domperidone with the SASA in place. 88.9% (8/9) felt confident using the checklist to identify the appropriateness of therapy and referral to a physician. CONCLUSIONS: The system in place allows the IBCLCs to initiate and supply domperidone in a timely manner to breastfeeding mothers with lactation insufficiency. The support tools, including domperidone SASA, REDCap® documentation database and the checklist domperidone as a Galactagogue Checklist, can be greatly appreciated by the LCs. Continued discussion with IBCLCs to refine and improve the SASA and associated education package will result in more consistent compliance.
Assuntos
Galactagogos , Farmácia , Feminino , Humanos , Domperidona/uso terapêutico , Galactagogos/uso terapêutico , Consultores , Pacientes Ambulatoriais , LactaçãoRESUMO
Botanicals and herbal supplements contain a diverse array of polyphenols that may affect mammary gland function and promote galactagogue activity. This scoping review is conducted to identify scientific literature elucidating how polyphenols affect mammary gland biology and cellular mechanisms critical for lactation. A literature search of PubMed and Medline reviews relevant studies in dairy animals, rodent models, and cultured mammary epithelial cells that are published from January 2010 until July 2023, to ascertain effects of polyphenols on mechanisms regulating milk production and composition. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review) strategy is applied and 80 studies on polyphenols and their implications on milk production and composition are included in this review. Limited information delineating effects of polyphenols on the molecular pathways that affect lactation are found, although available information suggests modulation of Stat5 signaling/differentiation, Stat3 signaling/remodeling, mTOR and insulin signaling/energy production, and nuclear factor kappa beta (NFκß) signaling/oxidative stress and inflammation may play roles. A profound lack of mechanistic information underscores the critical need for further research to understand the impact of botanical supplements and polyphenols on milk production and composition in humans to establish maternal nutritional guidelines to support lactation and breastfeeding goals.
Assuntos
Galactagogos , Lactação , Polifenóis , Lactação/efeitos dos fármacos , Polifenóis/farmacologia , Feminino , Humanos , Galactagogos/farmacologia , Animais , Suplementos Nutricionais , Glândulas Mamárias Animais/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Glândulas Mamárias Humanas/efeitos dos fármacos , Glândulas Mamárias Humanas/metabolismoRESUMO
Background: Lactation induction in transgender women is a clinical and research priority in the field of breastfeeding medicine. To date, there are four case reports detailing successful induced lactation in transgender patients who wished to breastfeed. The Academy of Breast Feeding Medicine does not formally recommend a specific medication regimen for transgender patients due to lack of high-quality research. Case Presentation: A 50-year-old transgender woman with a hypercoagulable disorder who was able to lactate and breastfeed with novel hormone regimen management at a gender care clinic. Her baseline hormone treatment was an estradiol 0.3 mg transdermal patch every 72 hours and micronized progesterone 200 mg daily. Results: Within four weeks of initiating a modified hormone regimen (estradiol 0.4 mg patch every 72 hours, progesterone 300 mg daily, metoclopramide 10 mg three times daily), the patient was lactating spontaneously. On multiple occasions, she breastfed and expressed up to 30 mL of milk through pumping. Conclusion: This report offers a new effective hormone regimen for transgender patients who wish to lactate and cannot access domperidone-the galactagogue used in previous case reports. It also provides a review of previously published case reports on this subject. Future research in this field should prioritize cohort studies of transgender patients who desire lactation to further assess patient attitudes, experiences, and outcomes.
Assuntos
Aleitamento Materno , Estradiol , Lactação , Pessoas Transgênero , Humanos , Feminino , Pessoas Transgênero/psicologia , Pessoa de Meia-Idade , Estradiol/administração & dosagem , Progesterona/administração & dosagem , Metoclopramida/administração & dosagem , Masculino , Galactagogos/administração & dosagemRESUMO
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.
