A quick search in mothers or breastfeeding groups is enough to see reports of women who have used or recommend teas and herbs that help increase breast milk production. The herbal medicines used for this purpose even have a specific name: galactogogues. Among them, one of the most famous is the cotton dye. The product is marketed both in compounding pharmacies and in common pharmacies, and is recommended by midwives, breastfeeding consultants and even some pediatricians. But does it have any effect?
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Cotton dye: what is it?
The plant from which the extract is taken is known as a cotton plant — yes, it is where the textile fiber we call cotton comes from. The scientific name, however, is a little more complicated: Gossypium herbaceum. The species belongs to the family malvaceae and is widely distributed in western India, Africa, some countries in the Middle East and Central Asia. “It is widely used in traditional oriental medicine systems, especially in unani medicines. [medicina perso-árabe, com origem na Grécia Antiga] and ayurvedic [medicina alternativa desenvolvida na Índia], in order to increase milk production, which we call the galactagogue effect, and to treat various diseases”, says pediatrician Roberto Gomes Chaves, a specialist in pediatric nutrition and a member of the Scientific Department of Breastfeeding of the Minas Gerais Society of Pediatrics (SMP) . “Cotton tincture is made with the seed of this plant, in a vehicle [base usada para diluição] alcoholic”, he explains.
Despite positive reports from mothers who do feel that breast milk production increases when they start using this herbal medicine, science, for now, does not confirm this effectiveness. “The largest medical update platform on medication and breastfeeding, called LACTMED, developed by renowned experts from the National Institutes of Health (NIH), concludes that ‘despite their frequent use as a galactagogue, the research supporting these uses is small. and inadequate to validate its effectiveness’”, points out Chaves.
A study published in the scientific journal pediatrics, from the American Academy of Pediatrics (AAP), reinforced that galactogogue drugs, such as cotton tincture, have a limited role in facilitating lactation. “These substances have not yet been subjected to adequate infant safety studies. [o bebê] and for the nursing mother [a mãe]” says the doctor.
Often, when it comes to herbal medicines, there is that stigma of being harmless. It is as if, coming from plants, they were “natural” and, therefore, “it does no harm”. But it’s not like that, no. In the case of cotton, in addition to the lack of proof of benefits, there may be some risks, according to the expert. Some scientific studies have already shown that the active ingredient in cotton, gossypol, has caused adverse effects in some cases. “Among them, reduced blood levels of potassium, leukocytes and platelets, as well as fatigue, dry mouth, dry skin and gastrointestinal disorders in nursing mothers. Unfortunately, no studies have yet been published to assess effects on the infant after use by the nursing mother.
But then why are so many teas, herbs and medicines sold with the promise of stimulating milk production, when there is not enough evidence about effectiveness and risks? According to Chaves, almost all the products marketed for this purpose have studies that show some increase in the production of prolactin by women. “With this argument, the laboratories obtain approval by regulatory agencies”, points out the specialist. But the increase in the hormone does not necessarily result in increased milk production when milk already has sufficient production or when the insufficiency is in the tissue of the mammary glands. “Studies have not shown greater weight gain in infants of mothers who used cotton tincture, compared to the group of mothers who reported insufficient milk production and did not use this medication”, explains the pediatrician.
Another issue to consider is the confusion between marketing and commercial appeals with what really works. For the doctor, because of this, the population comes to believe in the use of industrialized herbal compounds, without proper scientific research on safety for consumption. And not just the final audience. Many health professionals prescribe the products, due to media influences, not always based on reliable research.
So, according to him, there is no point in resorting to cotton tincture if your intention is to increase milk production. “The scientific literature aligned with the principles of Evidence-Based Medicine does not recommend the use of this drug due to the lack of scientific evidence on its effectiveness and concern regarding possible adverse effects”, he summarizes.
Little milk. Really?
One of the most frequent challenges for mothers who want to breastfeed is the lack of information. Many do not receive adequate guidance even before having the baby, during prenatal care, and therefore do not know what to expect. It’s such an intense romanticization that the mothers believe that it’s just going to be putting the baby on the breast and he, almost like magic, will know how to breastfeed. Anyone who has gone through this, however, knows that this is not how it works… In fact, breastfeeding is not always natural and instinctive. It involves learning on both sides, both for the mother and the baby.
“The main cause for the baby’s inadequate weight gain is the lack of knowledge of breastfeeding techniques, either by the mother or by the health professional who provides assistance”, says the specialist. “In addition, the maternal perception of low milk production is often related to situations such as: pain when breastfeeding, tiredness, stress, anxiety, fear and lack of self-confidence. All of these can inhibit the milk ejection reflex, impairing lactation,” he explains. In some cases, such as women who have had surgery before, such as breast reduction, the supply of breast milk may be impaired. In even rarer situations, insufficient production may be related to the use of some medication.
But to know if this is your case, there is no point in relying on “guessing”. A lot of confusion happens around the third month of the baby’s life, when production regularizes, adjusting to the child’s demands, and the breast stops being so large and leaking. It is a normal and expected phase. However, many women (sometimes also influenced by the famous “hunchbacks”), think that this means they are low on milk.
There’s no way. To know if, in fact, there is something out of the ordinary with your milk production or your child’s weight gain, you need to consult a health professional – preferably, one who is breastfeeding friendly. “The baby’s behavior, hydration status and the speed of weight gain are some of the parameters used to assess whether the baby is ingesting a satisfactory volume of milk”, says Chaves. Look for a pediatrician, a breastfeeding consultant or even a unit of a Human Milk Bank, trained to offer this help.
How, then, to stimulate the production of breast milk?
If, after a professional evaluation, it is really found that the amount of milk produced is lower than expected, there are several other techniques that can help. “Mothers can use non-pharmacological resources to support production, such as adequate breastfeeding techniques, breastfeeding on demand, increasing the frequency of feedings and the duration of milk pumping, and support in their support network for physical and mental rest. ”, recommends the expert.
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