Presentation talks about Lactagogue, How dose lactating process occur? and the most important plants considered as lactagogues.

1. Lactagogue
Under supervision of
Dr. Iman S. Khalaf

2. Lactagogue
Lactogogues are medications that aid
in initiating, maintaining, and augmenting of
adequate milk production. The term
"lactogogue" refers to substances that augment
established lactation. Lactogogues may be
synthetic, plant-derived or endogenous
products.
Definition

3. Lactation hormons
Milk production (lactogenesis) is a neuro-endocrine event,
along with action of multiple hormones, as follows:
 Progesterone growth of alveoli.
 Estrogene stimulate the milk duct system to grow
and differentiate.
These 2 hormones inhibit lactation and during expulsion
of the placenta, the concentration reduced resulting in
initiation of full milk supply.

4. Dopamine agonists and antagonists
regulate prolactin synthesis and
secretion through interaction with
the hypothalamus and anterior
pituitary.
 Prolactin increase the amount of
milk. By local feed back
mechanism, the amout of milk
maintains.
 Suckling stimulates nipple
pituitary gland secrets oxytocin
contraction of myoepithelial
cells resulting in ejection of
milk.

5. As many herbal plants contain large number of chemical active principles,
having galactogenic properties; this table discusses some of them and their
mechanism of action:
Lead compound Mechanism of action
Alkaloids Help in letting down of milk.
isoflavones Increases milk yield as well as fat, protein and lactose percentage
of milk.
Polyphenols Improve milk yield, concentration of milk protein and ovulation
rate.
Saponin Ruminotoric, improves the health status as well as productivity.
Stearidonic Acid Improve rumen bio-hydrogenation with proper ruminal protection
to achieve impressive increases in the omega 3 fatty acids in the
milk.
α-linolenic acid Ruminotoric, alter the milk fat composition and the oxidative
stability of the fat as well.
Tannins Ruminotoric, improves protein digestion and health status.

6. Galega officinalis
Goat's rue
The botanical name of the plant derives from
gala (milk) and ago (to bring on), the commen name
"Goats rue" comes as Galega has been used as a
galactogogue in small domestic animals.
 Origin
Leaves and flowering tops of Galega
officinalis L. F. Fabaceae (Leguminosae).
 Distribution
West Europe, South Europe (Mediterranean
Seashore), Asia Minor, South-West Asia (Iran).

7.  A.C.
Main active component which responsible for
lactogenesis is saponins; 3-Ο-[β-D-glucopyranosyl (1-02)
β-D-glucuronopyranosyl].
An active principle, galegin, a guanidine derivative, (3-
methylbut-2-en-l -yl) guanidine, 4- hydroxygalegin.
The alkaloid peganine.
 flavones, tannins, bitter principle, sucrose, and a fatty
oi1.

8.  Its use as lactagogue & other uses
Goat's rue is considered as galactagogue by increase milk
amount (30-50% within 24 hours) as it stimulates the growth
of breast tissue, moderately regulate estrogen levels.
 For diabetes as it lower blood sugar level and insulin
resistance attributed to galegine alkaloid.
 In herbal combination, goat's rue is used to stimulate the
adrenal gland and pancreas; protecting the liver; for digestion
problems, a tonic and for “blood purification”.
 As diuretic to help the body remove water through urine.

9.  Safety and precaution
 Bleeding conditions: Goat’s rue might slow blood
clotting, increasing the risk of bleeding.
 In case of diabetic patient which use goat's rue may
lead to low blood sugar (hypoglycemia).
 Surgery: The patients which use goats rue should stop
it at least 2 weeks before any surgery; it might
interfere with blood sugar control during and after
surgery.

10.  Allergic reactions: Goat's rue is a member of the pea
family of plants which also includes peanuts, soybean,
alfalfa, and fenugreek. If you have an allergy or
sensitivity to any of these plants, avoid using goat's rue.
 In case of an overabundant breast milk supply, Goat's
rue could further increase the milk supply and lead to
breastfeeding problems such as breast engorgement,
plugged milk ducts, and mastitis.

11.  How to Use Goat's Rue to Make More Breast Milk?
The herb is used in a dry form, although it's
most effective in fresh form; due to toxic effect in
the later; attributed alkaloid content. The dried
plant used as a tea, or in capsule form which
generally considered safe.
 A tea: Use 1 teaspoon of dried leaves in 8
ounces (1 cup) of water. Infuse for 10
minutes. Drink one cup up to three times a
day.
 Capsules: One capsule 3 or 4 times a day.
 Tincture: 20 to 40 drops (2-4 ml) 2-3 times
per day.
You should also follow the dosing
directions given to you by your doctor or
lactation consultant.

