Risperidone as a galactogogue of choice in peripartum: A concise review / Philippine Journal of Obstetrics and Gynecology

@#Human lactation is a dynamic physiological process that produces a complex biological fluid that provides nutritive and nonnutritive factors for an optimal child growth and well-being. Several factors play a formidable role in maternal breast milk production with respect to quality, and quantity, which will adequately sustain the child for at least the first 6 months after delivery. Evidence has shown majority of new mothers who wished to immediately commence exclusive breastfeeding after birth as recommended by the WHO, are unable to initiate lactation immediately. In view of this lactation insufficiency, health-care personnel have not only been campaigning on appropriate breastfeeding education but also offer early lactation support such as encouraging liberal fluid intake, dietary modifications, and in a worst-case scenario, administering agents/drugs such as galactogogue. Orthodox galactogogues in current use are either hormonal or antipsychotics; most of them have relative efficacy and safety limitations. Risperidone is an atypical antipsychotic which has been used for decades with established safety in lactating mothers and the highest propensity to induce galactorrhea as a secondary effect when compared to other antipsychotics that are currently being used as galactogogues. We call the attention of the medical community in conducting further researches on its possible adoption as a galactogogue, using this review as an insight.

Indução da lactação em mulheres nuligestas: relato de experiência / Inducción de la lactancia en mujeres nuligestas: informe de experiencia / Lactation induction in women who never got pregnant: experience report

Resumo Objetivo relatar a experiência de indução da lactação em nuligestas realizada por enfermeira consultora em aleitamento. Método relato de experiência. O processo de indução láctea foi realizado com três mulheres por motivo de gestação em útero de substituição e relacionamento homoafetivo. Resultados todas perceberam o aumento de tamanho e a sensibilidade nas mamas, bem como apresentaram secreção láctea. No entanto, a continuidade da amamentação foi diferenciada entre elas. A primeira não recebeu apoio de profissionais de saúde no contexto de pós-parto hospitalar, nem em casa, e não deu continuidade à amamentação. A segunda recebeu apoio da equipe do hospital e da parceira, amamentando por três meses. A terceira, com o apoio da parceira, amamentou por dois meses, mas interrompeu por sentir-se inibida por familiares. Conclusão e implicações para a prática a técnica de indução é capaz de desencadear a produção láctea. Já o processo de amamentação só se estabeleceu mediante a associação com a rede de apoio, o acolhimento, o incentivo da equipe de saúde e o olhar integral à mulher e sua família. Dessa forma, o cuidado de Enfermagem na indução láctea não deve focar apenas no manejo da indução, mas transcender o aspecto técnico, o que se mostra como fundamental para a proteção, o estabelecimento e a continuidade da amamentação.

Resumen Objetivo reportar la experiencia de inducir la lactancia en nuligestas realizada por una consultora de enfermería en lactancia materna. Método relato de experiencia. El proceso de inducción de la leche se realizó con tres mujeres por embarazo en útero de reemplazo y relación homoafectiva. Resultados todas notaron el aumento de tamaño y la sensibilidad en las mamas, además de presentar secreción de leche. Sin embargo, la continuidad de la lactancia materna se diferencia entre ellos. La primera no recibió apoyo de los profesionales de la salud en el contexto posparto hospitalario, ni en el domicilio, y no continuó con la lactancia. La segunda recibió apoyo del personal del hospital y su pareja, amamantando durante tres meses. La tercera, con el apoyo de su pareja, amamantó durante dos meses, pero la interrumpió porque se sentía inhibida por familiares. Conclusión e implicaciones para la práctica la técnica de inducción es capaz de desencadenar la producción de leche. El proceso de lactancia materna, en cambio, solo se estableció a través de la asociación con la red de apoyo, la acogida, el estímulo del equipo de salud y la mirada integral a la mujer y su familia. Así, el cuidado de Enfermería en la inducción de la leche no debe enfocarse solo en el manejo de la inducción, sino trascender el aspecto técnico, que se muestra fundamental para la protección, el establecimiento y la continuidad de la lactancia materna.

