• Breast Engorgement; Breast Milk, Enhancing; Milk Production; Nursing Support; Weaning
Principal Proposed Natural Treatments
Other Proposed Natural Treatments
• ENHANCING MILK PRODUCTION: Acupuncture; Fenugreek; Milk Thistle
• WEANING/BREAST ENGORGEMENT Proteolytic Enzymes; Sage
• NIPPLE PAIN Peppermint
• PREVENTING ALLERGIES IN CHILDREN: Probiotics; Reducing Saturated Fats
• GENERAL NUTRITIONAL SUPPORT: Calcium; Multivitamin/Multimineral Supplement; Omega-3 Fatty Acids
Probably Ineffective Treatments
• BREAST ENGORGEMENT/WEANING: Cabbage Leaves
Herbs and Supplements to Use Only With Caution
• Many natural treatments are potentially unsafe for use by nursing mothers. See the discussion at the end of this article.
It was one of the more shameful chapters of conventional medicine when, for many decades, physicians actively discouraged women from breastfeeding. Fortunately, by the 1970s, the poor judgment inherent in this recommendation had become abundantly clear. Today, there is no longer any doubt regarding what should have been obvious from the beginning: that human breast milk is the ideal food for a human infant.
Not only does breast milk contain all the necessary nutrients, it contains additional substances such as colostrum that provide important health benefits. In addition, human breast milk lacks allergenic substances found in infant formulas based on cow or soy milk. For this reason, breastfeeding, as opposed to formula feeding, may reduce the risk of the infant developing allergy-related diseases such as eczema .
However, nursing can also cause difficulties for the mother of a newborn. Milk flow may be insufficient, the breasts may become inflamed or infected, and when it comes time to stop nursing, there may be an interval of severe discomfort. There are medical treatments available for some of these problems, although in many cases they are more traditional and low-tech than gleamingly modern.
In addition, the constituents of human breast milk can be affected in both positive and negative ways by the mother’s diet. Herbs and supplements, like drugs, should be considered risky in breastfeeding until demonstrated otherwise—but on the other hand, certain supplements for the mother might benefit the baby.
There is considerable overlap in this subject between conventional and alternative medicine, and only the more “alternative” of the relevant information is presented here.
Sage leaf tea traditionally has been recommended to dry up milk supply and reduce breast engorgement for the purpose of weaning, but supporting scientific studies are lacking. 3 One early double-blind, placebo-controlled trial did find some benefit for breast engorgement with the use of proteolytic enzymes , 15 but considerably more evidence would be necessary before it could be considered an effective treatment.
According to traditional wisdom, the application of cabbage leaves to the breast can reduce the discomfort of breast engorgement during weaning, but controlled studies indicated that it is not effective for this purpose. 4-6
For a discussion of the homeopathic approach to this topic, see the breast engorgement chapter in the homeopathy database.
Pain and irritation in the nipples can cause a nursing mother to cease breastfeeding earlier than she might otherwise wish to. A double-blind study performed in Iran found that applying peppermint water (essentially, lukewarm peppermint tea) directly to the nipples helped prevent nipple and aureola cracks. 16
Promoting Milk Supply
Preventing Eczema and Other Allergic Conditions in Children
Double-blind, placebo-controlled trials suggest that nursing women may be able to help ward off eczema and other allergic conditions in their children by taking probiotics (friendly bacteria). 7-9 Cutting down on saturated fat (animal fat) may be helpful as well. 10
General Nutritional Support
Because breastfeeding requires a woman to supply nutrients to another human being, use of a general multivitamin/multimineral supplement is advisable. However, such supplements seldom contain adequate amounts of calcium, and for that reason a separate calcium supplement should be taken. Calcium supplements offer the additional benefit of reducing lead levels in breast milk. 14
Essential fatty acids in the omega-3 family are thought to be essential for infant health, especially brain development, and for this reason it has been suggested that nursing women should supplement their diet with this nutrient.
