Is Fenugreek compatible with breastfeeding? Do we have alternatives for Fenugreek?

Fenugreek

June 17, 2017 (Very Low Risk)

The seeds of this leguminous plant are used.

Content: carbohydrates, proteins, saponins, vitamins, minerals . 

Assigned properties: appetite stimulant, lowering of lipemia and glycemic (Gong 2016).
Indications according to Commission E of the German Ministry of Health: Anorexia, Atopic Dermatitis.



Widely used as a galactogogue in many cultures around the world (Ayers 2000, Winterfeld 2012, Sim 2013, The Royal Women's .. 2013, Bazzano 2016).



Case-control studies looking for evidence on the increment of milk production associated to the use of fenugreek are few (Turkyılmaz 2011, Ghasemi 2015), along with a variety of methodological deficiencies. Other studies have failed to find such an effect with the use of fenugreek (Damanik 2006).

Studies with an appropriate design are needed to provide high quality evidence to make clinical recommendations on its use (Forinash 2012, Zapantis 2012, Committee LM AEP 2012, Mortel 2013, Bazzano 2016)



A higher antioxidant effect in the breastmilk of women who have consumed mixed infusions containing this or other herbs has not been shown (Kavurt 2013).



Given the wide spread use and lack of toxicity of this herb, a moderate consumption would be compatible with breastfeeding, yet high doses may produce hypoglycemia (EMA 2011, Gong 2016) and, because of the odor appearing in the urine of the infant, a lab test may be required to make a differential diagnosis with maple syrup disease of the newborn (Sewell 1999, Korman 2001).

Avoid the use of a galactogogue without a sanitary control.



Best galactagogue results are achieved through on-demand breastfeeding along with an adequate technique in a mother who is able to maintain self-confidence (ABM 2011, Mannion 2012).

Precautions when taking plant preparations:
1. Ensure that they are from a reliable source: poisoning has occurred due to confusing one plant with another with toxic properties, as well as poisoning from heavy metals extracted from the ground and food poisoning due to contamination with bacteria or fungi.
2. Do not take in large amounts; follow recommendations from professional experts in phytotherapy. "Natural" products are not always good in any quantity: plants contain active substances from which much of our traditional pharmacopoeia has been obtained and can result in poisoning or act as endocrine disruptors if taken in excessive amounts or time periods.

Alternatives

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Greek hay
  • Wild Oat

Writings

  • Trigonella foenum-graecum (Latin, botanical name)

