Fact of the Day: Fenugreek and lactation

Fenugreek is one of the most commonly used galactogogues (supplements taken that are known to increase milk production). Fenugreek seeds (per 100 g) are rich sources of protein (46% of DV), dietary fibre (98% DV), B vitamins, iron (186% DV) and several other dietary minerals. The flavorful herb may be found in many Indian, Persian, Turkish, and Egyptian dishes. It is often the key ingredient in mother’s milk teas and lactation bars. Most mothers typically notice an increase in production 24-72 hours after starting the herb, but it can take two weeks for others to see a change. Some mothers do not see a change in milk production when taking fenugreek. Dosages of less than 3500 mg per DAY have been reported to produce no effect in many women. Interestingly enough, it’s been said if you want to know if you’re taking the correct dosage, you’re supposed to slowly increase the amount of fenugreek until your sweat and urine begin to smell like maple syrup. Got pancakes?

However, like any herb or supplement, be aware of what you are injesting. Some people are allergic to fenugreek, specifically people who have peanut allergy and chickpea allergy may have a reaction to fenugreek. Fenugreek seeds can cause diarrhea, dyspepsia, abdominal distention, flatulence, perspiration, and a maple-like smell to urine or breast milk. There is a risk of hypoglycemia particularly in people with diabetes; it may also interfere with the activity of anti-diabetic drugs. It may interfere with the activity and dosing of anticoagulants and antiplatelet drugs. You should not take it if you are pregnant as it may affect uterine contractions and may be unsafe for women with hormone-sensitive cancers. In summary, those with thyroid, blood sugar issues (such as diabetes), peanut allergies and those taking certain blood clotting medications should avoid fenugreek.

 

References:

Kellymom.com

[Bingel 1991] Bingel AS, Farnsworth NR. Higher plants as potential sources of galactagogues, in Wagner H, Farnsworth NR, eds. Economic and Medicinal Plant Research, Volume 6, Academic Press Ltd, New York, 1994: 1-54.
[Brinker 1998] Brinker F. Herb Contradictions and Drug Interactions. Sandy, OR: Eclectic Medical Publications, 1998, 70–1.
[Dugue 1993] Dugue P, Bel J, Figueredo M. Fenugreek causing a new type of occupational asthma. Presse Med 1993 May 29;22(19):922.
[Hale 2002] Hale T. Medications and Mothers’ Milk, 10th Edition. Pharmasoft Medical Publishing, 2002, p.277-279.
[Heller] Heller L. Fenugreek: A Noteworthy Hypoglycemic
[Huggins] Huggins KE. Fenugreek: One Remedy for Low Milk Production.
[Korman 2001] Korman SH, Cohen E, Preminger A. Pseudo-maple syrup urine disease due to maternal prenatal ingestion of fenugreek. J Paediatr Child Health 2001 Aug;37(4):403-4.
[McGuffin 1997] McGuffin M., Hobbs C, Upton R, Goldberg A. American Herbal Product Association’s Botanical Safety Handbook. Boca Raton: CRC Press, 1997.
[Ody 1999] Ody P. Herbs to Avoid During Pregnancy from Herbs for a Healthy Pregnancy. Los Angeles, Calif: Keats; 1999.
[Ohnuma 1998] Ohnuma N, Yamaguchi E, Kawakami Y. Anaphylaxis to curry powder. Allergy 1998 Apr;53(4):452-4.
[Patil 1997] Patil SP, Niphadkar PV, Bapat MM. Allergy to fenugreek (Trigonella foenum graecum). Ann Allergy Asthma Immunol 1997 Mar;78(3):297-300.
[Reeder 2011] Reeder C, Legrand A, O’Conner-Von S. The Effect of Fenugreek on Milk Production and Prolactin Levels in Mothers of Premature Infants. J Human Lactation 2011;27(1):74. Abstract only.
[Rice] Rice LA. Fenugreek, in Herbal Supplements in Pregnancy
[Swafford 2000] Swafford S, Berens B. Effect of fenugreek on breast milk production. ABM News and Views 2000;6(3): Annual meeting abstracts Sept 11-13, 2000

 

Fact of the Day: oxytocin and the milk ejection reflex

There two important hormones for breast milk production: oxytocin, which is your cuddle hormone, and prolactin, which is your milk maker. During suckling, milk ejection, or “let down”, occurs when oxytocin released into the circulation reaches the mammary glands. Maternal oxytocin is not only released into the circulation by suckling and skin-to-skin contact, but may be released when the mother sees and hears her newborn or simply thinks of him or her. Oxytocin release can even be conditioned to other stimuli, meaning your milk ejection reflex may occur even in the absence of suckling (Tancin, Kraetzl, Schams, & Bruckmaier, 2001). If you’re a Pumping mom this is important to grasp. Try building a routine with your baby during breastfeeding that you can carry over into pumping. Maybe it’s a song you listen to, a smell like lavender or vanilla, or holding a particular blanket. By bringing this into the pump room you can help stimulate oxytocin to help with let down.

