Lactational Issues and Homoeopathy

Abstract 

Lactation, a predominant process among mammals described as the milk secretion from mammary glands and period of time when a mother feeds her young ones under the influence of two hormones i.e. prolactin and oxytocin. It benefits not only new ones but also mother and society. Though there are many advantages of breastfeeding, yet fewer than half of infants below six months old are exclusively breastfed, as many mothers discontinue breastfeeding due to various health problems encountered by them during lactation. Homoeopathy treats the patient and not the disease, based on symptoms which are suited to relieve it. This article will discuss all benefits and challenges related to breastfeeding and its management with homoeopathic interventions.

Keywords: Benefits, Challenges, Homoeopathy, Lactation.

Introduction

Lactation is a process predominant among mammals described as the milk secretion from mammary glands and period of time when a mother feeds her young ones. “Exclusive breastfeeding” is when a baby is fed with only breastmilk, without any other food or drink, not even water. “Predominant breastfeeding” is when the infant’s main source of nourishment is breast milk, but the child’s diet contains other liquids such as water, water-based drinks or fruit juice. Maintenance of milk production is called Galactopoisis. Women produce milk after childbirth which is the primary source of nutrition for newborns under the influence of two hormones namely prolactin and oxytocin. The initial milk known as colostrum, a thin yellowish fluid, is high in immunoglobulin IgA, coats the gastrointestinal tract, protecting the newborn with passive immunity until the functioning of its own immune system, having a mild laxative effect expelling meconium and helps in preventing the build-up of bilirubin.1,2,3

WHO and the American Academy of Paediatrics (AAP) emphasize the value of breastfeeding for both mothers and children, recommending exclusive breastfeeding for the first 6 months of life followed by supplemented breastfeeding for at least 1year and up to 2 years or more.4,5,6

Benefits

Fresh, convenient, inexpensive, easily digestible, animal milk is inferior to breast milk in nutritional content; is sterile, ready to use, less solute load to kidney due to low protein, less minerals, high concentration of water, better absorption of calcium. Human milk quenches baby’s thirst, hunger and provides various nutrients needed for the baby’s growth and development in most effective way ensuring child’s health and survival.

• Child: Proper heat production, adipose tissue development, decreased risk of sudden infant death syndrome, increased intelligence, better immunity, better gut system, decreased dental problems, decreased risk of obesity and diabetic later in life, are at a less risk of morbidity and mortality compared to those who are not fed.
• Mother: reduces postpartum bleeding through oxytocin production, assists in returning the uterus to its pre-pregnancy size, reduces risk of breast cancer later in life. Most importantly increases the mother-child bond. 

Contents of Human Milk7

Though there are many advantages of breastfeeding yet fewer than half of infants below 6 months old are exclusively breastfed as many mothers discontinue breastfeeding due to various problems encountered by them. Breastfeeding is not easy; it takes time and practice for both the mother and the baby. Mothers experiencing challenges during breastfeeding need the right support for overcoming such issues.

           Most commonly experienced problems by lactating mothers are: breast engorgement, cracked or sore nipples and deficient lactation or insufficient milk production. 

• Breast engorgement

A painful and unpleasant condition affecting a large number of women in their early postpartum period, mostly occurring when a baby removes less amount of milk while feeding than the amount of milk produced by the mother. Primary engorgement occurs in the first few days of birth. Secondary engorgement occurs later when the mother is feeding frequently as she used to do before, or the baby removes less milk from the breast. Breast engorgement is associated with hard, painful, throbbing, aching, and tender breasts. Breast engorgement usually happens when the breast is switching from colostrum to mature milk often referred as when milk “comes in”.1,2,4,8

• Cracked and sore nipples

It may be due to incorrect positioning by mother and incorrect latching, due to strong sucking pressure, stretching and pulling the nipple by the infant, retracted nipples, Candida infection in mother or baby or both.5

• Deficient lactation or insufficient milk production

When the mother is not able to provide enough milk to the baby it is called “lactation failure”. Causes of insufficient milk production may be due to retracted nipple, cracked or sore nipple, breast engorgement or mastitis, severe stress, prolactin deficiency, maternal malnutrition, or mother suffering from health conditions temporarily delaying the milk production.9

          According to Homoeopathy, symptoms only indicate and point to the remedy which is suited to relieve it as explained in §7 of Organon of Medicine. §118 states that every medicine expresses itself with different symptoms which are peculiar to that only, and cannot be produced by other medicinal substances of different kind.26

