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Abstract

Background: One of the important reasons behind termination of breast-feeding in the first six months after childbirth is insufficient production of breast milk. Objectives: The aim of this study was to determine the effect of herbal tea containing fenugreek seed on the signs of breast milk sufficiency in Iranian girl infants aged 0 - 4 months, at the medical health centers of Tehran university of medical sciences. Patients and methods: This study was a clinical trial with a control group. Seventy-eight girl infants, 0 - 4 months old that were exclusively breastfed by their mothers, were randomly assigned to the intervention group (received herbal tea containing 7.5 g fenugreek seed powder in addition to 3 g of black tea, three times a day) and the control group (received herbal tea containing 3 g of black tea powder, three times a day). Before and during the four weeks of study, the signs of breast milk sufficiency were evaluated through measurement of growth parameters and use of follow-up forms for measuring the number of wet diapers in one day, frequency of defecation and infant breast-feeding times in a day. Results: Before the intervention there was no significant difference between weight, height, head circumference, the number of wet diapers and frequency of defecation between the two groups (P > 0.05), yet the number of breast feeding times of the control group was more than the Fenugreek group. At the end of the fourth week in proportion to the pre-intervention conditions, the weight of the infants in the fenugreek group increased significantly from 5282.0513 ± 1021.51121 to 6383.0769 ± 952.06190, while head circumference increased from 38.3103 ± 1.62736 to 39.9256 ± 1.50660, number of wet diapers from 5.2821 ± 0.93044 to 8.1648 ± 1.20620, frequency of defecation from 1.8846 ± 1.08495 to 2.7326 ± 0.94771 and the number of breast feeding times from 9.1795 ± 1.39778 to 15.9597 ± 1.45056 (P < 0.001). However, there was no significant effect on height variation (P = 0.078). While in the control group there was no significant difference between the mentioned variables (P > 0.05). Conclusions: Herbal tea of fenugreek seed in comparison to the control group improves the signs of breast milk sufficiency.
Iran Red Crescent Med J. 2015 August; 17(8): e21848. DOI: 10.5812/ircmj.21848
Published online 2015 August 15. Research Article
The Effect of Herbal Tea Containing Fenugreek Seed on the Signs of Breast
Milk Sufficiency in Iranian Girl Infants
Vida Ghasemi
1
; Masoomeh Kheirkhah
2,*
; Mohsen Vahedi
3
1
Department of Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran
2
Department of Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, IR Iran
3
Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
*Corresponding Author: Masoomeh Kheirkhah, Department of Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, P. O. Box: 19967-13883, Tehran, IR Iran.
Tel: +98-9124137578, Fax: +98-2188201978, E-mail: masoomeh_kheirkhah2002@yahoo.com
Received: July 8, 2014; Revised: August 16, 2014; Accepted: September 15, 2014
Background: One of the important reasons behind termination of breast-feeding in the first six months after childbirth is insufficient
production of breast milk.
Objectives: The aim of this study was to determine the effect of herbal tea containing fenugreek seed on the signs of breast milk sufficiency
in Iranian girl infants aged 0 - 4 months, at the medical health centers of Tehran university of medical sciences.
Patients and Methods: This study was a clinical trial with a control group. Seventy-eight girl infants, 0 - 4 months old that were exclusively
breastfed by their mothers, were randomly assigned to the intervention group (received herbal tea containing 7.5 g fenugreek seed
powder in addition to 3 g of black tea, three times a day) and the control group (received herbal tea containing 3 g of black tea powder,
three times a day). Before and during the four weeks of study, the signs of breast milk sufficiency were evaluated through measurement
of growth parameters and use of follow-up forms for measuring the number of wet diapers in one day, frequency of defecation and infant
breast-feeding times in a day.
Results: Before the intervention there was no significant difference between weight, height, head circumference, the number of wet
diapers and frequency of defecation between the two groups (P > 0.05), yet the number of breast feeding times of the control group was
more than the Fenugreek group. At the end of the fourth week in proportion to the pre-intervention conditions, the weight of the infants
in the fenugreek group increased significantly from 5282.0513 ± 1021.51121 to 6383.0769 ± 952.06190, while head circumference increased
from 38.3103 ± 1.62736 to 39.9256 ± 1.50660, number of wet diapers from 5.2821 ± 0.93044 to 8.1648 ± 1.20620, frequency of defecation from
1.8846 ± 1.08495 to 2.7326 ± 0.94771 and the number of breast feeding times from 9.1795 ± 1.39778 to 15.9597 ± 1.45056 (P < 0.001). However,
there was no significant effect on height variation (P = 0.078). While in the control group there was no significant difference between the
mentioned variables (P > 0.05).
Conclusions: Herbal tea of fenugreek seed in comparison to the control group improves the signs of breast milk sufficiency.
Keywords: Breast Feeding; Herbal Tea; Fenugreek; Trigonella foenum-graecum
Copyright © 2015, Iranian Red Crescent Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCom-
mercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial us-
ages, provided the original work is properly cited.
1. Background
Breast milk is the most ideal feeding source for infants
(1). For ideal and optimized growth of infants, the world
health organization (WHO) has recommended that in-
fants should be exclusively breastfed for six months
and after that in order to receive nutritious substances,
complementary feeding should be added to breast milk
for two years (2). Breast-feeding has long and short-term
effects on the infants’ health. Some of the short-term ef-
fects are the decrease of mortality and morbidity, and
protection against diseases. Long-term effects of breast-
feeding include increase of IQ, decrease of blood pres-
sure, serum cholesterol, obesity during adulthood, type 1
and 2 diabetes, and middle ear and respiratory infections
(3-5). The death risk of infants who receive other nutri-
tious substances in addition to breast milk is four times
more than infants who are exclusively breast fed (6). De-
spite reports showing increase of breast-feeding around
the world, from 22% to 30% in Saharan Africa and from 30%
to 45% in America, breast-feeding has still not reached the
WHO recommended level (7, 8). In Iran, breast-feeding
has been reported to be 56.8% at four months and 27.7%
at six months, respectively. This percentage in rural areas
is 58% at four months and 29% at six months, and in ur-
ban areas it is 56% and 27% at four and six months, respec-
tively (9). One of the important reasons of breast feeding
termination in the first six months after childbirth is
insufficient production of breast milk that is commonly
observed in the first four months of life (10). The results
of a study from Iran demonstrated that due to mothers’
lack of awareness about breast-feeding benefits, some-
times infants may be fed with items other than breast
milk such as water, hot water, cold water, sweetened wa-
Ghasemi V et al.
