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Clinical Study on Plant Galactagogue Worldwide in Promoting Women’s Lactation: a Scoping Review

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Abstract

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.

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References

  1. Sharp JA, Modepalli V, Enjapoori AK, Bisana S, Abud HE, Lefevre C, Nicholas KR (2014) Bioactive functions of milk proteins: a comparative genomics approach. J Mammary Gland Biol Neoplasia 19:289–302

    Article  PubMed  Google Scholar 

  2. Vass RA, Kemeny A, Dergez T, Ertl T, Reglodi D, Jungling A, Tamas A (2019) Distribution of bioactive factors in human milk samples. Int Breastfeed J 14:9. https://doi.org/10.1186/s13006-019-0203-3

    Article  PubMed  PubMed Central  Google Scholar 

  3. Sala-Vila A, Castellote AI, Rodriguez-Palmero M, Campoy C, López-Sabater MC (2005) Lipid composition in human breast milk from Granada (Spain): changes during lactation. Nutrition 21:467–473

    Article  CAS  PubMed  Google Scholar 

  4. World Health Organization (2009) Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals. World Health Organization. https://pubmed.ncbi.nlm.nih.gov/23905206/. Accessed 14 September 2020

  5. Lewis JA (2009) Maternal perceptions of insufficient milk supply in breastfeeding. MCN Am J Matern Child Nurs 34(4):264

    Google Scholar 

  6. Camurdan AD, Ilhan MN, Beyazova U, Sahin F, Vatandas N, Eminoglu S (2008) How to achieve long-term breast-feeding: factors associated with early discontinuation. Public Health Nutr 11:1173–1179

    Article  PubMed  Google Scholar 

  7. Karall D, Ndayisaba J-P, Heichlinger A, Kiechl-Kohlendorfer U, Stojakovic S, Leitner H, Scholl-Bürgi S (2015) Breast-feeding duration early weaning—do we sufficiently consider the risk factors? J Pediatr Gastroenterol Nutr 61:577–582

    Article  PubMed  Google Scholar 

  8. Sun K, Chen M, Yin Y, Wu L, Gao L (2017) Why Chinese mothers stop breastfeeding: mothers’ self-reported reasons for stopping during the first six months. J Child Health Care 21:353–363

    Article  PubMed  Google Scholar 

  9. Juvarajah T, Wan-Ibrahim WI, Ashrafzadeh A, Othman S, Hashim OH, Fung SY, Abdul-Rahman PS (2018) Human milk fat globule membrane contains hundreds of abundantly expressed and nutritionally beneficial proteins that are generally lacking in caprine milk. Breastfeed Med 13:631–637

    Article  PubMed  Google Scholar 

  10. Hinde K, German JB (2012) Food in an evolutionary context: insights from mother's milk. J Sci Food Agric 92:2219–2223

    Article  CAS  PubMed  Google Scholar 

  11. Hassiotou F, Geddes DT, Hartmann PE (2013) Cells in human milk: state of the science. J Hum Lact 29:171–182

    Article  PubMed  Google Scholar 

  12. Amir LH (2006) Breastfeeding: managing 'supply' difficulties. Aust Fam Physician 35:686–689

    PubMed  Google Scholar 

  13. Brodribb W, Academy of Breastfeeding Medicine (2018) ABM clinical protocol #9: use of galactogogues in initiating or augmenting maternal milk production, second revision 2018. Breastfeed Med 13:307–314

    Article  PubMed  Google Scholar 

  14. Foong SC, Tan ML, Foong WC, Marasco LA, Ho JJ, Ong JH (2020) Oral galactagogues (natural therapies or drugs) for increasing breast milk production in mothers of non-hospitalised term infants. Cochrane Database Syst Rev 5:CD011505

    PubMed  Google Scholar 

  15. Levac D, Colquhoun H, O'Brien KK (2010) Scoping studies: advancing the methodology. Implement Sci 5:69

    Article  PubMed  PubMed Central  Google Scholar 

  16. Cacchione PZ (2016) The evolving methodology of scoping reviews. Clin Nurs Res 25(2):115–119

    Article  PubMed  Google Scholar 

  17. Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(7):e1000097. https://doi.org/10.1371/journal.pmed.1000097

    Article  PubMed  PubMed Central  Google Scholar 

  18. Tricco AC, Lillie E, Zarin W, O'Brien K, Colquhoun H, Kastner M, Levac D, Ng C, Sharpe JP, Wilson K, Kenny M, Warren R, Wilson C, Stelfox HT, Straus SE (2016) A scoping review on the conduct and reporting of scoping reviews. BMC Medical Res Methodol 16:15. https://doi.org/10.1186/s12874-016-0116-4