Assuntos
Aleitamento Materno , Comportamento de Busca de Informação , Mães , Humanos , Aleitamento Materno/estatística & dados numéricos , Aleitamento Materno/psicologia , Feminino , Adulto , Estados Unidos , Mães/psicologia , Leite Humano , Inquéritos e Questionários , Adulto Jovem , Mídias Sociais , Conhecimentos, Atitudes e Prática em Saúde , Tomada de Decisões , Galactagogos , Lactação , Recém-NascidoRESUMO
Human milk adipokines in term babies seem partially determined by maternal factors and affect infant's development. We aimed to describe bioactive peptide concentration in very preterm human milk and associations to maternal characteristics and postnatal growth. Mothers delivering ≤32 weeks of gestation and their infant/s were recruited. At 4 weeks of lactation, an aliquot of 24-h-pooled milk was collected for exclusively breastfeeding dyads. Insulin, leptin, adiponectin, and milk fat globule epidermal growth factor-8 (MFG-E8) were measured by enzyme-linked immunoabsorbent assay in skimmed milk. One hundred mothers (28.8 ± 2.3 weeks at delivery) provided a milk sample. Milk insulin was related to gestational age, pre-pregnancy body mass index (BMI), and galactagogue treatment (final model: adjusted R2 : 0.330, p < 0.0001; adjusted ß coefficients: galactagogue treatment: 0.348, p 0.001; pre-pregnancy BMI: 0.274, p 0.009; gestational age: -0.290, p 0.007). Adiponectin was higher in mothers with gestational diabetes (30.7 ± 6.5 vs. 24.8 ± 8 ng/mL, p 0.044). Leptin was associated with pre-pregnancy BMI (Spearman's ρ: 0.648, p < 0.0001) and MFG-E8 to presence of labor and multiple pregnancy (final linear regression model, R2 : 0.073, p 0.028, adjusted ß coefficients: presence of labor -0.229, p 0.050; twins: -0.192, p 0.099). Milk adiponectin was associated with a greater decrease in length z-scores from birth to 28 days (Pearson's r: -0.225, p 0.032) and to discharge (Pearson's r: -0.290, p 0.003). Milk MFG-E8 was lower in milk of mothers whose babies experienced late-onset sepsis (13.3 ± 5.8 vs. 16.8 ± 6.3 µg/mL, p 0.023). Adipokines levels in preterm human milk are partially related to maternal metabolic status. Milk peptide concentration associates with early neonatal growth trajectories.
Assuntos
Galactagogos , Leite Humano , Recém-Nascido , Feminino , Gravidez , Humanos , Lactente , Leite Humano/metabolismo , Leptina , Adiponectina/metabolismo , Insulina/metabolismo , Adipocinas/metabolismoRESUMO
OBJECTIVE: To qualitatively describe breastfeeding experiences among mothers who used galactagogues to increase their milk supply. DESIGN: One-time, semistructured phone interviews. SETTING: US. PARTICIPANTS: Breastfeeding mothers (n = 19) who reported ever consuming foods, beverages, or herbal supplements to increase their milk supply in a cross-sectional online survey were purposefully sampled to participate in this qualitative study. Participants were diverse in terms of race and ethnicity, education, income, infant age (0-18 months), and prior breastfeeding experience (32% first-time breastfeeding). PHENOMENON OF INTEREST: Reasons for trying to increase milk supply, sources of information about increasing milk supply, and strategies tried to increase milk supply. ANALYSIS: Interviews were transcribed verbatim and analyzed using reflexive thematic analysis. RESULTS: Participants expressed determination and commitment to breastfeeding but unexpectedly struggled to breastfeed and increase their milk supply. They sought information from multiple sources and used individualized approaches to address milk supply concerns on the basis of recommendations from others, as well as the perceived convenience, cost, palatability, and safety of potential strategies. CONCLUSIONS AND IMPLICATIONS: Results suggest a need to expand breastfeeding education and support so that lactating parents anticipate common breastfeeding challenges and are aware of evidence-based strategies for increasing their milk supply.