Pumping Log: When to throw in the towel

I’ve never been a super pumper. I’ve diligently pumped three times a day at work for the last 8 months. I’ve almost always made just enough for the next day of feedings. Sometimes I’ve even had a conservative stash in the freezer for low pump days or when my husband and I want to go out. There are definitely times when I have to work on my supply to keep it up enough to feed my daughter. Oatmeal for breakfast, teas at lunch, a Guinness with dinner, more tea before bed. Pump. Breast massage. Pump. Repeat. It’s exhausting. Especially since my uninvited monthly visitor has me with a low supply. As I come up on my daughters first birthday, I’m torn.  Continue the schedule I’m on with the highs and lows of constant pumping? Drop the pumping and only breastfed when I’m home and offer something else while I’m gone? Or gradually wean all together? The professional side of me (the crunchy, granola, die hard side) says, “Stick it out!!! It’s not that bad!! Breast is best!!! Your baby needs your milk!!! Show your boobs who’s boss.” While the personal side of me screams, “Screw it! You’re working so hard! Give yourself a break. You went a whole year. You did the best you could with the support you had. Some other milk won’t kill your kid. She’s eating like a champ and she won’t even notice.” I get it now. I understand why some moms give up breastfeeding, especially working moms. I also get why mom’s push through and keep going. We all just want the best for our babies. I’m still on the fence. We’re T minus 1 month to the big one year birthday. I’ll keep you posted on what I decide. But for now, Happy Pumping!!

Pumping Log: Got Milk?

It’s struck again. My monthly reminder of my womanhood and with it a drop in my milk supply. It’s a good reminder, though, for every mom out there that a sudden dip in milk supply doesn’t mean anything is wrong. It just means you have hormones. Congrats. 🎈🍾  When I’m breastfeeding from the boob I don’t notice any difference. My daughter doesn’t seem to want to nurse more frequently or longer. I really only notice it when I’m pumps. “My poor supply” I think to myself. And yet I would never know except that I’m working. On these weeks I usually just eat more oats, make sure to stay hydrated, drink an extra cup of Mothers milk tea, and add an extra pump session at night. And wait for the crimson tide to stop messing with my liquid gold.

First and second pump of the day.
Third pump of the day after a cup of chamomile tea.

Fact of the Day

Babies are the best pump. They empty the breast better than either hand expression, manual or electric pumps. Even as the most efficient pump, babies never completely empty the breast. Breasts work on what could be called the “80:20 concept.” The 80 percent is the average amount of milk removed by your baby each day. The 20 percent is the residual amount of milk that remains in your breasts. If more than 80 percent of the milk is removed, supply increases to maintain the 80-20 ratio. If less than 80 percent is removed, supply decreases to maintain the 80-20 ratio. Even though this is an over-simplification of a very complex process, as new research emerges this core principle proves true.

Pumping Log

Everyday is a new day with its own stresses and joys. The more we can take time to enjoy each day, the less we are prone to worry and stress, the better it is for our overall health as well as our milk supply. The past few days I have been working in the neonatal intensive care unit at my hospital. It is my favorite place to work. I love coming alongside mommies and their new babies and helping them feed them in their most critical time. My job on the acute floors can sometimes be stressful. I am helping elderly patients and families make end-of-life decisions. I assess patients feeding skills and decide if the patients can still eat and the options they have for nutrition and hydration. This definitely impacts my milk supply. I always see more of my own milk when working in NICU. Of course when some of those hungry babies cry I can occasionally feel my mommy hormones stimulating my own letdown. Where is your happy place? Have you noticed certain aspects of your environment or work impacting your milk supply? Where do you find your peace when pumping? This really does make a big difference. Happy Pumping!!

I use whatever containers I have clean!! My pumping always decreases as the day goes on.