12. Carawya
Origin
It consists of dried ripe fruits of the
Carum carvi Linn.
Family: Umbelliferae.
Parts Used:
Seeds, Essential Oil

13.  Constituents:
 essential oils, mostly carvone and limonene
Dopamin
There is a structure similarity between carvon and Dopamin;
makes it easy tofit in dopaminergic receptor.

14.  Its use as lactagogue and other uses
 Caraway is a purported galactogogue, and maternal
use has been advocated to reduce colic in the
breastfeed infant.
 Caraway seeds are rich source of dietary fiber, binds to
toxins in the food and helps protect the colon mucusa
from cancers and to bile salts (produced from cholesterol)
and decrease their re-absorption in colon, and thus help
in reducing serum LDL cholesterol levels.

15.  Other uses of carawya
 caraway oil used to start menstruation and relieve
menstrual cramps; nursing mothers use it to increase the
flow of breast milk.
 used in mouthwashes and in skin rubs to improve local
blood flow.
 as a cooking spice.
 used for digestive problems including heartburn, bloating,
gas, loss of appetite.

16.  Potential Side Effects of Caraway
 Not safe to use the purified essential oil by
children below two years, because, it may cause
skin and mucous membranes irritation.
 In very high dose, cause abortion and it may be
neurotoxic; therefore, it should be avoided by
pregnant women.

17. • Another pharmaceutical preparation in Egyptian
market:
(Sekem lactagogue)
Natural and safe product
 Composition:
(Caraway - Fennel - Foenugreek - Dill - Anise - Nettel - Chamomile).

18.  Mode of Administration:
Pour a glass (150 ml) of boiled water over one filter
bag of "SEKEM LACTAGOGUE", let steep for 3 minutes, sweet
according to taste.
 Dose
 3 times daily and can be increased according to
physician's prescription.
 Store at a temperature below 30 degrees C.

19. Fennel
Fennel yields both a herb and a spice.
All plant parts are edible roots, stalks and
leaves, with the spice coming from the
dried seeds.
• Origin
The dried ripe fruit of Foeniculum vulgare
Mil
Family: Ulmbllife.
• Geological source
The plant widely cultivated in many parts
of Europe, china, Russia, Egypt and India. In
India.

20. • Active constituents
 Anethole.
There is a structural similarity between anthrole and
Dopamin; makes it easy to fit in the dopaminergic receptor.
 fenchone, flavonoids and coumarins.
 Volatile oil also contains methyl chavicol, anisic aldehydes, α
and β- pinene, ascorbic acid, niacin, riboflavin, etc
Dopamine

21.  Its use as lactagogue and other uses
 promote milk ejection by breast enlargement,
stimulates milk flow, and increases udder milk
production.
 Carminative, anti-spasmodic, anti-
inflammatory
 treat depression, heartburn, water retention,
respiratory congestion, coughs and boosting
sexual desire.

22.  Side effect
Allergic and estrogenic effects.
 Interactions
The fennel constituent methoxy psoralen has the
ability to inhibit cytochrome PA so , it should be
used cautiously with medications requiring this
isoenzyme as a substrate.

23.  Pharmaceutical preparation
Herbana gelatin capsules food supplement Herbana
capsules is a synergetic combination of seeds containing
volatile oils.

24.  Each capsule contains
Fenugreek )250 mg): contains vitamins A andC, beside
several minerals especially iron. It also contains
proteins, many aromatic volatile oils and Choline and
Lecithin which reduce cholesterol.
Fennel (50 mg): is rich in aromatic volatile oils and
several essential minerals . it also improve digestion.
Caraway (150 mg): contains large amounts of vitamins
and essential elements. Caraway is rich in volatile oils
Dill )50 mg): includes several volatile oils as Carvone.

25. Lipidium seed
 origin
 The used part: the dried ripe seeds.
 Botanical name: Lepidium sativum L.
Family: Brassicaceae = Cruciferae
Common name. cress from old Germanic cresso which means sharp
and spicy.
 G.S
Mediterranean region & North America & It occurs in Asia,
Europe, Pakistan.