Iran Red Crescent Med J. 2015;17(8):e218482
ter and pasteurized milk (11). In Iran, the most common
reason for breast-feeding termination has been reported
to be physicians’ lack of emphasis on the importance of
breast-feeding in 54% of cases and real milk insufficiency
in 28% of cases (12). Galactogogues have been used to re-
solve the problem of milk insufficiency. Galactogogues
are medicines or plants that initiate, induce and main-
tain milk production (13, 14). Fenugreek is one the most
common sources of galactogogues and belongs to the
pea family and has been used for this reason around the
world from olden times (14). Fenugreek seed contains
trigonelline, choline, prolamin, sapogenin, alkaloid and
mucilage fibers. Sapogenins of Fenugreek such as di-
osgenin and yamogenin have estrogen properties (15).
Their exact mechanism of action is unknown. Research-
ers believe that breast glands are improved sweat glands
and fenugreek increases milk production through in-
crease of sweat production. Also, fenugreek seed due to
having diosgenin has Phytoestrogen properties. Phytoes-
trogen has a chemical structure similar to estrogen and
can attach to α and β receptors and may have estrogenic
properties (13, 14, 16). This plant has been recognized as a
safe medicine by the US Food and Drug Administration
(17). Studies about galactogogues properties of fenugreek
have shown contradictive results. Turkyilmaz’s study
(2011) showed that milk production in the group who re-
ceived fenugreek was significantly more than the control
group (14). However, Damanik’s study in 2008 showed
little increase in milk production of the fenugreek group
in comparison to the Coleus amboinicus Lour group (18).
So far, nothing has been done to investigate the effect of
this plant on infant growth parameters, number of wet
diapers, frequency of defecation and number of infant
breast-feeding times. With regards to the locality, low
cost and availability of fenugreek in Iran, this innovative
study was conducted with the aim of determining the ef-
fect of this plant on breast milk sufficiency signs.
2. Objectives
The aim of this study was to determine the effect
of herbal tea containing fenugreek seed on the signs
of breast milk sufficiency in Iranian girl infants, 0 - 4
months old, at the medical health centers of Tehran Uni-
versity of Medical Science. This study was carried out with
the hypothesis that signs of breast milk sufficiency in the
fenugreek group are better than the control group.
3. Patients and Methods
This study was a double blind randomized clinical trial
with a control group. The research sample included 78 girl
infants, 0 - 4 months of age, who were referred to the med-
ical health centers affiliated to the Tehran university of
medical sciences, located in the south of Tehran city, Teh-
ran, Iran, during 2014. These centers were governmental
health providers. This research project was part of a thesis
approved by the research council of Tehran university of
medical sciences and was approved by the ethics commit-
tee of this university (92/D/130/1913) on the 23
rd
of Novem-
ber 2013. This study was registered in the Iranian Clinical
Trial data-base (Irct201312102751n10). The sample size was
calculated using the following formula, where power =
80%, α = 0/05, level of confidence = 95%, case = µ
1
=365.55, s =
69.40, control: µ
2
= 315.50, s = 58.66 and (n = 39).
(1)
n =
2δ
2
z
1
α
2
+z
1β
2
(
µ
1
µ
2
)
2
The inclusion criteria were being a term girl infant aged
between 0 and 4 months, having a birth weight between
2500 and 4000 g, normal ability of sucking, and not
consuming infant formula, herbal and chemical galac-
togogues, non-initiation of complementary feeding, and
mother and infant not infected by any diseases that have
contradiction with breastfeeding. These diseases include
infection with human immunity deficiency virus (HIV),
addiction to narcotic substances and alcohol, untreated
active tuberculosis, using special medicines such as phe-
nobarbital and ergotamine and so on, women under
breast cancer treatment, breast problems such as breast
nipple indentation, abscess, mastitis, and mother’s un-
derlying disease such as asthma, cardiac diseases, blood
clotting diseases and diabetes. The exclusion criteria
were mother’s unwillingness to continue her contribu-
tion in the study process and using any galactogogues
or infant formula during the study. After obtaining the
informed consent and explaining the objectives of the re-
search, the samples were randomly assigned to the inter-
vention (received herbal tea containing 7.5 g fenugreek
seed powder in addition to 3 g of black tea, three times
a day) or the control group (received herbal tea contain-
ing 3 g of black tea powder, three times a day) (Figure 1).
Ligible mother, who gave written
consent (n=78)
Randomization
Fenugreek group (n=39)
Control group (n=39)
follow up
weekly for 4 weeks
no sample loss happened and 78 mother
completed the study
Figure 1. Flow Diagram of Participants
Ghasemi V et al.
3
Iran Red Crescent Med J. 2015;17(8):e21848
Randomization was done with simple allocation. Herbal
tea was produced by Medicinal Plants Research Institute
of Iran under registration No. 771188. In this study, for mea-
suring variables, we used a follow up form and tools for
measuring growth parameters. For validity and reliabil-
ity of the demographic questionnaire and the follow up
form, content validity and test-retest method were used,
respectively (r = 0.88). Before sampling, to confirm the
reliability of the growth measuring tools, the researcher
and another person measured the weight, height and
head circumference of ten infants at the same time. Af-
ter confirming the same results, measurements were
performed by the researcher. To begin, the demographic
questionnaires, including 12 questions about demo-
graphic conditions and six questions about breast-feed-
ing conditions, were filled by the mothers. Before-inter-
vention growth parameters included weight, height and
head circumference of the infants, which were measured
with the Seca scale made in Germany, tall-meter table and
tape measure, respectively. Follow-up form was given to
the mothers to measure pre-intervention conditions for
the number of daily wet diapers, frequency of defeca-
tion and infant’s breast-feeding times during two days.
