Folk remedies often offered during breastfeeding, survey finds

As experts in this field, lactations specialists were surveyed to see how often they pass along this folklore to breastfeeding mothers, despite a lack of research-based evidence to support these suggestions, according to a recent survey by Dr. Jonathan Schaffir, an obstetrician at The Ohio State University Wexner Medical Center.

Results of the survey are published in Breastfeeding Medicine.

The online survey of 124 lactation consultants affiliated with U.S. medical centers in 29 states found that 69 percent reported hearing of folk remedies, and 65 percent had recommended at least one of these methods.

Survey respondents were asked to provide examples of advice they had heard of, as well as advice they routinely passed on to breastfeeding mothers. Advice was broken into five categories: recommendations to promote lactation, to initiate breastfeeding, to treat pain associated with breastfeeding, to assist with weaning, and about substances to avoid for the baby's sake.

The survey found that certain folk remedies are widely discussed among experts, particularly herbal remedies to increase milk production and cabbage leaves to ease pain from breastfeeding. They suggest that recommending folk remedies that are outside of the medical mainstream is a common practice among lactation consultants who advise women about breastfeeding.

"Despite the frequency with which such advice is given, there is little empirical evidence to support the use of most the remedies listed," said Schaffir. "But I'm all for anything that helps and is safe for the baby."

More than half of the lactation consultants who responded to the survey said they had heard of and passed on a folklore remedy intended to either increase milk production or ease/prevent pain associated with breastfeeding. Many respondents said they were aware of folklore recommendations to avoid certain foods to prevent infant gassiness, but only two educators relayed this advice to patients.

For example, using beer to promote milk production is a folk tradition of long standing that was in the spotlight when celebrity Mariah Carey was accused of endangering her twins for following it. This folk tradition began in the late 1800s, but no studies have demonstrated a positive impact in milk production.

In fact, maternal alcohol consumption has been demonstrated to decrease milk production, and may have an adverse effect on the baby, Schaffir said. Many cultures also encourage mothers to eat oatmeal to increase milk production, but no studies have been conducted to examine its use.

Folk traditions that aid with breast pain or engorgement were also mentioned, including using cabbage leaves, even though studies have questioned their effectiveness.

Several lactation consultants recommend tea bags to help women deal with nipple soreness, but a randomized trial of breastfeeding women with pain demonstrated that tea bags offered no additional benefit than a water compress, Schaffir said. A review of studies that examine treatment for nipple pain concluded that there was no significant benefit to the use of tea bags, lanolin or expressed milk on the nipple.

The lactation consultants who made recommendations based on folklore compared with those who only made medical recommendations did not have any significant difference in relation to age, parity, education, experience or socioeconomic status.

The folk traditions communicated in this survey represent a particular culture in the United States, and folklore in general varies by culture and background. Surveys of lactation consultants in different countries and different ethnicities may yield different results, Schaffir notes.

"With the attention given to these remedies, this survey may spur future research to objectively measure whether such recommendations are actually safe and effective, rather than relying solely on anecdotal evidence," Schaffir said.