    Article  Google Scholar 

  19. Poswal FS, Russell G, Mackonochie M, MacLennan E, Adukwu EC, Rolfe V (2019) Herbal teas and their health benefits: a scoping review. Plant Foods Hum Nutr 74:266–276. https://doi.org/10.1007/s11130-019-00750-w

    Article  CAS  PubMed  Google Scholar 

  20. Turkyılmaz C, Onal E, Hirfanoglu IM, Turan O, Koç E, Ergenekon E, Atalay Y (2011) The effect of galactagogue herbal tea on breast milk production and short-term catch-up of birth weight in the first week of life. J Altern Complement Med 17(2):139–142. https://doi.org/10.1089/acm.2010.0090

    Article  PubMed  Google Scholar 

  21. Abdou RM, Fathey M (2018) Evaluation of early postpartum fenugreek supplementation on expressed breast milk volume and prolactin levels variation. Gaz Egypt Paediatr Assoc 66(3):57–60

    Article  Google Scholar 

  22. Ravi R, Joseph J (2020) Effect of fenugreek on breast milk production and weight gain among infants in the first week of life. Clin Epidemiol Glob Health 8(3):656–660. https://doi.org/10.1016/j.cegh.2019.12.021

    Article  Google Scholar 

  23. Ghasemi V, Kheirkhah M, Vahedi M (2015) The effect of herbal tea containing fenugreek seed on the signs of breast milk sufficiency in Iranian girl infants. Iranian Red Crescent Med J 17(8):e21848

    Article  Google Scholar 

  24. Serrao F, Corsello M, Romagnoli C, D'Andrea V, Zecca E (2018) The long-term efficacy of a galactagogue containing silymarin-phosphatidylserine and galega on milk production of mothers of preterm infants. Breastfeed Med 2018(13):67–69. https://doi.org/10.1089/bfm.2017.0169

    Article  Google Scholar 

  25. Zecca E, Zuppa AA, D'Antuono A, Tiberi E, Giordano L, Pianini T, Romagnoli C (2016) Efficacy of a galactogogue containing silymarin-phosphatidylserine and galega in mothers of preterm infants: a randomised controlled trial. Eur J Clin Nutr 70:1151–1154. https://doi.org/10.1038/ejcn.2016.86

    Article  CAS  PubMed  Google Scholar 

  26. Di Pierro F, Callegari A, Carotenuto D, Tapia MM (2008) Clinical efficacy, safety and tolerability of BIO-C (micronised Silymarin) as a galactagogue. Acta Biomed 79:205–210

    PubMed  Google Scholar 

  27. Peila C, Coscia A, Tonetto P, Spada E, Milani S, Moro G, Fontana C, Vagliano L, Tortone C, Di Bella E, Bertino E (2015) Evaluation of the galactogogue effect of silymarin on mothers of preterm newborns (<32 weeks). Pediatr Med Chir 37(3):105. https://doi.org/10.4081/pmc.2015.105

    Article  Google Scholar 

  28. Ozalkaya E, Aslandoğdu Z, Özkoral A, Topcuoğlu S, Karatekin G (2018) Effect of a galactagogue herbal tea on breast milk production and prolactin secretion by mothers of preterm babies. Niger J Clin Pract 21(1):38–42

    CAS  PubMed  Google Scholar 

  29. Nordin ZM, Bakar IA, Omar MN, Mahmood A (2019) Effect of consuming lactogenic biscuits formulated with banana (Musa x paradisiaca) flower flour on expressed breast milk (EBM) among lactating working women. Food Res 4(2):294–300. https://doi.org/10.26656/fr.2017.4(2).292

    Article  Google Scholar 

  30. Paritakul P, Ruangrongmorakot K, Laosooksathit W, Suksamarnwong M, Puapornpong P (2016) The effect of ginger on breast milk volume in the early postpartum period: a randomised, double-blind controlled trial. Breastfeed Med 11:361–365. https://doi.org/10.1089/bfm.2016.0073

    Article  PubMed  Google Scholar 

  31. Estrella CP, Bias J, David GZ, Taup MA (2000) A double-blind, randomised controlled trial on the use of malunggay (Moringa oleifera) for augmentation of the volume of breast milk among non-nursing mothers of preterm infants. Philipp J Pediatr 49:3–6. https://miracletrees.org/moringa-doc/moringa_breastfeeding_study.pdf. Accessed 8 August 2020