Assuntos
Aleitamento Materno , Galactagogos , Lactente , Feminino , Humanos , Recém-Nascido , Animais , Leite , Lactação , Estudos Transversais , MãesRESUMO
Herbal galactagogues have been widely used as a treatment for postpartum hypogalactia due to the potential side effects associated with pharmacological therapy. Tri-Than-Thip (Tri-TT) is a Thai herbal medicine remedy that contains three main components: Cassia fistula, Pithecellobium dulce, and Ficus benjamina. These components are believed to have properties that contribute to milk production. However, despite the traditional use of Tri-TT, there is a lack of academic evidence supporting its efficacy in enhancing milk production. Therefore, the purpose of this study was to investigate the effect of Tri-TT on milk production and determine if it has a galactagogue effect. The weight suckle weight model was used to determine total milk production in lactating rats, while histological analysis was performed to assess the alveolar diameter of the mammary gland. The findings of this study revealed a significant increase in total milk production among lactating rats treated with 500 mg/kg of Tri-TT, compared to the control group. Furthermore, both the Tri-TT and Domperidone-treated groups exhibited a larger alveolar diameter of the mammary gland in comparison to the control group. In summary, these findings provide supportive evidence for the galactagogue activity of Tri-TT. The observed enhancement in milk production may be associated with Tri-TT could potentially be attributed to its ability to widen the alveolar diameter of the mammary gland, thereby facilitating increased milk volume.
Assuntos
Galactagogos , Leite , Feminino , Ratos , Animais , Lactação , Galactagogos/efeitos adversosRESUMO
INTRODUCTION: Little research has explored galactagogue food consumption in China. This study aims to investigate consumption patterns and how they relate to perceived insufficient milk supply and exclusive breastfeeding. METHODS: Data were collected from postpartum women in China at six time points: baseline demographic questionnaire before hospital discharge (T0), galactagogue food questionnaire at 1 month postpartum (T1), Hill and Humenick Lactation Scale at 6 weeks postpartum (T2), and breastfeeding practices at 1, 2, 3 and 4 months postpartum (T1, T3, T4, T5). RESULTS: Of 218 participants who completed the galactagogue food questionnaire, 64.68% were consumers. No association was found between galactagogue food consumption and perceived insufficient milk supply. Consumers were less likely to breastfeed exclusively. DISCUSSION: Future research should emphasize a deeper understanding of consumer behaviors and family support in providing professional guidance on postpartum nutrition that considers not only social and cultural experiences but also broader medical aspects.
Assuntos
Aleitamento Materno , Galactagogos , Animais , Feminino , Humanos , População do Leste Asiático , Leite , Mães , Percepção , Período Pós-Parto , Ingestão de AlimentosRESUMO
BACKGROUND: Perceived insufficient milk is a primary reason for early breastfeeding cessation. Some breastfeeding mothers may use galactagogues (ie, foods, beverages, herbal supplements, and pharmaceuticals) to try to increase milk supply. However, milk production requires frequent and effective milk removal, and there is limited evidence on the safety and efficacy of galactagogues. Additional research on the use of galactagogues is needed to inform breastfeeding support. OBJECTIVE: Describe the prevalence of use and perceived effects of galactagogues and compare galactagogue use by maternal characteristics. DESIGN: Cross-sectional online survey. PARTICIPANTS/SETTING: A convenience sample of 1,294 adult women breastfeeding a singleton child and living in the United States were recruited using paid Facebook advertisements between December 2020 and February 2021. MAIN OUTCOME MEASURES: Self-reported current or previous use of galactagogues and their perceived effects on milk production. STATISTICAL ANALYSES PERFORMED: Frequencies and percentages described the use and perceived effects of galactagogues. The χ2 test of independence and independent t tests compared galactagogue use by select maternal characteristics. RESULTS: More than half of participants (57.5%) reported using any galactagogues, 55.4% reported consuming foods or beverages, and 27.7% reported using herbal supplements. Few participants (1.4%) reported using pharmaceuticals. Participants reported varying effects of specific galactagogues on milk production. Reported galactagogue use was higher among participants who reported first-time breastfeeding (yes: 66.7% vs no: 49.3%; P < 0.001), breastfeeding pumped milk (yes: 63.1% vs no: 50.4%; P < 0.001), formula supplementation (yes: 66.8% vs no: 50.4%; P < 0.001), and perceived insufficient milk (yes: 78.8% vs no: 53.8%; P < 0.001). CONCLUSIONS: Breastfeeding mothers in the United States commonly reported using galactagogues to increase milk production, highlighting the need for research on the safety and efficacy of galactagogues and enhanced breastfeeding support.