The mothers consumed the herbal tea weekly for four
weeks, three times a day and two hours after each meal.
Before each visit, the mother was reminded by phone
contact about the next appointment and the herbal tea
consumption times. During each visit the infant’s weight
was measured by the weight measurement scale, height
by the tall-meter table and head circumference by the ex-
act meter. The device was calibrated daily before and after
the measurements. Infants were carefully weighed in the
morning, after changing the infants' diapers, and before
they were fed. The researcher strongly recommended to
the mothers to complete the forms accurately. The follow-
up form was given to the mothers to record the number
of wet diapers during one day and frequency of defeca-
tion and infant’s breast-feeding daily times during one
week. During the four-week follow-up, the differences be-
tween breast milk sufficiency signs were evaluated and
studied in the intervention and control group by using
follow-up forms and growth parameter measurements.
Examinations were performed by a physician according
to the routines of the health care center and the mothers
were asked to report any problems to the researcher.
The normally distributed data was checked by Kol-
mogorov-Simonov test and the normal distribution of the
data was verified. Obtained data was analyzed using the sta-
tistical package for social sciences (SPSS) software version
20 and independent sample t-test and repeated measure
analysis. All assumptions of repeated measurement were
examined. P values of < 0.05 were considered significant.
4. Results
In the present study, there were two groups of 39 par-
ticipants (78 persons). All of them were entered to the sta-
tistical analysis and no sample loss occurred.
Some of the characteristics of the participants of the
two groups are mentioned in Table 1. There was no signifi-
cant difference between the two groups regarding moth-
ers’ BMI and age, and weight, height and head circumfer-
ence of infants at the beginning of the study (Table 1).
Before the intervention there was no significant differ-
ence between the two groups regarding weight, height,
head circumference and the number of wet diapers and
frequency of defecation (P > 0.05). However, the number
of breast-feeding times in the control group was more
than the fenugreek group (P < 0.001) (Table 2).
Considering time and intervention concurrency at the
end of the fourth week compared to the pre-intervention
conditions, weight, head circumference, the number of
wet diapers, the frequency of defecation and the num-
ber breast feeding times of the infants of the fenugreek
group significantly increased (P < 0.001). However,
height growth was not significantly different between
the two groups (P = 0.078) (Table 3).
Table 1. Characteristics of Participants According to Specific Groups
a
Group Fenugreek
b
Control
b
P value
Mother age, y 28.13 ± 4.402 29.49 ± 4.855 0.091
BMI, kg/m
2
25.59 ± 3.333 24.87 ± 3.254 0.570
Infant age, day 71.02 ± 33.78 61.82 ± 32.76 0.433
Infant weight, g 5282.05 ± 1021.51 5334.87 ± 1318.59 0.519
Infant height, cm 58.16 ± 3.77 57.05 ± 4.68 0.499
Infant head circumference, cm 38.31 ± 1.62 38.60 ± 2.11 0.114
a
Abbreviations: BMI, Body Mass Index.
b
Data are presented for N = 39.
Ghasemi V et al.
Iran Red Crescent Med J. 2015;17(8):e218484
Table 2. Comparison of the Signs of Breast Milk Sufficiency in the Fenugreek and Control Group Before Intervention
Variable Mean (SD) P value
Weight 0.844
Fenugreek 5282.0513 (1021.51121)
Control 5334.8718 (1318.59948)
Height 0.250
Fenugreek 58.1692 (3.77458)
Control 57.0538 (4.68041)
Head 0.492
Fenugreek 38.3103 (1.62736)
Control 38.6051 (2.11597)
Number of wet diapers 0.072
Fenugreek 5.2821 (0.93044)
Control 5.9231 (1.68405)
Frequency of defecation 0.289
Fenugreek 1.8846 (1.08495)
Control 2.2051 (1.52487)
Frequency of infant feeding < 0.001
Fenugreek 9.1795 (1.39778)
Control 11.2051 (2.07338)
Table 3. Comparison of the Signs of Breast Milk Sufficiency in the Fenugreek and Control Group After Intervention
a
Variable/Intervention Week 1 Week 2 Week 3 Week 4 P value
Weight < 0.001
Fenugreek 5597.1795 (988.87482) 5876.6667 (963.55519) 6137.1795 (948.57497) 6383.0769 (952.06190)
Control 5510.0000 (1301.10479) 5682.5641 (1288.31125) 5724.6154 (1527.82929) 6018.7179 (1261.41353)
Height 0.078
Fenugreek 58.5949 (3.64027) 59.1179 (3.54593) 59.5385 (3.44067) 60.0769 (3.49815)
Control 57.3000 (4.62089) 57.6231 (4.60552) 57.8205 (4.52096) 58.9821 (6.23951)
Head < 0.001
Fenugreek 38.6641 (1.58172) 39.0949 (1.54510) 39.4872 (1.53025) 39.9256 (1.50660)
Control 38.8487 (2.03688) 39.1282 (2.02822) 39.3923 (2.02788) 39.7769 (2.00151)
Number of wet diapers < 0.001
Fenugreek 6.2821 (1.18959) 7.2271 (1.26496) 7.7326 (1.22373) 8.1648 (1.20620)
Control 5.7985 (1.64676) 5.7143 (1.50367) 5.5275 (1.53448) 5.5788 (1.46163)
Frequency of defeca-
tion
< 0.001
Fenugreek 2.4176 (1.08668) 2.4396 (0.98069) 2.7766 (0.90279) 2.7326 (0.94771)
Control 2.0440 (1.22635) 1.8974 (1.01331) 1.8059 (0.95859) 1.7363 (0.87053)
Frequency of infant
feeding
< 0.001
Fenugreek 11.1758 (1.66936) 13.3297 (1.59253) 14.9853 (1.41186) 15.9597 (1.45056)
Control 10.9048 (1.86215) 11.2381 (1.85290) 11.5861 (3.26370) 11.4176 (1.68470)
a
Data are presented as Mean (SD).