  32. Gupta M, Shaw B (2011) A double-blind randomised clinical trial for evaluation of galactogogue activity of asparagus racemosus willd. Iran J Pharm Res 10:167–172

    PubMed  PubMed Central  Google Scholar 

  33. Kappel VD, Cazarolli LH, Pereira DF, Postal BG, Madoglio FA, Buss ZDS et al (2013) Beneficial effects of banana leaves (Musa x paradisiaca) on glucose homeostasis: multiple sites of action. Rev Bras Farmacogn 23(4):706–715. https://doi.org/10.1590/S0102-695X2013005000062

    Article  CAS  Google Scholar 

  34. Singh YN (1986) Traditional medicine in Fiji: some herbal folk cures used by Fiji Indians. J Ethnopharmacol 15:57–88. https://doi.org/10.1016/0378-8741(86)90104-2

    Article  CAS  PubMed  Google Scholar 

  35. Raguindin PFN, Dans LF, King JF (2014) Moringa oleifera as a galactagogue. Breastfeed Med 9:323–324. https://doi.org/10.1089/bfm.2014.0002

    Article  PubMed  Google Scholar 

  36. Sibeko L, Johns T (2021) Global survey of medicinal plants during lactation and postpartum recovery: evolutionary perspectives and contemporary health implications. J Ethnopharmacol 270:113812. https://doi.org/10.1016/j.jep.2021.113812

    Article  CAS  PubMed  Google Scholar 

  37. Zhang BD, Cheng JX, Zhang CF, Bai YD, Liu WY, Li W, Koike K, Akihisa T, Feng F, Zhang J (2020) Sauropus androgynos L. Merr.- A phytochemical, pharmacological and toxicologycal review. J Ethnopharmacol 257:112778. https://doi.org/10.1016/j.jep.2020.112778

  38. Khan TM, Wu DBC, Dolzhenko AV (2018) Effectiveness of fenugreek as a galactagogue: a network meta-analysis. Phytother Res 32:402–412. https://doi.org/10.1002/ptr.5972

    Article  CAS  PubMed  Google Scholar 

  39. Oketch-Rabah HA (2012) Mondia whitei, a medicinal plant from Africa with aphrodisiac and antidepressant properties: a review. J Diet Suppl 9:272–284. https://doi.org/10.3109/19390211.2012.726704

    Article  PubMed  Google Scholar 

  40. Zulkefli AF, Idrus RBH, Hamid AA (2020) Nigella sativa as a galactagogue: a systematic review. Sains Malays 49(7):1719–1727

    Article  CAS  Google Scholar 

  41. Geraci A, Polizzano V, Schicchi R (2018) Ethnobotanical uses of wild taxa as galactagogues in Sicily (Italy). Acta Soc Bot Pol 87(2):3580. https://doi.org/10.5586/asbp.3580

    Article  CAS  Google Scholar 

  42. Sayed NZ, Deo R, Mukundan U (2007) Herbal remedies used by Warlis of Dahanu to induce lactation in nursing mothers. Indian J Tradit Know 6(4):602–605. http://nopr.niscair.res.in/handle/123456789/1009. Accessed 25 August 2020

  43. Jamal JA, Ghafar ZA, Husain K (2011) Medicinal plants used for postnatal care in Malay traditional medicine in the peninsular Malaysia. Pharmacogn J 3(24):15–24

    Article  Google Scholar 

  44. Rosengarten JF (1982) A neglected mayan galactagogue - Ixbut (Euphorbia lancifolia). J Ethnopharmacol 5:91–112

    Article  CAS  PubMed  Google Scholar 

  45. Chao J, Ko CY, Lin CY, Tomoji M, Huang CH, Chiang HC, Yang JJ, Huang SS, Su SY (2021) Ethnobotanical survey of natural galactagogues prescribed in traditional Chinese medicine pharmacies in Taiwan. Front Pharmacol 11:2443. https://doi.org/10.3389/fphar.2020.625869

    Article  Google Scholar 

  46. Sani NA, Kawu MU, Bako IG (2019) Effects of Launaea taraxacifolia and resveratrol on milk yield and serum prolactin and oxytocin levels: a lactogenic study. Int J Vet Sci Med 7:71–77

    Article  PubMed  PubMed Central  Google Scholar 

  47. Mahmood A, Omar MN, Ngah N (2012) Galactagogue effects of Musa x paradisiaca flower extract on lactating rats. Asian Pac J Trop Med 5:882–886