Assuntos
Aleitamento Materno , Galactagogos , Adulto , Criança , Feminino , Humanos , Estados Unidos , Galactagogos/farmacologia , Mães , Estudos Transversais , Leite Humano , Preparações FarmacêuticasRESUMO
One of the factors contributing to the disparities still present by race in the United States may be inequitable access to lactation education. In order to ensure that all parents receive the education they deserve to make informed infant feeding decisions, two checklists were created for patient and healthcare professional use, respectively. This paper describes the process of creating and validating the healthcare professional and patient checklists. The authors completed a review of the most recent literature surrounding barriers to lactation initiation and retention in the Black community to create the initial version of the checklists. Expert consultation was then utilized to assess their content validity. Local healthcare providers unanimously agreed that pregnant and postpartum parents need more education and support than currently provided. The consulted experts described the two checklists as useful and comprehensive and offered feedback for their revision and optimization. Implementing these checklists offer the possibility of increasing provider accountability in delivering adequate lactation education and enhancing client lactation knowledge and self-efficacy. Further research is needed to assess the effect of implementation of the checklists in a healthcare setting.
Assuntos
Aleitamento Materno , Galactagogos , Lactente , Feminino , Gravidez , Humanos , Estados Unidos , Lista de Checagem , Lactação , PaisRESUMO
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.
Assuntos
Domperidona , Galactagogos , Recém-Nascido , Feminino , Humanos , Gravidez , Domperidona/efeitos adversos , Leite Humano , Galactagogos/efeitos adversos , Aleitamento Materno , Estudos Transversais , Antagonistas de Dopamina/efeitos adversos , Lactação , Cesárea , AustráliaRESUMO
Background: Low human milk production frequently occurs in mothers of premature children with low birth weights who require intensive care. Research Aims: To investigate whether corn-based preparations increase human milk production in women with insufficient milk volumes. Method: This was an intervention study evaluated whether there was an increase in human milk production after a mother's consumption of corn-based preparations. The participants included women with hypogalactia and mothers of infants in neonatal and pediatric intensive care units. The corn-based preparations included green corn cakes and sweet hominies. A total of 35 mother-infant pairs participated in this study. Each mother served as their own control. The study took place over 2 weeks, and data were collected at baseline and after the intervention. At baseline, a socioeconomic questionnaire was used to collect information regarding maternal food consumption, volume of milk expressed, and infant weight and length. All evaluations, except for questionnaire administration, were performed during the intervention phase, when the lactating women ingested the corn-based preparations. Results: A significantly higher average volume of milk was expressed in the intervention period (397.6 ± 182.6 mL/day) compared to baseline (343.6 ± 155.8 mL/day) on the paired t-test (p < 0.001) analysis. Neither energy nor macronutrients consumed correlated with milk volume. Conclusion: The tested corn-based preparations acted as galactagogues and could be used to stimulate milk production in lactating women.