Finally, while human breast milk supplies nearly all essential nutrients, it does not contain an adequate amount of iron . This problem is exacerbated by the modern practice of rapidly cutting the umbilical cord, which has the effect of reducing the infant’s iron stores. For this reason, some physicians routinely recommend that breastfed infants should receive iron supplements. However, some evidence suggests that this practice is only warranted if the infant is anemic; otherwise, supplementation may decrease growth rate. 12
Virtually no medicinal herb has been established as safe in nursing, and even herbs that might seem safe because of their wide use in cooking could cause problems when they are taken in the form of highly concentrated extracts. There could even be problems with herbs traditionally recommended for use by nursing mothers. For example, the herb chasteberry is traditionally used to promote milk supply. However, it inhibits prolactin, a hormone that is vital to milk production, 1,2 and for this reason could very well have the reverse effect.
Supplements that are essential nutrients, such as vitamins, generally have a maximum safe intake established for them by a governmental agency. However, other supplements that are not essential nutrients are in much the same position as herbs, and could conceivably cause harm. This may even be the case for apparently safe supplements. For example, one double-blind, placebo-controlled study found that if a nursing woman consumes the supplement conjugated linoleic acid (CLA) , the fat content of her breast milk will be reduced with potentially harmful effects. 11
For more information on a particular herb or supplement, see its entry in the Herbs & Supplements portion of this database.
1. Wuttke W. Dopaminergic compounds in Vitex agnus castus. In: Lowe D, ed. Phytopharmaka: Forschung und klinische Anwendung. Darmstadt, Germany: Steinkopff; 1996:81-91.
2. Milewicz A, Gejdel E, Sworen H, et al. Vitex agnus castus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study [translated from German]. Arzneimittelforschung. 1993;43:752-756.
3. McGuffin M, ed. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press; 1997:102.
4. Roberts KL, Reiter M, Schuster D. Effects of cabbage leaf extract on breast engorgement. J Hum Lact. 1998;14:231-236.
5. Roberts KL. A comparison of chilled cabbage leaves and chilled gelpaks in reducing breast engorgement. J Hum Lact. 1995;11:17-20.
6. Nikodem VC, Danziger D, Gebka N, et al. Do cabbage leaves prevent breast engorgement? A randomized, controlled study. Birth. 1993;20:61-64.
7. Kalliomaki M, Salminen S, Arvilommi H, et al. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet. 2001;357:1076-1079.
8. Isolauri E, Arvola T, Sutas Y, et al. Probiotics in the management of atopic eczema. Clin Exp Allergy. 2000;30:1604-1610.
9. Majamaa H, Isolauri E. Probiotics: a novel approach in the management of food allergy. J Allergy Clin Immunol. 1997;99:179-185.
10. Hoppu U, Kalliomaki M, Isolauri E. Maternal diet rich in saturated fat during breastfeeding is associated with atopic sensitization of the infant. Eur J Clin Nutr. 2000;54:702-705.
11. Masters N, McGuire MA, Beerman KA, et al. Maternal supplementation with CLA decreases milk fat in humans. Lipids. 2002;37:133-138.
12. Dewey KG, Domellof M, Cohen RJ, et al. Iron supplementation affects growth and morbidity of breast-fed infants: results of a randomized trial in Sweden and Honduras. J Nutr. 2002;132:3249-3255.
13. Baumann-Jiang M. Does acupuncture help for milk production? A randomized, placebo-controlled clinical study. Essen, Germany: KVC Verlag; 2000.
14. Hernandez-Avila M, Gonzalez-Cossio T, Hernandez-Avila JE, et al. Dietary calcium supplements to lower blood lead levels in lactating women: a randomized placebo-controlled trial. Epidemiology. 2003;14:206-212.
15. Murata T, Hunzow M, Nomura Y. The clinical effects of 'protease complex' on postpartum breast engorgement. J Jap Obstet Gynaecol Soc. 1965;12:139-147.
16. Sayyah Melli M, Rashidi MR, Delazar A, et al. Effect of peppermint water on prevention of nipple cracks in lactating primiparous women: a randomized controlled trial. Int Breastfeed J. 2007 Apr 19. [Epub ahead of print]
17. Neri I, Allais G, Vaccaro V, et al. Acupuncture treatment as breastfeeding support: preliminary data. J Altern Complement Med. 2011;17(2):133-137.
Last reviewed July 2012 by EBSCO CAM Review Board
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