Pumping Log: right vs left

Unfortunately breasts do not come with markers on them. When you are an exclusively breast-feeding mom you never really know how much your baby is getting. We teach in lactation to watch for the signs that tell you your baby is getting enough milk. You look at swallowing patterns, wet diapers, and the overall health and weight gain of your baby. When you are pumping mom though, we are meticulous in knowing how much milk comes out of our tatas. Have you ever actually stopped and looked at that milk? I’m sure you have. I’m sure you analyze every drop that comes out of your body. Did you know that the left and right breast can make different amounts of milk? One research study found that stereotypically moms always make more milk out of the right breast. Which is interesting in light of the fact that most women have a slightly larger left breast. (Click on text to read the research articles) It really goes to show that size does not matter for production. Size is related to fat in the breast tissue and not the actual glandular tissue that produces milk. I love breastfeeding. And I try really hard to rotate which side I start on when I’m breast-feeding my daughter. When I am at work or use a double pump to pump both of the girls at the same time. It has been always consistent for me. My right always make slightly more than my left. Usually not very much more, but enough to be noticeable. And science still doesn’t really know why!! Oh, our fascinating bodies!!! Happy Pumping!!!

Pumping Log: back to normal.

Us pumping mamas tend to freak out about how much we pump. Can I get an amen?!? When our supply drops we freak the freaky freak out.  But what if we weren’t pumping. Would we actually notice any of these drops, or what our babies just happily do what they do and not even give us education that something has changed? Would we even have periods because we would be exclusively nursing And supply changeseould be a non issue? Yesterday I took my deep breaths and talked myself off the “I have no milk” ledge. Today my period is officially over. And low and behold my milk supply is back up. Remember, hormones do funny things to our bodies. Do what you can but don’t freak out over every little change. Stay the course. Love yourself. Love your body.

Sometimes being a woman sucks

More specifically, having a period because you’re a woman sucks. Not only are there mood swings and cramps to deal with, there’s also my monthly dip in milk production. Time to make some lactation cookies with extra chocolate chips and a cup of Mrs. Patel’s Milk Water Chai Tea. At least my daughter hasn’t seemed to notice. I was with her the past four days on a mini vacation and she’s been more interested in eating off my plate than my chest. Today I went back to work and knew it would be a lower volume day. Although I always note thamy the milk I pump during my period is a little creamier and more fat sticks to the sides of the bottle. I hope showing these pictures encourages you that is OK to have high and low volume days and not get discouraged. Love your body. Love the process. Worry and stress don’t help anything. Keep eating healthy, drinking plenty of water, taking your prenatal vitamins and taking supplements as needed. Happy pumping!

 

Pumping Log : Boosting Supply

Every working mother I know it’s concerned about her milk supply. We are terrified that if we don’t make enough milk while at work our babies will starve to death. I’ve had my moments of discouragement where I, too, feel like a failure as a mother because I had a low pumping day. Of course this stress only causes a further decrease in supply which becomes a vicious cycle of stress and poor pumping. While I can’t turn my boobs on line a faucet to pump specific amounts of milk each pump session, there are several things I do to promote the best possible milk supply.

1. Hydration. The best hydration is to drink to thirst. Since times in the busyness of my day, though, I forget to stay well watered. I keep a water bottle in my pumping bag and try to drink while pumping. I also work feeding patients. So each time I go into the kitchen at work I try to grab a cup of water.

2. Nutrition. Eating the right kinds of foods also help with adequate milk supplies. Fresh fruits, vegetables and plenty of protein help keep my body working at its best. Oatmeal is also a staple in my diet. Oatmeal contains a protein that may increase prolactin, the hormone that facilitates milk production in mammals. Other whole grains such as quinoa and sesame also contain this same protein.

3. Supplements. Fenugreek, mothers milk tea, and fennel are all known galactogogues, a fancy word for milk makers. I try to drink a cup of tea every night. I’ll admit I’m not the best at taking the fenugreek, but I definitely notice a boost in my supply when I do. Another supplement known to help breast milk production is brewers yeast. Brewer’s yeast comes from a single-celled fungus and is a byproduct of beer making, though it can also be grown as a nutritional supplement. A good source of iron, chromium and selenium, brewer’s yeast also contains several B vitamins, though not B-12. Brewer’s yeast has a history of use as a galactagogue, which is a food, herb or medication that increases milk supply in nursing mothers. Some mothers find drinking a single beer can immediately increase milk supply (although drinking beer is best left to evenings or weekends). You can also buy a powdered brewers yeast from the store or Amazon. It can be added to smoothies, cookies, or other recipes. Here’s one of my favorites!!