Abstract Objective to report the experience of lactation induction in women who never got pregnant by a lactation consultant nurse. Method experience report. The process of lactation induction was performed with three women due to surrogate pregnancy and homosexual relationships. Results all noticed an increase in the size and sensitivity of the breasts, as well as milk secretion. However, the continuity of breastfeeding was different between them. The first did not receive support from health professionals in the postpartum hospital setting, nor at home, and did not continue breastfeeding. The second received support from the hospital staff and her partner, breastfeeding for three months. The third, with the support of her partner, breastfed for two months, but stopped because she felt inhibited by family members. Conclusion and implications for practice the induction technique is capable of triggering milk production. However, the breastfeeding process was only established through the association with the support network, the reception, the encouragement of the health team, and the comprehensive view of the woman and her family. Thus, nursing care in lactation induction should not focus only on the management of induction, but transcend the technical aspect, which is essential for the protection, establishment, and continuity of breastfeeding.

Uso de galactogogos no manejo da amamentação: revisão integrativa da literatura / Uso de galactogogos en el manejo de la lactancia materna: revisión integradora de la literatura / Use of galactogogues in breastfeeding management: integrative literature review

Objective: Identifying the available evidence in the literature about galactogogues substances (liquids, herbs or foods with properties to increase milk production). Method: an integrative literature review that surveyed the bases BDENF, LILACS and MEDLINE with the descriptors "lactation disorders", "breastfeeding", "galactogogues," in portuguese, english and spanish, until the year 2011. The final sample was formed of 27 articles. Results: the most prevalent galactogogues were: black beer, hydration, hominy, chicken soup, metoclopramide, chlorpromazine, domperidone, fenugreek and fennel. Conclusion: the culture permeates practice of breastfeeding and therefore must be considered by health professionals in guidance and encouragement to breastfeeding...

Objetivo: Identificar as evidências disponíveis na literatura sobre substâncias galactogogas (líquidos, ervas ou alimentos com propriedades de aumentar a produção láctea). Método: revisão integrativa da literatura que pesquisou as bases BDENF, LILACS e MEDLINE com os descritores: “transtornos da lactação”,“aleitamento materno”, “galactogogos”, em português, inglês e espanhol, até o ano 2011. A amostra final foi de 27 artigos. Resultados: os galactogogos de maior prevalência foram: a cerveja preta, a hidratação, a canjica, a canja de galinha, a metoclopramida, a clorpromazina, a domperidona, o feno-grego e o funcho. Conclusão: o universo cultural permeia a prática do aleitamento materno e, portanto, deve ser contemplado pelos profissionais de saúde na orientação e no incentivo à amamentação...

Objetivo: Identificar las evidencias disponibles en la literatura sobre las sustancias galactogogas (líquidos, hierbas o alimentos con propiedades para aumentar la producción de leche). Método: es una revisión integradora de la literatura que examino las bases BDENF, LILACS y MEDLINE utilizando los descriptores: "trastornos de la lactancia", "lactancia materna", "galactogogos" en portugués, inglés y español, hasta el año 2011. La muestra final fue de 27 artículos. Resultados: los galactogogos más prevalentes fueron: la cerveza negra, la hidratación, sémola de maíz, sopa de pollo, metoclopramida, clorpromazina, domperidona, fenogreco y el hinojo. Conclusión: el universo cultural impregna la práctica de la lactancia materna y por lo tanto deben ser considerados por los profesionales de la salud en la orientación y estímulo a la lactancia materna...