Assuntos
Galactagogos , Lactente , Recém-Nascido , Criança , Humanos , Feminino , Galactagogos/farmacologia , Aleitamento Materno , Zea mays , Lactação , Leite Humano , Mães , Ingestão de AlimentosRESUMO
Objectives: Domperidone is an antiemetic that is commonly used as an off-label prescription to induce lactation. Neuropsychiatric adverse effects of domperidone such as akathisia and depression are previously described. It has never been reported to be associated with infanticide ideation. The aim of this article is to discuss the occurrence of infanticide ideation following domperidone usage in an adoptive mother and the potential mechanisms by which these may occur. Methods: With Institutional Review Board approval, we herein report a nulliparous adoptive mother who developed infanticide ideation after 3 months of exposure to domperidone. The infanticide ideation was intrusive, recurrent, ego-dystonic, causing significant depressive symptoms and affecting the patient's functions. Physical examination and relevant biological investigations were unremarkable. Results: The patient is treated as domperidone-induced obsessional thought with adjustment disorder. The domperidone was stopped immediately. Serotonin and norepinephrine reuptake inhibitors was started. The infanticide ideation gradually resolved and patient achieved complete remission after 10 months of treatment. Conclusion: The infanticide ideation following consumption of domperidone is a potential neuropsychiatric adverse event that warrants further examination into the safety of domperidone as an "off-labeled" galactagogue. Comprehensive psychological assessment of mother who wishes to use domperidone as galactagogue is recommended.
Assuntos
Domperidona , Galactagogos , Aleitamento Materno , Domperidona/efeitos adversos , Feminino , Galactagogos/efeitos adversos , Humanos , Infanticídio , LactaçãoRESUMO
INTRODUCTION: With cultural and social evolution and improvements in reproductive technology, an increasing number of babies are born to lesbian, gay, bisexual, transgender, intersex, queer and/or questioning, and asexual and/or ally parents. As parental roles and gender expression become more expansive, the role of breastfeeding a baby must naturally also expand to include the option of sharing of breastfeeding among parents, called co-lactation (Bamberger & Farrow, 2021). In most cases, co-lactation involves a gestational parent and a non-gestational parent. If a non-gestational parent desires to produce milk for the purpose of breastfeeding, they do so by inducing lactation. While interest in and research about induced lactation are developing quickly, little information is currently available about co-lactation. MAIN ISSUE: A couple identifying as queer presented with concerns about inducing lactation in the non-gestational parent, as well as seeking assistance in managing a successful sharing of the breastfeeding relationship. MANAGEMENT: Breast massage, milk expression, acupuncture, hormone therapy, and galactagogues, including domperidone, goat's rue, and malunggay (moringa oleifera) were used to initiate and establish lactation by the non-gestational parent. Parents shared the breastfeeding relationship equally and carefully managed milk expression when the other parent was breastfeeding to maintain or increase lactation. CONCLUSION: With professional lactation support, commitment to a lactation plan, responsive parenting, and strong communication and cooperation between parents, two parents were able to successfully co-lactate for more than a year. Breastfeeding was shared equally and supplementation of breastfeeds was rarely needed.
Assuntos
Galactagogos , Minorias Sexuais e de Gênero , Feminino , Humanos , Aleitamento Materno , Domperidona , Lactação , Lactatos , HormôniosAssuntos
Galactagogos , Aleitamento Materno/psicologia , Aconselhamento , Feminino , Humanos , Lactação , Mães/psicologiaRESUMO
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.
Assuntos
Galactagogos , Lactente , Feminino , Humanos , Galactagogos/uso terapêutico , Galactagogos/farmacologia , Aleitamento Materno , Estudos Transversais , Domperidona , Estudos Prospectivos , Austrália , Lactação , MãesAssuntos
Galactagogos , Galactorreia , Aleitamento Materno , Feminino , Galactagogos/farmacologia , Humanos , Lactação , GravidezRESUMO
ABSTRACT: Development of a milk supply is a complex process that is not always understood by women who are breastfeeding. Galactagogues are substances commonly used by breastfeeding women who perceive that they have an insufficient milk supply. They can be herbal substances or pharmaceuticals. Herbal galactagogues are advertised and sold to women as capsules, cookies, milk shakes, and teas, as well as other forms of herbal supplements. Herbal galactagogues are classified as dietary supplements and not reviewed or regulated by the U.S. Food and Drug Administration. There are limited data on their safety and efficacy. Women experiencing problems with their milk supply should receive a thorough and thoughtful assessment of the situation. There are many factors that should be considered when counseling breastfeeding women about use of galactagogues. The physiology of lactation, process of milk supply development, and the evidence for use of galactagogues are reviewed to add to the knowledge of nurses and other health care providers working with women who are breastfeeding.