26.  Active constituents :
 Glucosinolates (sulpher glucosides) mainly glucohirsutin
, sinigrin , sinalbin ,glucobrassicin.
 lepidines, flavonoids and sterols.
 The main A.C is Glucosinolates( sulpher glucosides)
mainly glucohirsutin.
Glucosinolates
( sulpher glucosides)
Glucohirsutin

27. Uses
Galactagogue , stimulant , applied as a poultice to
pains and hurts .
The aqueous extract as antihypertensive and
hypoglycemic.
Warning & Precautions
Because of its hot potency, people with Pitta body
type should use it with care. They can tolerate it,
when used after boiling in milk. It is best to avoid it
during pregnancy.

28. Warning & Precautions
 There isn't enough information to know whether
garden cress is safe to use as a medicine. Large
amounts might cause irritation of the intestines.
 Low potassium levels (hypokalemia): Garden
cress might flush potassium out of the body,
possibly leading to potassium levels that are too
low. Until more is known, use garden cress with
caution if you are at risk for potassium
deficiency.

29.  Warning & Precautions
 Low blood pressure (hypotension): Garden cress
might lower blood pressure. There is some
concern that garden cress might interfere with
blood pressure control in people prone to low
blood pressure.
 The seeds in large doses or prolonged use are
described as harmful for kidneys.

30. • Pharmaceutical preparations
DudhNahar is a herbal
granules used as galactagouge
containg lipedium sativum as
one of its components.
Dose:
40 biscuits daily
herbal

31. Chasteberry
• Origin
Fruit of Vitex agnus-castus F: verbenaceae
• Geographical source
Vitex agnus-castus is widely cultivated in warm temperature and
subtropical regions for its delicate texture it grow to height of 1-5 meters.

32.  As lactogogue
 promote milk ejection by breast enlargement,
stimulates milk flow, and increases udder milk
production.
Other uses
 Carminative, anti-spasmodic, anti-inflammatory
 treat depression, heartburn, water retention,
respiratory congestion, coughs and boosting sexual
desire.

33.  Active constituents
 Mainly flavonoids (vitexin.casticin) agnuside.
 p-hydroxy benzoic acid.
 alkaloids diterpenoids and steroidal hormones.

34.  Uses
 promotes lactation
 remedies amenorrhea
 treat endometriosis
 clear up acne
 improve female fertility
 reduce uterine fibroids
 relieves premenstrual
syndrome symptoms
 lowers menopause symptoms
 treats enlarged prostate
 Side effects:
 Uncommon vitex side effect.
 upset stomach.
 Nausea.
 Rash ,acne ,itching.
 Headache.
 diffeculty sleeping.
 weight gain.
 change in menstrual flow.

35.  Preparation & Dosage
 once daily following breakfast.
 Tincture: 1-3ml (20-60 drops)
 Capsules: 500-1,000 mg daily
for female reproductive health
and acne; 30-40mg daily for
breastmilk production
 Can also be taken as a tea, or
ground and sprinkled over food
(peppery flavor).

36.  Mechanism of action
The plant has dopaminergic effects resulting
in changes of prolactin secretion at low doses it
inhibit activation of dopamine 2 receptors by
competitive binding causing a slight increase in
release of prolactin.

37. Foenugreek
 Origin: It is dried ripe seeds of trigonella foenum graecum linnѐ.
 Family : leguminosae.
 Subfamily: papilionoideae.
 Geographical sources: The plant is indigenous to the eastern
shores of Mediterranean sea, India, Egypt and Marocco.

38. • Active constituents:
 6-7% fixed oil ( responsible for lactagoge )
 22%protein
 Volatile oil
 Free amino acids
 27% mucilage (soluble dietary fiber )
 Sapogenin in the embryo
 Two nitrogenous bases trigonilline and cholin
 4-hydroxyisoleucine
Others : Arginine and lysine

39.  Its effect on milk production
The herb stimulat sweat production of sweat
glands found in the breast.
An increase in milk production occurs within
24-72 hours after starting using the herb, but it
can take over two weeks for some females in
order to see a change.

40.  Other uses:
 Fixed oil is a lactagogue.
 Cholesterol-lowering effects (due to steroidal sapogen
in and mucilage).
 Glucose-lowering effects (due to 4-hydroxyisoleucine
and mucilage).
 Antioxidant effects.
 Anti-inflammatory effects.
 Bitter tonic and Stomachic.
 Nutritive (vitamins, proteins, amino acids, and
minerals).
 Emollient and laxative.