Homoeopathic Therapeutics

1. 1. Agnus castus – Agalactia with sadness, says soon she will die. Scanty, deficient, suppression or disappearing milk. Milk deficiency in lying-in women with despair of recovery. A woman indulged extensively in secret vice before marriage discovered no milk in mammae after confinement. Agnus will bring milk back at the end of 3weeks.
   2. Asafoetida – Disorders of lactation, deficient milk with over sensitiveness after confinement. Increased or diminished milk.
   3. Belladonna – Breast is hard, red, feels heavy. Mastitis with throbbing pain, redness streaks radiate from the nipple. Pain <after jerk & lying down, >by pressure and in semi-erect posture.
   4. Bryonia alba – Mastitis. Breasts hot, heavy, painful must support the breast with stony hardness. Stitching pain <from least motion, at night, deep inspiration, exertion and by touch, >by absolute rest, lying on painful side.
   5. Calendula officinalis – Homoeopathic antiseptic, restores vitality of injured part. Sometimes there are no constitutional symptoms for prescription, clean the affected part and apply locally. Promotes healing and healthy granulation. Prevents suppuration.
   6. Castor equi – Cracked, sore, ulcerated nipples in nursing women. Excessive tenderness of nipple, cannot bear touch of clothing. Useful even in neglected case where the nipple is nearly ulcerated off and only hangs by small strings. Redness of areola and nipples, very painful on the left side. Violent itching of breast.
   7. Conium maculatam – affects mammary glands with engorgement. Inflamed breast sensitive to stepping. Stony hardness of breast with piercing pain <night. Wants to press the breast hard with the hand. Stitches in mammae and nipples on taking deep breaths or walking. Axillary gland is painful with a numb feeling down the arm. Flabby breasts. Inflammation of mammae with stitches, scirrhous induration with itching and shooting pain after contusion.15,16
   8. Graphites – Soreness and cracks, fissure of nipples of nursing women with small corrosive blisters or ulcers. Oozing of thin transparent fluid forming a crust which gets removed by nursing. Repeated crust formation. Retarded flow of milk, tendency to develop abscess.
   9. Lac caninum – Mastitis, extreme tenderness and soreness, breast swollen, painful <by least jar, towards evening. Must hold the breast firmly while going up or down the stairs. Much trouble with breasts, feels as if they would suppurate. Scanty milk secretion. Loss of milk while nursing without any known cause. Galactorrhoea. Drying up of milk in women who cannot nurse the baby. Constant pain in nipples. Erratic pain constantly flying from one part to another, changing from side to side every few hours or days.12,14,15,16,17,18
   10. Lac defloratum – Diseases due to faulty or defective nutrition with reflex affection of the nervous centre. Defective lactation. Decrease in size of breast. Diminished milk secretion. Never failed to bring back milk within 12-24 hours. Affections of breast including poor lactation.12,14,15,16,19

• Phytolacca decandra – Chiefly affects the right breast. Breast stony hard, painful, very sensitive and of purple hue. When a child nurses pain goes from the nipple to all over the body.  Mastitis from taking cold. Milk is thick, scanty and unhealthy. Hard nodes in the breast with enlarged axillary glands. Hasten suppuration of breasts. “Gathered breasts” with large, fistulas, gaping, angry ulcers, discharging watery, fetid pus. Fullness of both breasts, lump in upper part of left. Breast shows an early tendency to cake especially when suppuration is inevitable. Tumefied breast neither heals nor suppurates “hard as old cheese”. Cracked, inverted, sensitive, sore, fissured small ulcers, sensitive nipples. When child nurses pain seems to start from nipple and radiate over the whole body. Pain flying like electric shocks, shooting, lancinating, rapidly shifting <motion, at night. Bloody watery discharge from mammae.13,15,16,20

1. Ratanhia peruviana – Cracks and fissures of nipples in nursing women.13,14,15,16,17
2. Sarsaparilla officinalis – soft, unexcitable nipples small, retracted, cracked and withered. Suppuration of breast. Scirrhous of breast.
3. Urtica urens –Agalactia. Affects the mammary glands. Suppressed, diminished secretion of milk. Excessive swelling of breast with stinging, burning pain. Brings back the milk in cases of agalactia. Skin and joint symptoms may be associated.13,15,16,25

Management

• Breast feeding should be initiated soon after delivery at frequent intervals. 
• “Breast feeding on demand” should be practiced i.e. putting the baby on breast as soon as it becomes hungry.
• Some milk may be expressed to soften the nipples before putting the baby to the breast, if the breast feels hard and overfilled. 
• Baby should be latched on properly.
• Application of hot and cold packs whenever necessary.
• Gentle breast massage.
• Avoiding soaps, harsh washing or drying of nipples. 
• Adequate intake of nutritious diet by the lactating mother.
• Maintaining local hygiene and keeping the area dry and moisturised.

Discussion and conclusion

Lactation is not only emotionally, socially, nutritionally important, but is also important from homoeopathic point of view for both baby and mother. In footnote to §285 Samuel Hahnemann explains the wonderful powers of homoeopathic medicines acting upon the infants when moderate doses administered through mothers’ milk or wet nurse is helpful and certainly more easily utilized by the new world citizen than is possible in its later years. He further explains, since psora have been imparted to them through mother’s milk, they may be at the same time protected anti-psorically.26 This literature is a unique attempt to deal with the challenges and its ways to overcome them faced by mothers during lactation with effective homoeopathic interventions.