Assuntos
Galactagogos , Aleitamento Materno/psicologia , Aconselhamento , Feminino , Galactagogos/efeitos adversos , Humanos , Lactação , Mães/psicologiaRESUMO
BACKGROUND: Insufficient milk production is a common problem affecting breastfeeding women, in particular following Cesarean delivery. Wang Nam Yen herbal tea is a promising traditional Thai medicine used by postpartum women to stimulate milk production, as an alternative to pharmaceutical galactagogues. We aimed to compare the efficacy of Wang Nam Yen herbal tea, domperidone, and placebo, in increasing milk production in mothers who underwent Cesarean delivery. METHODS: Women who underwent uncomplicated cesarean delivery at Sunpasitthiprasong Hospital were randomized into three groups. The participants received the treatments daily for three consecutive days. The primary outcome was breast milk volume at 72 hours after delivery. Secondary outcomes were pregnancy and neonatal outcomes, adverse events, and participant satisfaction. RESULTS: Of the 1,450 pregnant women that underwent cesarean delivery, 120 women were enrolled. Their mean age and gestational ages were 28.7 years and 38.4 weeks, respectively. Breast milk volume at 72 hours postpartum was significantly different among the three groups (p = 0.030). The post hoc Bonferroni correction indicated a significant difference in breast milk volume between Wang Nam Yen herbal tea group and placebo control group (p = 0.007) while there was no difference between Wang Nam Yen herbal tea group and domperidone group (p = 0.806) and between domperidone group and placebo control group (p = 0.018). There was no difference in pregnancy and neonatal outcomes, adverse events, and participant satisfaction among the three groups. CONCLUSION: Wang Nam Yen herbal tea was effective in augmenting breast milk production at 72 hours postpartum in mothers following cesarean delivery, and there was no evidence that herbal tea and domperidone differed in terms of augmenting breast milk production. TRIAL REGISTRATION: The study was approved by the institutional review board of Sunpasitthiprasong Hospital (No.061/2559) and was registered TCTR20170811003 with the Thai Clinical Trial Registry.
Assuntos
Galactagogos/administração & dosagem , Lactação/fisiologia , Leite Humano/metabolismo , Chás de Ervas/análise , Adolescente , Adulto , Cesárea , Domperidona/administração & dosagem , Feminino , Humanos , Efeito Placebo , Período Pós-Parto , Gravidez , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVES: This study investigates the availability, accessibility, and product depth of in-store infant feeding and galactagogues products in majority Black and majority white zip codes in Los Angeles County. METHODS: A cross-sectional study was conducted to determine racial/ethnic neighborhood differences in the availability of infant and follow-on formula and galactagogues products in 47 retail stores in 21 zip codes. Store-level data were collected in June 2019 and an observational tool for galactagogues products and infant/follow-on formula (availability, accessibility, product depth) was employed at each store. RESULTS: Most of the stores were grocery stores (87.2%). Stores in majority Black zip codes had less availability of infant formula ready-to-use (p = 0.001), less accessibility of follow-on powder (p = 0.028), and availability of galactagogues beverages (p = 0.036) versus majority white zip codes. Product depth (number of brands sold) of stores with one or more brands of the aforementioned products was consistently higher in majority white zip codes compared to majority Black zip codes. Stores in majority Black zip codes were most likely to have lower availability of infant formula and galactagogues products, an important part of the food environment for infant feeding options, in particular, for lactation support. CONCLUSIONS FOR PRACTICE: Most studies investigating the association of the food environment and health outcomes have focused only on solid foods. However, additional food products (e.g., liquids, powders) may be contributors to extensive disparities in infant mortality between Black and white infants and may lead to health disparities beyond infant stage (e.g., children, adolescents, and adults). Lastly, for breastfeeding inequities to decrease, pregnant and postpartum Black persons need equitable access and education on safe and quality galactagogues products.