Ghasemi V et al.
5
Iran Red Crescent Med J. 2015;17(8):e21848
5. Discussion
In this study the effect of herbal tea containing fenu-
greek seed on the signs of breast milk sufficiency, includ-
ing infant’s growth parameters such as weight, height and
head circumference and also the number of wet diapers
in one day, frequency of defecation and infant’s breast-
feeding times were evaluated in girl infants aged between
0 and 4 months, during four weeks. Our study showed im-
provement of the signs of breast milk sufficiency in the
fenugreek group compared to the control group. How-
ever, the height growth of the infants was not influenced.
With regards to the point that height growth in the first
six months of birth has less improvement in comparison
to weight, it seems reasonable for height growth in com-
parison to other variations to be less impressed.
In the study of Gabay et al. fenugreek was considered as
a galactogogues plant, and it was mentioned that using
fenugreek has been a custom since 1945 and women re-
ported an increase in their milk production after 24 - 72
hours of use (13).
The results of our study support the results of many
studies that inspected galactogogues properties of fenu-
greek with other variations.
In the study of El Sakka et al. (19), 75 mothers along with
their infant were classified in three groups: herbal tea
with fenugreek (n = 25), palm dates (n = 25) or no galacto-
gogues as the control (n = 25). Maternal milk volume was
measured through manual pumping of breasts on the
third postpartum day. Infants were weighed on days 0, 3,
7 and 14, using an infant scale. They concluded that breast
milk volume on the third postpartum day was more in
dates and fenugreek group as compared with the control
group (P < 0.001). Although there was a drop in weight af-
ter the three days in all groups, this drop was higher in the
control group when compared to the fenugreek and dates
groups; these differences were statistically significant be-
tween the control group and either intervention group, P
= 0.001. On the seventh day, newborns in the dates group
showed an increase in weight (2.9 ± 4.5%) while those in
the fenugreek or control groups were still below their
birth weight (P = 0.001). On the fourteenth day, there was
no significant difference between the groups (P = 0.156).
Therefore, the authors concluded that palm dates and fen-
ugreek herbal tea seem to be useful for enhancing breast
milk production during the early postpartum period (19).
These data are in agreement with our study results.
In the study of Turkyilmaz et al. (14), 66 mothers along
with their infants were classified in three groups: inter-
vention group, receiving three cups of fenugreek daily,
apple tea and control group. They concluded that fenu-
greek tea, increased breast milk volume (73.2 ± 53.5) in
comparison to the control group (31.1 ± 12.9) (P = 0.004).
The infants in the fenugreek group in comparison to the
control group, lost less weight during the first week of
birth (5.7 ± 2.6 vs. 8.3 ± 2.3) and gained their initial weight
sooner than the other infants (6.7 ± 3.2 vs. 9.9 ± 3.5) (14).
Since in this study, fenugreek resulted in an increase of
milk production, their findings confirm our study results.
The results of the study by Dehkhoda et al. confirm that
of our study regarding variations of breast feeding times
and weight gain. The mothers received galactogogues
pill containing fennel, fenugreek, cumin seed and dill
and 10 mg of metoclopramide pill. On the 14
th
day of the
study infant’s breast feeding times in the intervention
group was reported to be 5 - 12 times in comparison to 1
- 7 times in the control group and infants’ weight of the
interference group was 1765.86 ± 156.96 g in comparison
to 1673.00 ± 131.280 g in the control group (20).
Swafford’s study on ten women at the end of the second
week after giving birth showed significant differences in
milk production. Milk production in the first week was
considered as the base amount. In the second week the
mothers drank three cups of fenugreek daily. The results
showed that milk production increased from 207 mL/day
in the first week to 464 mL/day in the second week. The
results of this study confirm the galactogogues effect of
fenugreek and are in line with the results of our study
(21). However, the number of samples in this study are
very few with this being one of its limitations.
The study of Damanik et al. on 75 women included three
groups: Coleus amboinicus group, fenugreek group and
moloco + B
12
(reference group). The amount of milk pro-
duction was converted to grams through measuring the
weight difference of infants before and after each meal
and by using 0.938 mL/g factor was converted to mL. The
results showed a 65% increase of milk production in the
group receiving Coleus amboinicus, 20% in the fenugreek
group, and 10% in the control group (18). According to the
results, galactogogue of Coleus amboinicus is more than
fenugreek, yet because there was no Coleus amboinicus
in the country and since fenugreek is cheap and local in
Iran, it was studied instead. In addition, the difference be-
tween results of this study with present study may be due
to the dosage, medicine type and the method of calculat-
ing milk production.
The strength point of this study was the careful and con-
tinuous follow-up. The weak point of this study, despite
the researcher’s strong recommendations, may be short-
comings in the follow-up forms, which cannot be easily
investigated. Herbal tea of fenugreek seed in comparison
to the control group improved the signs of breast milk
sufficiency.
Acknowledgements
This study was supported by the Tehran university of
medical sciences. We are grateful to the south Tehran
health center for their data collection and institute of me-
dicinal plant (ACECR) for preparation of the Herbal tea.
Authors’ Contributions
Vida Ghasemi participated in the data collection. Vida
Ghasemi and Masoomeh Kheirkhah participated in the
design and writing of the manuscript. Mohsen Vahedi
Ghasemi V et al.
Iran Red Crescent Med J. 2015;17(8):e218486
contributed to the analysis of the data. All authors ap-
proved the final version submitted for publication.
Funding/Support
This study was supported financially by the Tehran uni-
versity of medical sciences.
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... 21 Previous research related to the use of Fenugreek seeds to increase breast milk production is available in capsule preparations, teabags, tea from pure Fenugreek seed steeping as well as powdered tea and with a mixture of other ingredients whose measurements related to breast milk production only use breast milk adequacy indicators seen from breast milk volume, baby weight, baby height, frequency of breastfeeding babies, defecation, urination, and other breast milk adequacy indicators. [22][23][24] The previous study conducted with three research groups conducted giving Fenugreek seed tea derived from 2 tablespoons pure Fenugreek seeds and 100 g of dates, as well as a control group that was not given anything obtained significant results on breast milk volume and baby body weight in the Fenugreek seed group and dates. 24 The study only used Fenugreek seeds and Phoenix dactylifera in different groups. ...
