professional ethical considerations of herbal galactagogues, · choose complementary and...

Professional Ethical Considerations of Herbal Galactagogues,

2005 ILCA Conference, Cheryl R. Scott PhD, RN, IBCLC 5

Counseling Families

who choose

Alternative Medicine

•  Health Care Professionals should consider using these following guidelines when discussing galactagogues with clients/patients:

Ask about use.

Enquiring does not equal endorsing.

Have a non-judgmental attitude Seek information for yourself.

Be prepared to share it with families.

Identify risks of potential harmful

effects (including costs, possible

financial burden)

Educate families to evaluate

information on all treatment options



Avoid dismissal of alternative therapies

that communicates lack of sensitivity of

family preferences

American Academy of Pediatrics, Committee on Children with Disabilities. Counseling families who

choose complementary and alternative medicine for their child with chronic illness or

disability. Pediatrics 2001;107:598-601.

World s Most Popular Medicine:

Botanical Medicine

•  World Health Organization (WHO) estimates herbal remedies are the most frequently used therapies worldwide.

•  4-5.1 billion people, 80-85% of world population, use herbal preparations for primary health care. (WHO)

•  Women have a history for thousands of years as healers, midwives, and kitchen herbalists.

Herbs/Plant Medicine

•  Protect

•  Promote health

•  Treat common ailments and personal well-being for 6-20,000 years or more

Synthetic Drugs

•  Often act in the body as an irritant or toxin

•  Upsetting the balance of whole body systems

•  Producing side effects that can be lethal

Plant Medicines "Often safer and gentler than synthetic drugs.

" Humans have co-evolved with plants over the past few million years.

" We eat plants, drink their juices, ferment and distill libations from them

" Ingredients in plants: from carbohydrates, fats and proteins, to vitamins and minerals are part of our body composition & chemistry.

Comparison of

Intrinsic Natures

Pharmaceutical Medicine

•  Single components

•  Strong Medicine = Strong side effects

•  Poor safety record

•  Short historical use 40-150 years

Herbal Medicine/

Mother s Milk

Medicine

Herbal Medicine

•  Over 200+ components

•  Living components: Carbohydrates, alkaloids, flavonoids, proteins, fats, vitamins

•  Gentle/nurturing/supportive

•  Very long, historical safety record 2-6,000 years

Mother s Milk Medicine

•  Over 200+ components

•  Living components: Protein, vitamins, fats, minerals, micro-elements, carbohydrates

•  Very long ,historical safety record: 6,000+years



The Yang of

Medicinals

Pharmaceuticals

•  Strong meds/strong side effects

•  Often deadly side effects

•  Over 51% of new drugs post-approval risks include: heart failure, myocardial infarction, anaphylaxis, respiratory depression and arrest, seizures, kidney and liver failure, severe blood disorders, birth defects and fetal toxicity, and blindness. Source: General Accounting Office of the FDA

The Yin of

Medicinals

Botanical/ Herbals

•  Gentle effects (may take longer time for desired effects)

•  Contain multiple constituents

•  Nutritive, calming, carminative, aromatic / relaxing, adaptogenic, antidepressant, nervine, hormonally supportive, tonic, lactogenic, $ breast growth

Let the Numbers

Speak for

themselves

Herbal /Dietary Annual Death Rate in USA

•  < 5 confirmed deaths per year over the past 25 years.

•  Most are related to a batch of genetically engineered tryptophan from the 1980 s

•  Food poisoning causes 5,000 to 9,000 deaths per year. (Source, CDC.)

•  FDA noted 184 deaths due to herbal products over a 5-year period.

Prescription Drug

Death rate in USA

•  Properly researched, regulated, prescribed and properly used drugs are the fourth most common

cause of death - but they are never reported •  90,000 to 160,000 deaths per year. (JAMA) •  As few as 5%-20% of iatrogenic mistakes are

reported, i.e. If medical errors were reported completely and accurately, the iatrogenic death rate would be in the multimillions per year

(Leape LL., Error in medicine., JAMA, 1994) (Wald, Shojania, Incident Reporting in Making Health Care

Safer: A Critical Analysis of Patient Safety Practices, Agency for Health Care Research and Quality, 2001)

Out of 783,936 annual deaths from

conventional medicine mistakes….

•  Approximately 106,000 of those are the result of prescription drug use. (Null, Death by Medicine, 2011)

•  According to the Journal of the American Medical Association, two-hundred and ninety people in the United States are killed by prescription drugs every day (JAMA, 2000)

•  See more at: http://www.collective-evolution.com/

2013/05/07/death-by-prescription-drugs-is-a-growing-problem/#sthash.TcQwhkTA.dpuf

Knowledge is

Power

•  The more you learn of herbal galactagogues, the more safer alternatives you will discover, that are safer, more effective, and have less harmful side effects.

•  The more you learn about botanical galactagogues !.you will learn of safer, highly therapeutic, with additional synergistic benefits that are less costly, easier to obtain, and culturally appropriate.



Comparison of

Common

Galactagogues

Reglan® •  $Prolactin levels •  $ Milk volumes •  Need a prescription •  Only safe for short term use •  Long term Side effects: •  Tardiff dysconesia, (27-29%

prevalence for long term users*) migraines, HA,

•  Nervous system disorders, Neuroleptic Malignant Syndrome, Endocrine disturbances, Cardiovascular problems, Gastrointestinal problems such as Chrones disease, akathesia

•  >3 months usage leads to permanent Parkinson’s Syndrome

•  *46 lawsuits pending

Fenugreek $  Prolactin (alkaloids, flavonoids,

choline, carbohydrates, galactomannans)

$  Milk volumes $  Breast growth $  Stimulates appetite $  Oxytocin $  Diaphoretic, secretolytic $  Mild antiseptic No prescription necessary Side effects: smell sweet, initial gas,

stomach cramping, diarrhea, $asthma symptoms if allergic

Contraindicated if allergic to legumes (peanuts),

Consult with Dr. if mom is diabetic to adjust insulin levels

Basics for Ethical

Decision Making

₪ Best therapeutic agent for specific underlying issue

₪ Safety record / Contraindications

₪ Cultural appropriateness

₪ Availability / Accessibility

₪ Affordability $$$

Can your mother get her galactagogue

from a….?

%Prescription from MD?

% Domperidone from a compounding pharmacy? Have internet access?

% Health food stores/retail stores with health nutritional supplements?

% Can she grow and make her galactagogue?

Availability/

Accessibility

•  Does your client have health insurance to pay for costly pharmaceuticals?

•  15.4% Americans are uninsured, (2012)

•  Are your clients able to get prescriptions?

•  Can they grow their medicines?

•  Can they buy the safest pharmaceutical in their town/city/country???

•  How long will it take her to get her medicine?

Affordability

Cost Comparison

•  Metformin (Glucophage) 500 mg/ 100 tabs $51

•  Reglan (Metoclopramide): 10 mg /100tabs =$30

•  Domperidone: 10 mg /100 tabs =$36

•  Fenugreek: 610 mg /100 caps = $13.00

•  More Milk Plus: Motherlove 120 caps/ $24.99

•  Mountain Meadows Maxi Milk 2 oz $20

(*Figures based on website search 1/2014)

How do YOU honor individual and

community/cultural values?

•  Which ethnic populations do you most commonly assist?

•  Do you know what their birthing rituals are?

•  Dietary customs assoc. with their birthing rituals?

•  Do you take classes to increase your knowledge of the ethnic populations where you live?

We will continue this discussion in next session ☺

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