References

1. Wikipedia Contributors. Breast milk [Internet]. Wikipedia. Wikimedia Foundation; 2019. Available from: https://en.wikipedia.org/wiki/Breast_milk.
2. Wikipedia Contributors. Lactation [Internet]. Wikipedia. Wikimedia Foundation; 2019. Available from: https://en.wikipedia.org/wiki/Lactation.
3. Babakazo P, Bosonkie M, Mafuta E, Mvuama N, Mapatano MA. Common breastfeeding problems experienced by lactating mothers during the first six months in Kinshasa. PLOS ONE. 2022 Oct 12;17(10):e0275477. https://doi.org/10.1371/journal.pone.0275477. Available from: https://www.ncbi.nlm. nih.gov/pmc/articles/PMC9555666/
4. Breast engorgement [Internet]. Wikipedia. 2023. Available from: https://en.wikipedia.org/wiki/Breast_engorgement.
5. Cracked nipple [Internet]. Wikipedia. 2023. Available from: https://en.wikipedia.org/wiki/Cracked_nipple.
6. 5 common breastfeeding problems [Internet]. www.unicef.org. Available from: https://www.unicef.org/parenting/food-nutrition/5-common-breastfeeding-problems.
7. Kant S U. Mother and child care.2nd ed. New Delhi: Jaypee publishers;2016.
8. Mangesi L, Dowswell T. Treatments for breast engorgement during lactation. Mangesi L, editor. Cochrane Database of Systematic Reviews [Internet]. 2010 Sep 8; Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4161489/
9. Piccolo O, Kinshella MLW, Salimu S, Vidler M, Banda M, Dube Q, et al. Healthcare worker perspectives on mother’s insufficient milk supply in Malawi. International Breastfeeding Journal. 2022 Feb 23;17(1). Available from: pubmed.ncbi.nlm.nih.gov/35197105/
10. CCRH. Homoeopathy for Mother and Child Care(obstetrics) training manual vol 1. New Delhi: CCRH;2009.
11. Clarke JH. A Dictionary of Practical Materia Medica. 36th impression India: B. Jain Publishers (P) Ltd. 2020, vol 1.
12. Clarke JH. A Dictionary of Practical Materia Medica. 36th impression India: B. Jain Publishers (P) Ltd. 2020, vol 2.
13. Clarke JH. A Dictionary of Practical Materia Medica. 36th impression India: B. Jain Publishers (P) Ltd. 2020, vol 3.
14. Allen HC. Keynotes and Characteristics with Comparisons of some of the Leading remedies of the Materia Medica with Bowel Nosodes. 8th ed. Delhi: B Jain Publishers(P)Ltd.; 2002.
15. Boericke W. Pocket Manual of Homoeopathic Materia Medica and Repertory. Reprint ed. New Delhi: B Jain Publishers(P)Ltd.; 1998.
16. Phatak SR. Materia Medica of Homoeopathic Medicines. 4th ed. Noida: B Jain Publishers(P)Ltd.; 2005.
17. Kent J.T., Lectures on Homoeopathic Materia Medica Reprint edition. India: B. Jain Publishers Pvt. Ltd.
18. Nash EB. Leaders in Homoeopathic Therapeutics with Grouping and Classification.6th ed. New Delhi: B Jain Publishers(P) Ltd.; 2008.
19. Hering C. The guiding symptoms of our Materia Medica. Reprint edition. New Delhi: B. Jain Publishers.1984; III:29.
20. Hering C. The guiding symptoms of our Materia Medica. Reprint edition. New Delhi: B. Jain Publishers.1984; VIII:421.
21. Hering C. The guiding symptoms of our Materia Medica. Reprint edition. New Delhi: B. Jain Publishers.1984; V:460.
22. Hering C. The guiding symptoms of our Materia Medica. Reprint edition. New Delhi: B. Jain Publishers.1984; IX:238.
23. Hering C. The guiding symptoms of our Materia Medica. Reprint edition. New Delhi: B. Jain Publishers.1984; I:105.
24. Hering C. The guiding symptoms of our Materia Medica. Reprint edition. New Delhi: B. Jain Publishers.1984; II:195.
25. Hering C. The guiding symptoms of our Materia Medica. Reprint edition. New Delhi: B. Jain Publishers.1984; X:363.
26. Hahnemann S. Organon of Medicine. 5th and 6th ed. New Delhi: B. Jain Publishers (P) Ltd.;2011

Authors

1. Dr. Prasoon Choudhary – Professor (HOD)
2. Dr. Kamal Nainawat, Dr. Ritika Sharma – PG Scholar, 

Department of Paediatrics, Dr. MPK Homoeopathic Medical College, Hospital and research Centre, Homoeopathy University, Jaipur (Rajasthan)