... This research was conducted at the Sidomulyo Health Center in Pekanbaru City between February and March 2022. The population in this study were postpartum 14thday breastfeeding mothers with a sample number of 32 with the inclusion criteria being standard puerperal mothers with a productive age range (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35), had no history of breast-related diseases, gave breast milk only without additional food or drinks, were not consuming breast milk booster, did not smoke and consumed alcohol, did not use hormonal contraceptives, has no history of legume allergies, the baby's weight was born ≥ 2500 grams, the baby's weight on the 14th day of postpartum returned to his birth weight. The baby's suction reflex was good. ...
... The exclusion criteria in this study are that the mother gets a special massage that can increase the mother's milk production, the baby is sick for more than three days, and the mother gives additional food or drinks to the baby. [23][24][25] The sample was randomly divided into two groups: the group given a combination drink of Fenugreek seeds and Phoenix dactylifera and the group given the Phoenix dactylifera drink only. ...
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Background: Breast milk is the best leading food for the growth and development of the baby; however, the production of breast milk produced by breastfeeding mothers is still lacking and impacts the baby's weight. One of the efforts is consuming a combination drink of Fenugreek seeds and Phoenix dactylifera containing galactagogue, which has never been done in this study before, to see an increase in breast milk production from indicators of prolactin hormone levels and its impact on baby weight.Purpose: Knowing the effect of giving drinks a combination of Fenugreek seeds and Phoenix dactylifera on the hormone prolactin and its impact on baby weight.Methods: This is an experimental study with a combination design, pretest-posttest, and posttest-only design. Respondents totaled 32 breastfeeding mothers, 16 were given drinks combination of Fenugreek seeds and Phoenix dactylifera, and 16 were given Phoenix dactylifera drinks. The intervention was given for 14 days, and the Mann-Whitney test analyzed prolactin hormone and baby weight using the Independent T-test.Results: Mean levels of the hormone prolactin in the intervention group were higher (279.52 ng/ml) than in the control group (263.31 ng/ml) with p>0.05. The average increase in body weight of infants of the intervention group (606.25 g) was higher than the control group (381.25 g) with a p<0.05.Conclusion: A drink combination made from Fenugreek seeds and Phoenix dactylifera can increase hormone prolactin. However, it is not statistically meaningful, and mothers who consume drinks have babies weighing higher than mothers who only give Phoenix dactylifera drinks.
... Literatürde laktasyon döneminde en çok rezene çayı, hurma, çemen tohumu gibi bitkilerin kullanıldığı dikkati çekmektedir. (27)(28)(29) Ghasemi ve ark. (27) (2015)'nın çemen tohumun anne sütü miktarı üzerine etkisini incelemek amacıyla 0-4 aylık kız bebeğe sahip 78 anne ile yaptığı çalışmada, deney grubuna günde üç defa, dört hafta boyunca çemen tohumu çayı içirilmiş. ...
... (27)(28)(29) Ghasemi ve ark. (27) (2015)'nın çemen tohumun anne sütü miktarı üzerine etkisini incelemek amacıyla 0-4 aylık kız bebeğe sahip 78 anne ile yaptığı çalışmada, deney grubuna günde üç defa, dört hafta boyunca çemen tohumu çayı içirilmiş. Kontrol grubuna ise siyah çay içirilmiştir. ...
... Anne-bebek ile yakından ilişkide bulunan hemşireler, tamamlayıcı terapiye yönelik bilgilerini geliştirmeli ve bu bilgisini uygulamaya aktarabilmelidir. Aynı zaman da27 Ekim 2014 Geleneksel ve Tamamlayıcı Tıp Uygulamaları Yönetmeliği hemşirelerin tamamlayıcı terapilerle ilgili bağımsız rollerini sınırlamakta olup bu rollerin genişletilmesi kapsamında hemşireler desteklenmelidir. Tamamlayıcı tıp uygulamalarının gerçekleştirilmesinde yararları ve olumsuz etkileri hakkında birey aile ve toplumu bilgilendirmede yeni bir rol üstlenmelidir. ...
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Laktasyon süreci hem anne hem bebek açısından önemli bir dönemdir. Bu süreç, doğumdan önce, gebelikteki hormonların etkisiyle oluşmaya başlar. Doğumla beraber süt üretiminin başlamasıyla birlikte laktasyon süreci başlar. Anne bu süreçten hem fizyolojik hem psikolojik olarak etkilenir. Anne bu süreçten olumlu etkilendiği gibi çevresel faktörler-den dolayı olumsuz da etkilenebilmektedir. Meme sorunları sıklıkla kadınların laktasyon süreci boyunca karşılaştığı sorunların başında ge-lir. Bununla birlikte emzirme süreci de kesintiye uğrayabilir. Emzirme-nin kesintiye uğraması hem anne hem bebek açısından olumsuz sonuç-lara yol açabilir. Emzirme sürecindeki sorunların tedavisinde kimyasal ilaçların kullanımı sütün kalitesini etkileyebilir veya anne sütü ile bebe-ğe geçerek zarar verebilir. Bu bağlamda laktasyon döneminde kimyasal olmayan tamamlayıcı tıp uygulamaları emzirmenin desteklenmesi ve meme sorunlarının giderilmesine yardımcı olabilir. Yönetmelikte be-lirtilen roller çerçevesinde tamamlayıcı tıp uygulamalar buı alanda ça-lışan hemşirelerin bakım uygulamalarında yer alabilir. Bu derlemede, tamamlayıcı tıbbın laktasyon sürecinde emzirme ve emzirme sorunları üzerindeki etkisini içeren çalışmalar incelenerek emzirmenin sürdürül-mesi ve desteklenmesinde, tamamlayıcı tıp uygulamalarının etkinlikle-ri ve hemşirenin rolü irdelendi.
