Since the United States lacks regulatory guidelines or a standardized risk assessment for herbal supplement use, it falls on pediatricians to try and recognize what natural pharmaceuticals could be impacting the health of mothers and children during breastfeeding.
Although there is scant scientific evidence to support the efficacy or safety of herbal supplements, it is a common practice both nationally and internationally. Holistic and complementary medicine are big business, even the National Institutes of Health spends $120 million per year of taxpayer money without being able to define what the terms even mean. Because of the small number of studies on herb use during lactation, numerous resources have mixed reports and safety recommendations, making it confusing for both mother and clinician.
After completing a systematic review of human lactation and herbal medicine literature, the researchers found poor methodology in the few available studies and concluded that further research is needed to assess the prevalence, efficacy and safety of commonly used herbs during breastfeeding.
"It is important for physicians and clinicians to be more aware that mothers are using herbal supplements and how vital it is to ask the mothers, who are seeking a doctor's opinion when having trouble breastfeeding, about their use before making an assessment," said senior author Paula Gardiner, MD, MPH, assistant professor at BUSM and a physician of family medicine at Boston Medical Center. "The use of herbal supplements while breastfeeding is two-sided—there are benefits, but there are also safety concerns. "About 18 percent of the US population use herbs and dietary supplements. We just want to make sure physicians and clinicians are aware of this prevalent use when communicating with breastfeeding mothers about their health."
Herbal remedies claim to increase the milk supply, relieve engorgement, treat mastitis, or for other therapeutic uses unrelated to lactation.
"Since there is very limited research, it is difficult to develop accurate information on the safety and effectiveness of specific herbs during breastfeeding," said Gardiner. "It is crucial that more research is conducted in this area, including national prevalence studies and safety and efficacy studies."
Citation: Katarzyna Budzynska, Zoë E. Gardner, Tieraona Low Dog, and Paula Gardiner, 'Complementary, Holistic, and Integrative Medicine: Advice for Clinicians on Herbs and Breastfeeding', Pediatrics in Review 2013; 34:343-353; doi:10.1542/pir.34-8-343