Drug trade names

References

  1. Bazzano AN, Littrell L, Brandt A, Thibeau S, Thriemer K, Theall KP. Health provider experiences with galactagogues to support breastfeeding: a cross-sectional survey. J Multidiscip Healthc. 2016Abstract
  2. Bazzano AN, Hofer R, Thibeau S, Gillispie V, Jacobs M, Theall KP. A Review of Herbal and Pharmaceutical Galactagogues for Breast-Feeding. Ochsner J. 2016Abstract
  3. Gong J, Fang K, Dong H, Wang D, Hu M, Lu F. Effect of fenugreek on hyperglycaemia and hyperlipidemia in diabetes and prediabetes: A meta-analysis. J Ethnopharmacol. 2016Abstract
  4. Ghasemi V, Kheirkhah M, Vahedi M. The Effect of Herbal Tea Containing Fenugreek Seed on the Signs of Breast Milk Sufficiency in Iranian Girl Infants. Iran Red Crescent Med J. 2015Abstract
  5. Powers CN, Setzer WN. A molecular docking study of phytochemical estrogen mimics from dietary herbal supplements. In Silico Pharmacol. 2015Abstract Full text (link to original source) Full text (in our servers)
  6. The Royal Women’s Hospital Victoria Australia. Herbal and Traditional Medicines in Breasfeeding. Fact Sheet. 2013 Full text (link to original source) Full text (in our servers)
  7. Kavurt S, Bas AY, Aydemir O, Yucel H, Isikoglu S, Demirel N. The effect of galactagogue herbal tea on oxidant and anti-oxidant status of human milk. J Matern Fetal Neonatal Med. 2013Abstract
  8. Mortel M, Mehta SD. Systematic review of the efficacy of herbal galactogogues. J Hum Lact. 2013Abstract
  9. Sim TF, Sherriff J, Hattingh HL, Parsons R, Tee LB. The use of herbal medicines during breastfeeding: a population-based survey in Western Australia. BMC Complement Altern Med. 2013Abstract Full text (link to original source) Full text (in our servers)
  10. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. 2013Abstract
  11. Sachs HC; Committee On Drugs. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics. 2013Abstract Full text (link to original source) Full text (in our servers)
  12. Forinash AB, Yancey AM, Barnes KN, Myles TD. The use of galactogogues in the breastfeeding mother. Ann Pharmacother. 2012Abstract
  13. Comité de Lactancia Materna AEP. Preguntas frecuentes sobre lactancia materna. Folleto. 2012 Full text (link to original source) Full text (in our servers)
  14. Zapantis A, Steinberg JG, Schilit L. Use of herbals as galactagogues. J Pharm Pract. 2012Abstract
  15. Winterfeld U, Meyer Y, Panchaud A, Einarson A. Management of deficient lactation in Switzerland and Canada: a survey of midwives' current practices. Breastfeed Med. 2012Abstract
  16. Mannion C, Mansell D. Breastfeeding self-efficacy and the use of prescription medication: a pilot study. Obstet Gynecol Int. 2012Abstract Full text (link to original source) Full text (in our servers)
  17. EMA. Community herbal monograph on Trigonella foenum-graecum L., semen. 2011 Full text (in our servers)
  18. Turkyılmaz C, Onal E, Hirfanoglu IM, Turan O, Koç E, Ergenekon E, Atalay Y. 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. 2011Abstract
  19. Muresan M. Successful relactation--a case history. Breastfeed Med. 2011Abstract
  20. ABM. Comité de Protocolos de la Academia Médica de Lactancia Materna. ABM Protocolo Clínico #9: Uso de Galactogogos para Iniciar o aumentar la tasa de secreción de Leche Materna. Breastfeed Med. 2011 Full text (link to original source) Full text (in our servers)
  21. ABM. Academy Of Breastfeeding Medicine Protocol Committee. ABM Clinical Protocol #9: Use of galactogogues in initiating or augmenting the rate of maternal milk secretion (First Revision January 2011). Breastfeed Med. 2011Abstract Full text (link to original source) Full text (in our servers)
  22. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011Abstract Full text (link to original source) Full text (in our servers)
  23. Zuppa AA, Sindico P, Orchi C, Carducci C, Cardiello V, Romagnoli C. Safety and efficacy of galactogogues: substances that induce, maintain and increase breast milk production. J Pharm Pharm Sci. 2010Abstract Full text (link to original source) Full text (in our servers)
  24. Abdulrazzaq YM, Al Kendi A, Nagelkerke N. Soothing methods used to calm a baby in an Arab country. Acta Paediatr. 2009Abstract
  25. WHO. World Health Organization. Geneva. WHO monographs on selected medicinal plants. Volume 3. WHO monographs. 2007 Full text (link to original source) Full text (in our servers)
  26. Bryant CA. Nursing the adopted infant. J Am Board Fam Med. 2006Abstract Full text (link to original source) Full text (in our servers)
  27. Damanik R, Wahlqvist ML, Wattanapenpaiboon N. Lactagogue effects of Torbangun, a Bataknese traditional cuisine. Asia Pac J Clin Nutr. 2006Abstract
  28. Gabay MP. Galactogogues: medications that induce lactation. J Hum Lact. 2002Abstract
  29. Korman SH, Cohen E, Preminger A. Pseudo-maple syrup urine disease due to maternal prenatal ingestion of fenugreek. J Paediatr Child Health. 2001Abstract
  30. Ayers JF. The use of alternative therapies in the support of breastfeeding. J Hum Lact. 2000Abstract
  31. Sewell AC, Mosandl A, Böhles H. False diagnosis of maple syrup urine disease owing to ingestion of herbal tea. N Engl J Med. 1999Abstract