... Many galactagogue plant species were reported to have estrogenic properties that may stimulate mammary alveolar growth, increased serum prolactin level, cortisol level, total protein, and glycogen content (Sahoo et al., 2016), and stimulate the blood flow to mammary glands, thus enriching milk flow (Patel et al., 2013). The presence of hormone-like action of steroidal saponin was associated with a lactogenic effect whereby the chemical structure is alike to endogenous estrogen and fixed to estrogen receptors (Ghasemi et al., 2015). ...
... Some assumptions increasing milk flow is due to the action of plant galactagogue mechanism in a biological pathway. Some herbal or plant galactagogues contain steroidal saponins in which chemical structures are alike endogenous estrogen, thus fix to estrogen receptors (Ghasemi et al., 2015). In a Malaysian study, aqueous extracts of banana blossom were demonstrated to act as a significant galactagogue in female lactating rats (Mahmood et al., 2012). ...
Article
There is limited evidence to support the effectiveness of banana blossom in promoting breast milk supply among mothers undergoing cesarean section. To investigate the clinical galactagogue effect of banana blossom on breast milk production among mothers undergoing cesarean section. A randomized controlled trial was conducted with the experimental group (ne=30) who consumed banana (Musa X paradisiaca) blossom beverage and the control group (nc=30) who consumed plain water. The results showed that mothers undergoing cesarean section in the experimental group had significantly higher milk flow levels at Day 2 (P = 0.017), Day 3 (P = 0.005) and milk volume at Day 2 (P = 0.005), and Day 3 (P = <0.001) than those of control group. This study had proven the galactagogue effect of banana blossom beverage to promote breast milk production, without any notable adverse effect. It could be used to be the alternative daily menu for postpartum mothers and a solution for midwives to deal with those who have inadequate production of breast milk.
... Des études réalisées chez l'homme mettent en évidence un effet galactologue significatif mesuré de manière directe (tirage du lait) [113,115] ou indirecte (poids de l'enfant, nombre de couches humides…) [116] tandis que d'autres études montrent un effet limité sur l'initiation de la lactation [117] ou une absence d'effet sur la production de lait [114]. Plusieurs de ces études souffrent de biais, comme l'absence de mesure directe de la production de lait [116], l'absence de placebo [115] ou la présence d'autres plantes potentiellement galactologues dans la supplémentation à base de fenugrec [113,118]. ...
... Des études réalisées chez l'homme mettent en évidence un effet galactologue significatif mesuré de manière directe (tirage du lait) [113,115] ou indirecte (poids de l'enfant, nombre de couches humides…) [116] tandis que d'autres études montrent un effet limité sur l'initiation de la lactation [117] ou une absence d'effet sur la production de lait [114]. Plusieurs de ces études souffrent de biais, comme l'absence de mesure directe de la production de lait [116], l'absence de placebo [115] ou la présence d'autres plantes potentiellement galactologues dans la supplémentation à base de fenugrec [113,118]. Cependant, une méta-analyse récente conclut à un effet galactologue significatif mais limité du fenugrec malgré un manque de variabilité dans le recrutement des participantes aux différents essais cliniques [119]. ...
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Du fait de ses bénéfices pour la santé de la mère et de l’enfant, l’allaitement maternelexclusif est recommandé par l’Organisation Mondiale de la Santé jusqu’à l’âge de 6 mois.Cependant, la prévalence mondiale de l’allaitement reste relativement faible, notamment du faitd’arrêts précoces causés par la perception des mères de produire du lait en quantité insuffisantepour permettre une croissance optimale de leur bébé. Même si les déterminants de la productionde lait maternel sont multiples, la prise de suppléments nutritionnels aux propriétésgalactagogues, qui stimulent la lactation, pourrait aider les femmes ayant des difficultés àallaiter. Des extraits de plantes, comme le fenugrec, sont utilisés depuis des millénaires pourfavoriser la production de lait tandis que des acides aminés, comme l’arginine, ont été utiliséschez les animaux de rente pour augmenter les performances de lactation. Cependant, les preuves scientifiques de leur capacité galactagogue restent peu nombreuses et les mécanismes sont mal compris. Nous avons démontré, dans un modèle de rates allaitant des portées de grande taille, que le fenugrec et la L-arginine avaient la capacité de favoriser la croissance de la descendance par une augmentation de la production de lait et une modulation de sa composition. De plus, nous avons vérifié l’absence d’effets métaboliques délétères chez les mères et la descendance. Une étude de l’expression de gènes de la glandes mammaires et de l’hypophyse a permis d’avancer des pistes mécanistiques afin de jeter les bases physiologiques qui permettent d’envisager des essais cliniques futurs chez les femmes confrontées à des difficultés de lactation.
... Galactagogue mix supplementation containing fenugreek enhanced breast milk production in women and increased infant birth weight gain in early postnatal days (24,66) . ...
Article
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Milk production is essential for optimal feeding of infants. The most common lactogenic drugs are dopamine 2 antagonists, oxytocin, recombinant bovine somatotropin (rBST), thyrotropin releasing hormone (TRH) and estrogenic drugs. However, many medicinal plants possess lactogenic effects in humans and animals. The current review focused on medicinal plants with lactogenic effect as natural sources of galactogogues characterized by efficacy and safety.
... As indicated in the table, the plants consumed include fenugreek, goat's rue, milk thistle, carduus, stinging nettle, melissa, caraway, anise, fennel, lemongrass, banana flower, ginger, malunggay and Asparagus racemosus. A total of 4 out of 13 studies involved the use of fenugreek, with all studies demonstrated an increase in milk production and babies' weight [20][21][22][23]. Among the four studies, all but one have focused on the first 7-15 days after the mothers have given birth. ...