Clinical update and treatment of lactation insufficiency

Lactation is beneficial to mother's health as well as provides specific nourishments, growth, and development to the baby. Hence, it is a nature's precious gift for the infant; however, lactation insufficiency is one of the explanations mentioned most often by women throughout the early discontinuation of breast-feeding and/or for the introduction of supplementary bottles. Globally, lactation insufficiency is a public health feeding and/or for the introduction of supplementary bottles. Globally, lactation insufficiency is a public health concern, as the use of breast milk substitutes increases the risk of morbidity and mortality among infants in developing countries, and these supplements are the most common cause of malnutrition. The incidence has been estimated to range from 23% to 63% during the first 4 months after delivery. The present article provides a literary search in English language of incidence, etiopathogensis, pathophysiology, clinical features, diagnosis, and current update on treatment of lactation insufficiency from different sources such as reference books, Medline, Pubmed, other Web sites, etc. Non-breast-fed infant are 14 times more likely to die due to diarrhea, 3 times more likely to die of respiratory infection, and twice as likely to die of other infections than an exclusively breast-fed child. Therefore, lactation insufficiency should be tackled in appropriate manner

Galactagogue effects of Musa x paradisiaca flower extract on lactating rats

OBJECTIVE@#To investigate the potential of Musa x paradisiaca (M. x paradisiaca) flower extracts in promoting milk production of lactating rats and its effects on growth of the suckling pups.@*METHODS@#Galactagogue activity was evaluated in terms of quantity of milk produced from the rats treated with petroleum ether, ethanol or water extracts of the flower. Lactating rats (n = 5) of Spraque Dawley with six pups each were administered with the extracts in the amount of 500 mg/kg body weight, while the control rats were given an equivalent amount of distilled water. The rats were daily administered via oral feeding starting from Day 5 until Day 14 and the performance of milk production was measured along the experimental period by weight-suckle-weight method. Results were statistically analyzed using SPSS by means of ANOVA at 0.05 and was expressed as their mean?standard deviation. The rates of pups' growth were measured as the weight gain along the experimental period.@*RESULTS@#The rats treated with aqueous extract produced higher milk than control and ethanol groups. Aqueous extract was identified to increase milk production by 25%, while petroleum ether extract by 18%. The mean of yields produced by the rats during suckling period for aqueous, petroleum ether, ethanol and control were 4.62±2.45, 4.37±1.93, 3.65±1.89 and 3.69±1.79, respectively. Growth rates of pups for the rats treated with control, aqueous, ethanol extract and petroleum ether were (1.85±0.49), (1.78±0.56), (1.65±0.46) and (1.56±0.42) g/pup, respectively.@*CONCLUSIONS@#The present study reveals the potential of M. x paradisiaca flower to enhance milk production of nursing mothers which could be exploited for commercialization of the isolated extract.

Factors Related to Success in Relactation

PURPOSE: An increase in the breastfeeding rate has been followed by an increase in the number of mothers seeking help in relactation. We investigated the factors related to successful relactation by assessing the impact of medications, supplementer, consultations, and family support. METHODS: A retrospective review of the medical records and telephone survey of mothers who had visited the relactation clinic were conducted from January 2004 to April 2007. RESULTS: Data from 84 mothers were analyzed to identify the factors associated with success in relactation. Seventy-five percent of the mothers succeeded in obtaining exclusive breastfeeding. Success in relactation was associated with informed referral from medical personnel, the use of galactogogues, and family support. CONCLUSION: This study provides new and noteworthy insights concerning relactation. This highlights the need to inform the mothers about the data of relactation, to use galactogogues, and to have their families involved for psychological support and endurance during visits to the relactation clinic.

Factors Related to Success in Relactation

PURPOSE: An increase in the breastfeeding rate has been followed by an increase in the number of mothers seeking help in relactation. We investigated the factors related to successful relactation by assessing the impact of medications, supplementer, consultations, and family support. METHODS: A retrospective review of the medical records and telephone survey of mothers who had visited the relactation clinic were conducted from January 2004 to April 2007. RESULTS: Data from 84 mothers were analyzed to identify the factors associated with success in relactation. Seventy-five percent of the mothers succeeded in obtaining exclusive breastfeeding. Success in relactation was associated with informed referral from medical personnel, the use of galactogogues, and family support. CONCLUSION: This study provides new and noteworthy insights concerning relactation. This highlights the need to inform the mothers about the data of relactation, to use galactogogues, and to have their families involved for psychological support and endurance during visits to the relactation clinic.