41.  Dose
Recommended dosage is < than 3500 mg per
DAY. To determine if you’re taking the correct
dosage is too slowly increase the amount of
fenugreek until your sweat and urine begin to smell
like maple syrup.

42.  Drug interactions:
 Oral drugs or herbs taken at the same time as
fenugreek may have delayed absorption due to the
mucilage content of fenugreek.
 Glipizide and other antidiabetic drugs :Fenugree
reduces blood glucose levels and may enhance the
effects of these drugs.
 Insulin: Fenugreek reduces blood glucose levels, so
insulin dosage may need to be adjusted.

43.  Possible side effects and cautions:
 Sweat and urine smells like maple syrup, in addition
to milk.
 Use of more than 100 grams of fenugreek seeds daily
can cause intestinal distress and nausea
(recommended dose is less than 8 grams per day).
 Ingestion of fenugreek seeds or tea in infants or
late-term pregnant women can lead to false
diagnosis of maple syrup urine disease in the infant
due to presence of sotolone in the urine.

44.  Possible side effects and cautions:
 Most of the time, baby is unaffected by mom’s use of
fenugreek (except that more milk may be available for
baby). some moms have noticed that baby is fussy
and/or has green, watery stools when mom is taking
fenugreek and the symptoms go away when mom
discontinues the fenugreek.
 Use with caution or avoid if you have a history of :
Diabetes or hypoglycemia or Asthma.

45.  Pharmaceutical preprations
1. fenugreek seed:
 Naturally contain such as B vitamins, vitam
in c and beta carotene all of which is lactag
oge
 adults take 2-3 cpsoul 2 times daily after m
eals
 not be used during pregnancy and keep awa
y from children

46. 2. lactation support
 Contain herbs such as :fenugreek
and red raspberry leaf are included
in this formula to support milk flow
.
 Adults take 1 capsule 3 times daily
between meals

47. 3. lactation support tea
 Fresh-tasting tea made from all organic
herbs, including Stinging Nettle, Goat's
rue and fenugreek.
 Adults pour one cup of freshly boiled wat
er over tea bag and steep covered for 10
min. drink once daily.

48. Shatavari
A known name of the herb is a “Queen
of herbs”, because it promotes love and
devotion.
• Origin : The dried roots of Asparagus
racemosus (A. racemosus). Family:
Liliaceae and commonly known as
Satawar.
• Geographical source:
The plant is Distributed throughout
Asia, Australia and Africa. Out of
several species of Asparagus grown in
India.

49. • Active constituents of shatavri:
Shatvari is known to possess a wide range of
photochemical constituents:
Steroidal saponins, known as shatvarins which is
the main active constituents.

50. • Other active constituents
Oligospirostanoside referred to as Immunoside.
Polycyclic alkaloid-Aspargamine A, a cage type
pyrrolizidine alkaloid
 Flavanoids-Glycosides of quercitin, rutin and
hyperoside are present in flower and fruits
Isoflavones-8-methoxy-5, 6, 4-trihydroxy
isoflavone-7-0-beta-D-glucopyranoside.

51. • Its use as lactagogue:
The plant is used as galactagogue as it prevents
infertility and miscarriage, milk supply and weight
of the mammary glands, inhibits involution of
lobulo-alveolar tissue and maintained milk
secretion.
Other uses:
The herb is also used as: (Antisecretory and
antiulcer- Antitussive effect- Adaptogenic-
Antibacterial Antiprotozoal activity-
Antihepatotoxic- Antidepressant).

52.  Side effects and contraindications:
No significant adverse effects have
been reported for this plant.
Shatavari, as part of the asparagus
family, should be avoided by
anyone with an allergy to
asparagus.

53. Side effects and contraindications:
The plant has a diuretic effect, and therefore,
should be used with caution in people taking
diuretic drugs.
From an Ayurvedic perspective, one should
avoid shatavari in cases of excess kapha,
congestion and ama.

54. • Pharmaceutical preparations:
Shatavari churna is useful in
General debility, weakness and
loss of immunity. It is a best tonic
for women menstrual problems,
lactation vaginal disorders . It is
also helpful in increasing Breast
milk supply. This product is highly
nutritious and is of high quality.

