Complementary and alternative therapies: supporting the woman with inadquate milk production

While the benefits of breastfeeding are well established, and high initiation rates indicate that women recognize these benefits and wish to provide their infants with the healthiest beginnings, duration rates indicate that women are having difficulty overcoming challenges in the early weeks of breastfeeding. Studies indicate that early breastfeeding cessation is correlated with perceived or actual inadequate milk supply (Lewallen et al., 2006). While the traditional management of insufficient supply during breastfeeding has involved breastfeeding support with particular attention to effectiveness of maternal and infant position, milk transfer, and frequency of feeds, some women may not see improvement in supply from traditional measures. Breastfeeding websites, parenting books, and review articles by breastfeeding professionals suggest the use of complementary and alternative therapies such as acupuncture, herbal medicines, relaxation therapy, aromatherapy, and homeopathy to increase milk supply, however little clinical evidence exists to support the use of such therapies. This literature review summarizes the available data in research and grey literature regarding the use of acupuncture and herbal medicine in managing insufficient milk supply. The majority of evidence supporting the use of acupuncture and herbal medicine in the breastfeeding woman is qualitative and quasi-experimental, with few randomized controlled trials supporting the safety and efficacy of these treatments for increasing milk production in the lactating woman. The role of the nurse practitioner in supporting patients using complementary and alternative therapies is discussed. --Leaf 2.