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The following describes
the use of some treatments for breastfeeding
mothers who are having various problems.
Cabbage leaves for engorgement
Severe engorgement about the third or fourth
day after the baby is born can usually be
prevented by getting the baby latched on
well and drinking well from the very beginning.
(See handouts #1, Breastfeeding—Starting
Out Right and 1b, The
Importance of Skin to Skin Contact,
as well as Protocol
to Increase Breastmilk Intake by the Baby.
See also the videos
to help use the Protocol). If you do become
engorged, please understand that engorgement
diminishes within 1 or 2 days even without
any treatment. Continue to breastfeed the
baby, making sure he gets on well and nurses
well. However, if you should get engorged
to the point of severe discomfort or if
the baby is not able to take the breast,
cabbage leaves seem to help decrease the
engorgement more rapidly than ice packs
or other treatments. If you are unable to
get the baby latched on, start cabbage leaves,
start expressing your milk and give the
expressed milk to the baby by spoon, cup,
finger feeding or eyedropper and get help
quickly.
1. Use green cabbage.
2. Crush the cabbage leaves with a rolling
pin if the leaves do not accommodate to
the shape of your breast.
3. Wrap the cabbage leaves around the breast
and leave on for about 20 minutes. Twice
daily is enough. It is usual to use the
cabbage leaf treatment two or three times
or less. Some will say to use the cabbage
leaves after each feeding and leave them
on until they wilt. Some are concerned that
such frequent use will decrease the milk
supply.
4. Stop using as soon as engorgement is
beginning to diminish and you are becoming
more comfortable.
5. You can use acetaminophen (Tylenol™,
others) with or without codeine, ibuprofen,
or other medication for pain relief. As
with almost all medications, there is no
reason to stop breastfeeding when taking
analgesics.
6. Ice packs also can be helpful.
7. If you are one of the women who gets
a large lump in the armpit about 3 or 4
days after the baby’s birth, you can
use cabbage leaves in that area as well.
Herbs for increasing
milk supply
It is quite possible that
herbal remedies help increase milk supply.
There are several drugs that obviously do
increase milk supply, and of course it is
reasonable to assume that some plants and
herbs might contain similar pharmacological
agents. Almost every culture has some sort
of herb or plant or potion to increase milk
supply. Some may work as placebos, which
is fine; some may not work at all; some
may have one or more active ingredients.
Some will have active ingredients that will
not increase the milk supply but have other
effects, not necessarily desirable. Note
that even herbs can have side effects, even
serious ones. Natural source drugs are still
drugs, and there is no such thing as a 100%
safe drug. Luckily, as with most drugs,
the baby will get only a tiny percentage
of the mother’s dose. The baby is thus
extremely unlikely to have any side effects
at all from the herbs. Two herbal treatments
that seem to increase the milk supply are
fenugreek and blessed thistle, in the following
dosages:
Fenugreek: 3 capsules
3 times a day
Blessed thistle: 3 capsules 3 times
a day, or 20 drops of the tincture 3 times
a day
The tincture container
states that blessed thistle should not be
taken by nursing mothers, presumably because
of the tiny amount of alcohol the mother
would get. There are some preparations of
both herbs that are labelled “not for
use by nursing mothers”. Don’t
worry about this; these herbs are safe for
the mother to take because so little gets
into the milk. Teas also seem to work, but
to take enough to make a difference, you
will be drinking tea all day and night,
since the amount of the herbs you get is
much less.
- Fenugreek and blessed
thistle seem to work better if you take
both, not just one or the other.
- Fenugreek and blessed
thistle work quickly. If they do work,
you will usually notice a difference within
3 to 4 days of starting taking them. If
not, they probably won’t work.
- Fenugreek is often sold
as a combination with thyme. Do not buy
this combination, but try to get the capsules
with fenugreek alone.
- Herbal remedies are
not standardized, so though the bottle
of fenugreek, for example, may say that
it contains 405, 505, 605 or 705 mg/capsule,
we do not really know how much of the
active ingredient you are taking. Fenugreek
has a distinct smell. If you cannot smell
it on your skin, you are not taking enough,
even if you are taking three capsules
three times a day.