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Human milk is recommended by the World Health Organization (WHO) for the general well-being of infants. However, many mothers face an insufficient milk supply to breastfeed their children. Galactagogue, in particular, plant galactagogue, serves as a method to promote lactation. This in-depth review examines the evidence supporting different plants' galactagogic activity through clinical studies around the globe. A scoping review approach was adopted to establish the research questions, and define the findings, selection and analysis of the study. This scoping review highlights and compiles the clinical research performed globally involving plant galactagogue to better inform the medical practitioners, lactation consultants, nursing mothers, communities and relevant personnel on practicing, guidelines, policymaking and research. In general, a total of 1041 research publications were retrieved from different global bibliographic databases, of which only 13 articles were retained for analysis after applying the exclusion criteria. A total of 14 types of plants have undergone clinical studies in the past decade to verify their galactagogic activity. All but two showed a positive effect on promoting milk production. There were 42 articles categorised as excluded studies. The category includes review articles, surveys, case reports, introductory articles of regional plant galactagogue and preclinical studies, which involves animal testing and the studies exploring other issues related to plant galactagogue. The findings demonstrate that there is a significant research gap on the plant galactagogue using clinical studies. More clinical research is necessary to identify and verify the efficacy of various types of plant galactagogue for the benefit of humankind.
Article
Trigonella foenum-graecum Linne, commonly known as fenugreek, is a herb with medicinal and nutraceutical values which has been used from ancient times in the Indian medicine system. According to the literature analysis, the presence of various bioactive compounds such as alkaloids, flavonoids, saponins, fibers, fatty acids, etc. contributes to the therapeutic potential of the herb. In context to its therapeutic competency, fenugreek has anti-biotic, anti-oxidant, anti-carcinogen properties and controls hyperglycemia in diabetic patients. The present review is an attempt to highlight the nutraceutical, health and therapeutic benefits of fenugreek.
Chapter
Fenugreek (Trigonella foenum-graecum) is an annual plant in the Fabaceae family designated by the FDA as Generally Recognized as Safe (GRAS). Its seeds are used as a cooking spice in India to imitate maple flavor. Because it is high in steroidal saponins, fenugreek is used in the commercial production of steroids. It may be beneficial for hyperlipidemia, diabetes, obesity, lactation, dysmenorrhea, polycystic ovary syndrome, menopause, female and male sexual dysfunction, Parkinson’s disease, and athletic performance. Fenugreek has hypocholesterolemic, hypolipidemic, hypoglycemic, antioxidant, antiplatelet, antimicrobial, and hepatoprotective effects. This chapter examines some of the scientific research conducted on fenugreek, both alone and in combination formulas, for treating numerous health conditions. It summarizes results from several human studies of fenugreek’s use in treating cardiometabolic, genitourinary, and neurological disorders, among others. Finally, the chapter presents a list of fenugreek’s Active Constituents, different Commonly Used Preparations and Dosage, and a Section on “Safety and Precaution” that examines side effects, toxicity, and disease and drug interactions.
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Background Breast-feeding provides optimal nutrition along with immune support to newborns and infants and a host of lifelong health benefits to mother and child. Unfortunately, in daily health care practice, there are increasing numbers of reports on unsuccessful breastfeeding related problems. Galactagogues are substances that stimulate milk production. Hemocare®LACT, is a product of MMC Pharmaceuticals Ltd to enhance the milk secretion in lactating women. Objective To evaluate the safety and efficacy of Hemocare®LACT capsules on prolactin levels, infant body weight and hemoglobin in lactating mothers. Methods Open-label, placebo controlled, pilot, randomized controlled trial was conducted in a tertiary care hospital. A total of 72 eligible mothers were randomized to placebo or Hemocare®LACT in the ratio of 1:1. Serum prolactin, hemoglobin levels and infant weight were evaluated at baseline, 30th day, 60th day and in the 90th day post commencement of treatment. Results A significant difference in infant weight was found from baseline to 90th day in Hemocare®LACT group (p<0.01). Similarly, statistically significant difference was found in prolactin levels at 90th day when compared to baseline (p<0.05). Hemoglobin levels well maintained in Hemocare®LACT group. Conclusion Hemocare®LACT capsules increased prolactin levels and infants body weight in lactating mothers when compared to placebo with good tolerability.
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Introduction: Re-establishing breastfeeding (relactation) is necessary in preterm infants who are deprived of breastfeeding due to hospitalized in the neonatal intensive care unit (NICU). Although NICU nurses train mothers about breastfeeding and relactation to some degree, there exists a lack of support or evaluation for restarting breastfeeding. The present study tried to determine the effects of an educational and supportive relactation program on weight gain of preterm infants. Methods: This clinical trial study was performed on 60 preterm infants with mean gestational age of 29 weeks hospitalized in NICU of Alzahra Hospital (Tabriz, Iran). The infants were evaluated in two groups of 30. The mothers of infants in the control group received routine training and support about relactation while the intervention group received routine training as well as the designed educational and supportive relactation program including breast pumping, increasing milk agents and kangaroo mother care. Daily follow-up was conducted by the researcher. All the infants were weighed by a co-researcher. Results: On the 14(th) day of the study, the mean (SD) weight of infants in the control and intervention groups was 1666.67 (136.08) and 1765.86 (156.96) g, respectively. Conclusion: Providing mothers with support from the medical team and training on relactation and kangaroo mother care can lead to better weight gain of the low birth weight premature infants.
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Background: Childhood malnutrition still persists in some parts of Iran. Poor breast feeding is proposed as a probable risk factor for
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We have previously shown that in Iran, only 28% of infants were exclusively breastfed at six months, despite a high prevalence of breastfeeding at two years of age. The primary aim of this study was to investigate the reasons women discontinued exclusive breastfeeding. This retrospective study was based on questionnaires and interviews with 63,071 mothers of infants up to 24 months of age, divided into two populations: infants younger than six months and six months or older. The data were collected in 2005-2006 from all 30 provinces of Iran. Only 5.3% of infants less than six months of age stopped breastfeeding (mean age of 3.2 months); more commonly in urban than rural areas. The most frequently cited reasons mothers gave for discontinuing exclusive breastfeeding were physicians' recommendation (54%) and insufficient breast milk (self-perceived or true, 28%). Breastfeeding was common after six months of age: only 11% of infants discontinued breastfeeding, at a mean of 13.8 months. The most common reason for discontinuation at this age was insufficient breast milk (self-perceived or true, 45%). Maternal illness or medication (10%), infant illness (6%), and return to work (3%) were uncommon causes. Use of a pacifier was correlated with breastfeeding discontinuation. Maternal age and education was not associated with duration of breastfeeding. Multivariate analysis showed that using a pacifier and formula or other bottle feeding increased the risk of early cessation of breastfeeding. Physicians and other health professionals have an important role to play in encouraging and supporting mothers to maintain breastfeeding.