    Article  PubMed  Google Scholar 

  48. Badgujar SB, Bandivdekar AH (2015) Evaluation of a lactogenic activity of an aqueous extract of Cyperus rotundus Linn. J Ethnopharmacol 163:39–42

    Article  PubMed  Google Scholar 

  49. Barbosa CC, Nishimura AN, Santos ML, Junior WD, Andersen ML, Mazaro-Costa R (2020) Silymarin administration during pregnancy and breastfeeding: evaluation of initial development and adult behavior of mice. Neurotoxicology 78:64–70

    Article  CAS  PubMed  Google Scholar 

  50. Liu H, Hua Y, Luo H, Shen Z, Tao X, Zhu X (2015) An herbal galactagogue mixture increases milk production and aquaporin protein expression in the mammary glands of lactating rats. Evid Based Complement Alternat Med 2015:760585. https://doi.org/10.1155/2015/760585

    Article  PubMed  PubMed Central  Google Scholar 

  51. Sevrin T, Alexandre-Gouabau MC, Castellano B, Aguesse A, Ouguerram K, Ngyuen P, Darmaun D, Boquien CY (2019) Impact of fenugreek on milk production in rodent models of lactation challenge. Nutrients 11:2571

    Article  CAS  PubMed Central  Google Scholar 

  52. Hosseinzadeh H, Tafaghodi M, Abedzadeh S, Taghiabadi E (2014) Effect of aqueous and ethanolic extracts of Pimpinella anisum L. seeds on milk production in rats. J Acupunct Meridian Stud 7:211–216

    Article  PubMed  Google Scholar 

  53. Hosseinzadeh H, Tafaghodi M, Mosavi MJ, Taghiabadi E (2013) Effect of aqueous and ethanolic extracts of Nigella sativa seeds on milk production in rats. J Acupunct Meridian Stud 6:18–23. https://doi.org/10.1016/j.jams.2012.07.019

    Article  PubMed  Google Scholar 

  54. Dhulappa DM (2020) Experimental evaluation of karpasa beeja (Gossypium herbacum linn.) with special reference to its galactagogue effect. Int J Ayurvedic Med 11:35–43

    Article  Google Scholar 

  55. Sim TF, Hattingh HL, Sherriff J, Tee LBG (2014) Perspectives and attitudes of breastfeeding women using herbal galactagogues during breastfeeding: a qualitative study. BMC Complement Altern Med 14:216. https://doi.org/10.1186/1472-6882-14-216

    Article  PubMed  PubMed Central  Google Scholar 

  56. Sim TF, Hattingh HL, Sherriff J, Tee LB (2015) The use, perceived effectiveness and safety of herbal galactagogues during breastfeeding: a qualitative study. Int J Environ Res Public Health 12(9):11050–11071

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. Othman N, Lamin RAC, Othman CN (2014) Exploring behavior on the herbal galactagogue usage among Malay lactating mothers in Malaysia. Procedia Soc Behav Sci 153:199–208

    Article  Google Scholar 

  58. Jendras G, Monizi M, Neinhuis C, Lautenschläger T (2020) Plants, food and treatments used by BaKongo tribes in Uíge (northern Angola) to affect the quality and quantity of human breast milk. Int Breastfeed J 15:88. https://doi.org/10.1186/s13006-020-00329-1

    Article  PubMed  PubMed Central  Google Scholar 

  59. Buntuchai G, Pavadhgul P, Kittipichai W, Satheannoppakao W (2017) Traditional galactagogue foods and their connection to human milk volume in Thai breastfeeding mothers. J Hum Lact 33:552–559

    Article  PubMed  Google Scholar 

  60. Ali Z, Bukari M, Mwinisonaam A, Abdul-Rahaman AL, Abizari AR (2020) Special foods and local herbs used to enhance breastmilk production in Ghana: rate of use and beliefs of efficacy. Int Breastfeed J 15:1–9

    Article  Google Scholar 

  61. Bazzano AN, Cenac L, Brandt AJ, Barnett J, Thibeau S, Theall KP (2017) Maternal experiences with and sources of information on galactagogues to support lactation: a cross-sectional study. Int J Women's Health 9:105–113

    Article  Google Scholar 

  62. Bazzano AN, Littrell L, Brandt A, Thibeau S, Thriemer K, Theall KP (2016) Health provider experiences with galactagogues to support breastfeeding: a cross-sectional survey. J Multidiscip Healthc 9:623