55. • Dosage :
Shatavari Churna can be used
on a regular basis, 1-2 teaspoons
twice a day with water or milk
available in100 gm

56. Anti-lactagogue
 Function
Treat excessive or abnormal breast milk
production, certain menstrual problems caused
by; too much prolactin in the blood
(hyperprolactinemia).
It may also be used to treat certain tumors in
pituitary gland; leading to too much prolactin.

57.  General mechanism
Bromocriptine and Caberrgolliine is a
dopamine agonist; stimulat dopamine receptors;
resulting in blocking the release of prolactin.
 Side effects
Vomiting ,nausea and headaches.

58.  Pharmaceutical preparation
DOSTINEX Tablets.
 Dose
0.25 mg twice a week, may be
increased up to a dosage of 1
mg twice a week according to
the patient's serum prolactin
level.

59.  Other herbs reported to have galactopoietic properties:
EffectsChemical constituentsParts usedFamilyCommon name
Estrogenic and lactogenic
stimulant, presence of
“TRHlike material ” in
turn stimulates prolactin
release.
Alkaloids (stachydrine, 1-
homostachydrine),
coumesterol, flavonoids, iso
flavonoids, carotenoids,
phenolic acids and minerals
(Fe, Ca, K, P and Zn).
Fabaceae
Alfalfa
(Leaves)
raspberry and fenugreek
acts as ruminotorics and
increases blood flow to
the mammary gland
improves post partum
hemorrhage.
Sesquiterpene lactone
(cnicin).
Asteraceae
Blessed
thistle
(Flowering
tops,
leaves,
seeds)

60. EffectsChemical constituentsParts usedFamilyCommon name
double the
volume of milk,
no effect on
mammary gland,
milk
composition.
Sesquiterpenes, eleinol,
vanillic acid, p-
hydroxycinnamic acid,
dihydroxycoumarin, β-
sitosterol, daucosterol, D-
glucopyranoside.
Euphorbiaceae
Ixbut
(Dried
aerial part)
Increase milk
yield and correct
Milk irregularity.
Leptadenol, triacontane,
cetyl alcohol, leptidin-1 and
sitosterol.
Asparagaceae
Jivanti
(Root)

61. • Refrences
 Mohanty, I., et al. "Ethnoveterinary importance of herbal
galactogogues—a review." Veterinary World 7.5 (2014): 325-330.
 Fukunaga, Takehiko, et al. "Studies on the constituents of Goat's Rue
(Galega officinalis L.)." Chemical and pharmaceutical bulletin 35.4
(1987): 1610-1614.
 GOAT'S RUE. (n.d.). From, https://goo.gl/V7KNHw.
 Simon, David and Deepak Chopra. The Chopra Center Herbal
Handbook. Three Rivers Press, New York; 2000. 73-75.
 Frawley, David, and Vasant Lad. The Yoga of Herbs. Lotus Press, Twin
Lakes, Wisconsin; 2001. 183-184.

62.  Steroidal saponins from Asparagus racemosus. Sharma U.
Saini R. Kumar N. Singh B. Chemical & Pharmaceutical
Bulletin.
 Encyclopedia of Herbs & Their Uses Deni Bown, Dorling
Kindersley, 1995; ISBN: 0-7894-0184-3 <14> Simon D. The
wisdom of healing. /ew York: )armony Books; 1, p. 14.
 Sholapurkar M-. -actare-for improving lactation. Indian
Prac 1; 39: 1023-102
 Blumenthal, Mark: The Complete German Commission E
Monographs. Austin, Texas, American Botanical Council.
1998.
 van Wyk, Ben-Erik & Michael Wink: Medicinal Plants of the
World. Portland, Oregon, Timber Press. 2004.

63.  Bown, D.: Encyclopedia of Herbs and their Uses. DK Adult. First
Edition edition. 1995.
 Chevallier, A.: The Encyclopedia of Medicinal Plants. DK Publishing.
1996.
 Karalliedde, L. and Gawarammana, I.; Traditional Herbal Medicines; A
Guide to Their Safer Use. Hammersmith Press Limited. 2007.
 Allardice, P.: A – Z of Companion Planting. Angus & Robertson. 1993.

64. Presented by:
 Reem Mahrous Mohamed
 Reem Ahmed Abd El-monem
 Reham Gamal El-din
 Reem Gamal Hussein
 Reham Abd-elrady
 Reem Yassin Abd El-kareem
 Romany Nabil
 Reham kolta
Thank You