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      Management of Breast Milk Oversupply in Traditional Persian Medicine

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          Abstract

          Comprehensive explanation about milk oversupply is not available in the current literature because few studies have been done on this topic. In traditional Persian medicine, milk oversupply and its management have been described. The aim of this study was to investigate milk oversupply from the perspective of medieval Persian practitioners. In this study, some main medical resources of traditional Persian medicine such as Al-Havi and the Canon of Medicine were studied to extract valuable information about milk oversupply. Etiology of milk overproduction according to traditional Persian medicine is based on humors theory and cannot be easily compared with current medical concepts. Diet modifications and natural remedies have been applied for managing this condition but the majority of traditional Persian medicine interventions for reducing milk oversupply have not been scientifically investigated in modern medicine. The knowledge of milk oversupply in traditional Persian medicine may be helpful to conduct further related studies.

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          Pregnancy and lactation: physiological adjustments, nutritional requirements and the role of dietary supplements.

          Mary Frances Picciano (2003)
          Nutritional needs are increased during pregnancy and lactation for support of fetal and infant growth and development along with alterations in maternal tissues and metabolism. Total nutrient needs are not necessarily the sum of those accumulated in maternal tissues, products of pregnancy and lactation and those attributable to the maintenance of nonreproducing women. Maternal metabolism is adjusted through the elaboration of hormones that serve as mediators, redirecting nutrients to highly specialized maternal tissues specific to reproduction (i.e., placenta and mammary gland). It is most unlikely that the heightened nutrient needs for successful reproduction can always be met from the maternal diet. Requirements for energy-yielding macronutrients increase modestly compared with several micronutrients that are unevenly distributed among foods. Altered nutrient utilization and mobilization of reserves often offset enhanced needs but sometimes nutrient deficiencies are precipitated by reproduction. There are only limited data from well-controlled intervention studies with dietary supplements and with few exceptions (iron during pregnancy and folate during the periconceptional period), the evidence is not strong that nutrient supplements confer measurable benefit. More research is needed and in future studies attention must be given to subject characteristics that may influence ability to meet maternal and infant demands (genetic and environmental), nutrient-nutrient interactions, sensitivity and selectivity of measured outcomes and proper use of proxy measures. Consideration of these factors in future studies of pregnancy and lactation are necessary to provide an understanding of the links among maternal diet; nutritional supplementation; and fetal, infant and maternal health.
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            Nutrient composition of human milk.

            Mary Frances Picciano (2001)
            A complex interplay of maternal homeostatic mechanisms influences nutrient transfer to nursing infants, and with a few exceptions, excess maternal intake or a moderate deficiency in the maternal diet does not appreciably alter nutrient transfer to infants unless it has persisted for some time. Milk vitamins D and K contents, even in apparently well-nourished women, may not always provide adequate amounts for infants. Investigations provide evidence that human milk possesses many unique characteristics and that maternal and environmental influences are stronger than previously recognized and appreciated. A complete body of knowledge does not exist to serve as a basis for dietary recommendations to ensure optimal nutrition for mothers and infants. The success of lactation usually is measured in terms of infant performance, and cost and consequence to the mother are seldom considered. Human milk feeding is recommended for the entire first year of life, but few studies focus on the nursing dyad for more than 3 months' duration. Continued study is needed so that nutritional adequacy may be maintained and appropriate dietary guidance can be provided. When human milk feeding is not practiced, modern and reliable data on human milk constituents and their significance to infants also are essential for the preparation of formulas, especially those not based on bovine milk. The adequacy of human milk substitutes cannot be predicted from compositional analysis because of possible differences in compartmentalization and molecular form of nutrients, and such preparations must be evaluated using specific indices of nutrient use, together with traditional anthropometric measures in infants.
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              Biological underpinnings of breastfeeding challenges: the role of genetics, diet, and environment on lactation physiology

              Sooyeon Lee, Shannon Kelleher (2016)
              Lactation is a dynamic process that has evolved to produce a complex biological fluid that provides nutritive and nonnutritive factors to the nursing offspring. It has long been assumed that once lactation is successfully initiated, the primary factor regulating milk production is infant demand. Thus, most interventions have focused on improving breastfeeding education and early lactation support. However, in addition to infant demand, increasing evidence from studies conducted in experimental animal models, production animals, and breastfeeding women suggests that a diverse array of maternal factors may also affect milk production and composition. In this review, we provide an overview of our current understanding of the role of maternal genetics and modifiable factors, such as diet and environmental exposures, on reproductive endocrinology, lactation physiology, and the ability to successfully produce milk. To identify factors that may affect lactation in women, we highlight some information gleaned from studies in experimental animal models and production animals. Finally, we highlight the gaps in current knowledge and provide commentary on future research opportunities aimed at improving lactation outcomes in breastfeeding women to improve the health of mothers and their infants.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Evid Based Complementary Altern Med
                Journal ID (iso-abbrev): J Evid Based Complementary Altern Med
                Journal ID (publisher-id): CHP
                Journal ID (hwp): spchp
                Title: Journal of Evidence-based Complementary & Alternative Medicine
                Publisher: SAGE Publications (Sage CA: Los Angeles, CA )
                ISSN (Print): 2156-5872
                ISSN (Electronic): 2156-5899
                Publication date (Electronic): 18 August 2017
                Publication date (Print): October 2017
                Volume: 22
                Issue: 4
                Pages: 1044-1050
                Affiliations
                [1 ]Department of Traditional Medicine, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
                [2 ]School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                [3 ]Vali-e-Asr Hospital, Emam Khomeini Complex, Tehran University of Medical Sciences, Tehran, Iran
                Author notes
                [*]Farnaz Sohrabvand, MD, Vali-e-Asr Hospital, Emam Khomeini Complex, Tehran University of Medical Sciences, Tehran, Iran. Email: sohrabva@ 123456tums.ac.ir
                Author information
                http://orcid.org/0000-0002-2309-9336
                Article
                Publisher ID: 10.1177_2156587217722474
                DOI: 10.1177/2156587217722474
                PMC ID: 5871304
                PubMed ID: 28817945
                SO-VID: 4f2d71bf-2f47-4ff5-ae51-6e0b4d5af386
                Copyright © © The Author(s) 2017
                License:

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Date received : 19 October 2016
                Date revision received : 28 April 2017
                Date accepted : 21 June 2017
                Categories
                Subject: Topical Review Articles

                Keywords: milk oversupply,breastfeeding,traditional medicine
                Data availability:
                Keywords: milk oversupply, breastfeeding, traditional medicine

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