- Fenugreek and blessed
thistle seem also to work better in the
first few weeks than later. In fact they
tend to work best in the first week. Domperidone
works better after the first few weeks.
(See handouts 19a
and 19b
Domperidone
1 and Domperidone
2 for more information.)
- You can take fenugreek
and blessed thistle together with domperidone
if you feel they are helping. If you take
the herbs and domperidone, take domperidone
at the same time, 3 tablets three times
a day.
- If you are ready to
stop fenugreek and blessed thistle, you
can probably stop suddenly, or wean off
over a week or so.
- Fenugreek does not cause
low blood sugar. Where this rumour came
from is unknown.
Other herbal treatments that have been used
to increase milk supply are: raspberry leaf,
fennel, goat’s rue, brewer’s yeast,
alfalfa, nettle tea and many others. The
effectiveness of none of these treatments,
including blessed thistle and fenugreek,
has been proved. Remember! Herbal treatments
are only part of the solution to “not
enough milk” (see Protocol
to increase breastmilk intake by the baby).
See also the videos
on how to latch a baby on, how to know the
baby is getting milk, how to use compression,
how to use a lactation aid, as well as information
sheets on breastfeeding.
Lecithin
Lecithin is a food supplement
that seems to help some mothers prevent
blocked ducts. It may do this by decreasing
the viscosity (stickiness) of the milk,
by increasing the percentage of polyunsaturated
fatty acids in the milk. It is safe, inexpensive,
and seems to work in some cases. The dose
is 1200 mg four times a day. There is more
to preventing blocked ducts than taking
lecithin. See handout #22 Blocked Ducts
and Mastitis.
For
information on “all purpose nipple
ointment”, gentian violet, grapefruit
seed extract, vitamin B6, nifedipine, and
nitroglycerin paste, and fluconazole, see
the handout Treatments
for Sore Nipples and Sore Breasts, or
the handouts Gentian
Violet and Fluconazole.
Questions? (416) 813-5757
(option 3) or drjacknewman@sympatico.ca
or my book Dr. Jack Newman’s Guide
to Breastfeeding (called The Ultimate Breastfeeding
Book of Answers in the USA)
Handout #24. Miscellaneous
treatments. January 2005
Written by Jack Newman, MD, FRCPC. ©
2005
This handout may be copied
and distributed without further permission,
on the condition that it is not used in
any context in which the WHO code on the
marketing of breastmilk substitutes is violated
1. Breastfeeding:
Starting out right
a) The
importance of Skin-to-Skin contact
2. Colic in the Breastfed Baby
3. a) Sore Nipples
b) Treatments
for Sore Nipple and Sore Breasts
4. Is my baby getting enough?
5. Using a Lactation Aid
6. Using Gentian Violet
7. Breastfeeding and Jaundice
8. Finger Feeding
9. a) You should continue breastfeeding
(Medications and breastfeeding)
b) You
should continue breastfeeding (Illness in the mother or baby)
10. Breastfeeding and other foods
11. Some breastfeeding myths
12. More breastfeeding myths
13. Still more breastfeeding
myths
14. More and more breastfeeding
myths
15. Breast compression
16. Starting solid foods
17. What to feed the baby when
the mother is working outside the home
18. How to know a health professional
is not supportive of breastfeeding
19. a) Domperidone 1
b) Domperidone
2
20. Fluconazole
21. Breastfeed a toddler –
Why on earth?
22. Blocked ducts and
mastitis
23. Breastfeeding your adopted baby
24. Miscellaneous treatments for problems
25. Slow weight gain after
the first few months
26. When the Baby refuses to
latch on
27. Expressing Milk
28. Toxins and Infant Feeding
How breastmilk protects Newborns
Risks of formula feeding
Breastfeeding and guilt
Candida protocol
Protocol to increase the intake
of Breastmilk by the Baby ("Not enough milk")
When latching
Protocols for Induced Lactation
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