    Article  PubMed  PubMed Central  Google Scholar 

  63. Steyn N, Zunza M, Decloedt EH (2017) A cross-sectional descriptive study of breastfeeding behaviour and galactogogue use among private-sector patients in Cape Town, South Africa. S Afr J Obstet Gynaecol 23:20–23

    Google Scholar 

  64. Silva FV, Dias F, Costa G, Campos MG (2018) Chamomile reveals to be a potent galactogogue: the unexpected effect. J Matern Fetal Neonatal Med 31:116–118. https://doi.org/10.1080/14767058.2016.1274300

    Article  PubMed  Google Scholar 

  65. Smith T (1850) Galactagogue and emmenagogue effects of the leaves of the Ricinus communis. Lond J Med 2(22):951–956

    Article  PubMed Central  Google Scholar 

  66. Ağagündüz D (2020) Determination of the total antioxidant and oxidant status of some galactagogue and herbal teas. Food Sci Hum Wellness 9(4):377–382. https://doi.org/10.1016/j.fshw.2020.06.002

    Article  Google Scholar 

  67. Kavurt S, Bas AY, Aydemir O, Yucel H, Isıkoglu S, Demirel N (2013) The effect of galactagogue herbal tea on oxidant and anti-oxidant status of human milk. J Matern Fetal Neonatal Med 26:1048–1051

    Article  CAS  PubMed  Google Scholar 

  68. Wagner CL, Boan AD, Marzolf A, Finch CW, Morella K, Guille C, Gardner Z, Marriott BP (2019) The safety of mother's milk® tea: results of a randomised double-blind, controlled study in fully breastfeeding mothers and their infants. J Hum Lact 35:248–260

    Article  PubMed  Google Scholar 

  69. Ouzir M, Bairi KE, Amzazi S (2016) Toxicological properties of fenugreek (Trigonella foenum graecum). Food Chem Toxicol 96:145–154

    Article  CAS  PubMed  Google Scholar 

  70. Cazorla-Ortiz G, Obregón-Guitérrez N, Rozas-Garcia MR, Goberna-Tricas J (2020) Methods and success factors of induced lactation: a scoping review. J Hum Lact 36(4):739–749. https://doi.org/10.1177/0890334420950321

    Article  PubMed  Google Scholar 

  71. Amano T, González-Varo JP, Sutherland WJ (2016) Languages are still a major barrier to global science. PLoS Biol 14:e2000933. https://doi.org/10.1371/journal.pbio.2000933

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Redvers N, Blondin BS (2020) Traditional indigenous medicine in North America: a scoping review. PLoS One 15(8):e0237531. https://doi.org/10.1371/journal.pone.0237531

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Kilian A, Chock YP, Huang IJ, Graef ER, Upton LA, Khilnani A et al (2020) Acute respiratory viral adverse events during use of antirheumatic disease therapies: a scoping review. Semin Arthritis Rheum 50(5):1191–1201. https://doi.org/10.1016/j.semarthrit.2020.07.007

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Michielsens CAJ, van Muijen ME, Verhoef LM, van den Reek JMPA, de Jong EMGJ (2021) Dose tapering of biologics in patients with psoriasis: a scoping review. Drugs 81(3):349–366. https://doi.org/10.1007/s40265-020-01448-z

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Verstegen RH, McMillan R, Feldman BM, Ito S, Laxer RM (2020) Towards therapeutic drug monitoring of TNF inhibitors for children with juvenile idiopathic arthritis: a scoping review. Rheumatology 59(2):386–397. https://doi.org/10.1093/rheumatology/kez285

    Article  CAS  PubMed  Google Scholar 

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Funding

This work was supported by the Bantuan Khas Penyelidikan (BKS001–2021) and Impact-Oriented Interdisciplinary Research Grant (IIRG032B-2019) provided by Universiti Malaya to Dr. Abdul-Rahman. The postdoctoral position of Dr. Kwan was supported by the UM Postdoctoral Research Fellowship (PDRF).

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Dr. Kwan initiated the idea of constructing a scoping review. All authors contributed to the conception and design of the study. All authors did the collection and screening of articles. Dr. Kwan wrote the first draft of the manuscript and all authors commented on the previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Soon Hong Kwan or Puteri Shafinaz Abdul-Rahman.

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Kwan, S.H., Abdul-Rahman, P.S. Clinical Study on Plant Galactagogue Worldwide in Promoting Women’s Lactation: a Scoping Review. Plant Foods Hum Nutr 76, 257–269 (2021). https://doi.org/10.1007/s11130-021-00901-y

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