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ABSTRACT: Exclusive breastfeeding (EBF) for the first six months of infants' lives is a cost effective intervention in saving children's lives and can avert 13 - 15% of the 9 million deaths of children under 5 years old in resource poor settings. However, EBF rates have been shown to be low in resource poor settings, ranging between 20 and 40%. In Tanzania, the prevalence of EBF among infants under 6 months is 41%, with limited information on predictors of EBF. The aim of the study was to determine prevalence of EBF and its predictors in Kigoma Municipality, Western Tanzania. A cross-sectional study was conducted in March to May 2010 among 402 consenting women, with infants aged 6 to 12 months, from randomly selected households. A questionnaire was used to collect information on demographic characteristics, knowledge of EBF, infant feeding practices, and on HIV status. The prevalence of EBF among women in Kigoma Municipality was 58%. Knowledge of EBF was relatively higher (86%) compared to the practice. In the multivariable analysis, women with adequate knowledge of EBF (AOR 5.4), women who delivered at health facilities (AOR 3.0) and women who had no problems related to breasts, like engorgement/cracked nipples (AOR 6.6) were more likely to exclusively breastfeed compared to others. Prevalence of EBF in Kigoma municipality was slightly higher than the national figure of 41%, however it was way below the EBF prevalence of 90% recommended by the WHO. Strategies that target improving knowledge and skills for lactation management among women, as well as strategies to improve health facility delivery, may help to improve EBF in this setting.
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The aim of this study was to evaluate whether consumption of maternal herbal tea containing fenugreek had any effects on breast milk production and infants' weight gain pattern in the early postnatal period. Sixty-six (66) mother-infant pairs were randomly assigned to 3 groups. Group 1 (n = 22) consisted of mothers who were receiving herbal tea containing fenugreek every day. Group 2 (n = 22) and group 3 (n = 22) were assigned as placebo and controls, respectively. Birth weight, loss of birth weight, time of regain of birth weight, amount of breast milk assessed on the third day after delivery were determined. Maximum weight loss was significantly lower in infants in group 1 compared to both the placebo and control groups (p < 0.05). Infants in group 1 regained their birth weight earlier than those in control and placebo groups (p < 0.05). The mean measured breast milk volume of the mothers who received galactagogue tea was significantly higher than the placebo and control groups (p < 0.05). Maternal galactagogue herbal tea supplementation seems to be useful for enhancing breast milk production and facilitating infant birth weight regain in early postnatal days.
Article
Background: Artificial or natural substances called galactagogues may assist the production of breast milk. Objective: To evaluate the effect of consumption of fenugreek herbal tea or palm dates on breast milk production. Methods: Seventy-five puerperal women were randomly assigned for two weeks to one of three groups: herbal tea with fenugreek (n = 25), palm dates (n = 25) or no galactagogue as control (n = 25). Maternal milk volume was measured through manual pumping of breasts on the third postpartum day. Infants were weighed on days (0, 3, 7, &14) using an infant scale. Results: Breast milk volume at 3 days postpartum and percentage weight change were statistically significant either dates or fenugreek groups and control group p<0.001, p=0.001 respectively. On the seventh day, newborns in date's group showed an increase in weight while those in fenugreek or control groups were still below their birth weight (p=0.001). On the fourteenth day, there was no significant difference between any of the groups (p=0.156). Conclusion: Palm dates and fenugreek herbal tea seems to be useful for enhancing breast milk production during early postpartum period.
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In this introductory overview, I explore the observation that breast milk is the gold standard for protective nutrients fed to newborn infants and present clinical evidence of its strong protective effect against age-related infectious gastroenteritis. The composition of breast milk changes according to the newborn infant's needs for passive protection. In addition, substances in breast milk can actively stimulate development of the newborn's host defenses to provide continued mucosal protection after breastfeeding is terminated. Later I present several specific examples of the development of intestinal host defenses due to breastfeeding. An important function of early breastfeeding is its anti-inflammatory effect on the immature, excessive inflammatory response in newborns. Several components of breast milk can reduce the inflammatory response to stimuli in the newborn intestine. These include transforming growth factor (TGF)-beta, interleukin (IL)-10, erythropoietin, and lactoferrin. These components of breast milk can act individually or in concert to contain the neonatal immature anti-inflammatory response.
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Phytoestrogens are plant derived compounds found in a wide variety of foods, most notably soy. A litany of health benefits including a lowered risk of osteoporosis, heart disease, breast cancer, and menopausal symptoms, are frequently attributed to phytoestrogens but many are also considered endocrine disruptors, indicating that they have the potential to cause adverse health effects as well. Consequently, the question of whether or not phytoestrogens are beneficial or harmful to human health remains unresolved. The answer is likely complex and may depend on age, health status, and even the presence or absence of specific gut microflora. Clarity on this issue is needed because global consumption is rapidly increasing. Phytoestrogens are present in numerous dietary supplements and widely marketed as a natural alternative to estrogen replacement therapy. Soy infant formula now constitutes up to a third of the US market, and soy protein is now added to many processed foods. As weak estrogen agonists/antagonists with molecular and cellular properties similar to synthetic endocrine disruptors such as Bisphenol A (BPA), the phytoestrogens provide a useful model to comprehensively investigate the biological impact of endocrine disruptors in general. This review weighs the evidence for and against the purported health benefits and adverse effects of phytoestrogens.