The increased mucus production may protect the gastrointestinal tract against ulcers and excess acidity. There has been little scientific research on slippery elm, but it is often suggested for the following conditions:. Slippery elm is a medium-sized tree native to North America. It can reach well over 50 feet in height and is topped by spreading branches that form an open crown. The red, brown, or orange branches grow downward, and the stalkless flowers are arranged in dense clusters.
The plant's leaves are long and green, and they darken in color during the fall. The bark has deep fissures, a gummy texture, and a slight but distinct odor. Give slippery elm to a child only under the supervision of a knowledgeable practitioner. Dosage is usually dependent on weight.
The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications.
For these reasons, you should take herbs with care, under the supervision of a health care provider. Slippery elm is not known to have serious side effects. Because it coats the digestive tract, it may slow down the absorption of other drugs or herbs. You should take slippery elm 2 hours before or after other herbs or medications you may be taking. Some scientists think slippery elm is safe in pregnancy and during breastfeeding, but no scientific studies have been done to confirm this.
The outer bark of the elm tree may contain substances that could increase the risk of miscarriage, so sometimes pregnant women are advised to avoid slippery elm.
There is some folk herbal history that Slippery elm may cause miscarriage, however, it is unclear whether this refers to the practice of inserting Slippery elm preparation vaginally or taking the herb orally.
DO NOT take any herbal supplements when pregnant or breastfeeding unless you're under a provider's supervision. There are no scientific reports of slippery elm interacting with any other medications, although it may slow down the absorption of other drugs or herbs see " Precautions " section.
Bock S. Integrative medical treatment of inflammatory bowel disease. Int J Integr Med. Digestive Problems During Colonial times, slippery elm was used extensively to treat digestive problems. Cautions and Contraindications Most herbalists say that slippery elm bark is one of the safest herbs to use. Natural Remedies for Morning Sickness.
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Learn More. Main concerns for lactating women about medications include the safety of their breastfed infants and the potential effects of medication on quantity and quality of breast milk. While medicine treatments include conventional and complementary medicines, most studies to date have focused on evaluating the safety aspect of conventional medicines.
Despite increasing popularity of herbal medicines, there are currently limited data available on the pattern of use and safety of these medicines during breastfeeding. This study aimed to identify the pattern of use of herbal medicines during breastfeeding in Perth, Western Australia, and to identify aspects which require further clinical research. This study was conducted using a self-administered questionnaire validated through two pilot studies.
Participants were 18 years or older, breastfeeding or had breastfed in the past 12 months. Participants were recruited from various community and health centres, and through advertising in newspapers.
Simple descriptive statistics were used to summarise the demographic profile and attitudes of respondents, using the SPSS statistical software. A total of questionnaires from eligible participants were returned Amongst the respondents, Most commonly used herbs were fenugreek The majority of participants Only The use of herbal medicines is common amongst breastfeeding women, while information supporting their safety and efficacy is lacking.
This study has demonstrated the need for further research into commonly used herbal medicines. Evidence-based information should be available to breastfeeding women who wish to consider use of all medicines, including complementary medicines, to avoid unnecessary cessation of breastfeeding or compromising of pharmacotherapy.
Breastfeeding provides numerous benefits for newborn infants and mothers. Breast milk provides tailored nourishment to the growing needs of infants [ 1 ], offering optimal nutrition, improved cognitive performance and neurological development [ 2 ] and enhanced immunity [ 3 , 4 ].
Breastfeeding may also play a role in decreasing post-partum depression, bleeding, and improving weight control [ 8 ]. Furthermore, women who have a history of breastfeeding experience a reduced risk of osteoporosis and reduced incidence of breast and ovarian cancers [ 8 - 10 ].
Besides these health advantages, mothers and their babies are brought into closer contact through nursing itself [ 11 ]. Breastfeeding should be continued until 12 months of age and beyond as complementary feeding if the infant and mother both wish [ 12 ]. Many national efforts, including the initial development of the National Breastfeeding Strategy — [ 13 ] followed by the Australian National Breastfeeding Strategy — [ 14 ], have been initiated to support and promote successful breastfeeding in Australia.
With our increasing awareness of the advantages of breastfeeding, health professionals from all disciplines should work together to promote breastfeeding. A concern for lactating women who are taking medications is the transfer of medicines into breast milk [ 5 , 8 ]. Medicines circulating in the maternal bloodstream can potentially be transferred into human breast milk, exposing breastfed infants to medicines that may potentially be harmful [ 5 , 8 ].
Another concern is the effect of medication on the quantity and quality of breast milk produced, which may impact on the exclusivity, duration and success of breastfeeding [ 15 , 16 ]. Medicines that have been reported to compromise production of milk include cabergoline [ 18 ], bromocriptine [ 19 ], ergotamine [ 20 ], pseudoephedrine [ 21 ], and oestrogens [ 20 , 22 ]. Besides conventional medications, some natural substances have also been associated with reduction of breast milk supply.
Peppermint, sage and parsley have been used traditionally for weaning, however there is a lack of research-based evidence to support their clinical use [ 15 , 23 ]. While medicine treatments include both conventional and alternative medicines, most available studies have focused on evaluating the transfer of conventional medicines into breast milk. The use of complementary and alternative medicines CAMs is increasingly common worldwide. Research undertaken in the last couple of decades in many countries including the United States [ 24 , 25 ], Canada [ 26 ], the United Kingdom [ 27 , 28 ] and the United Arab Emirates [ 29 ] all demonstrated substantial increase in the use of CAMs amongst the general population.
Research conducted in Australia has shown results consistent with the above findings [ 30 - 36 ]. A prevalence study conducted in by Xue et al. Zhang et al. These included aloe vera, garlic, green tea, chamomile, echinacea, ginger, cranberry, peppermint, ginseng, ginkgo biloba, evening primrose, dandelion, valerian, liquorice, St. Many women self-medicate with complementary medicines and supplements, most commonly on recommendation by friends or family, or as prescribed by their health care professionals [ 37 - 43 ].
Studies conducted by Nordeng et al. We anticipated that some use of herbal medicines was likely to occur during breastfeeding as Stultz et al. Despite the increasing popularity of herbal medicines, there is currently limited information available on the extent of use and safety of these medicines amongst breastfeeding women.
This study aimed to provide current information on the prevalence and pattern of herbal medicines used by women whilst breastfeeding in Western Australia, and to identify commonly used herbal medicines. This information will inform and direct future clinical research. The study also explored the attitudes of breastfeeding women towards herbal medicines and their perceptions of the safety and efficacy of herbal medicines used during breastfeeding, as well as their information-seeking behaviour.
This study was conducted using a self-administered structured questionnaire validated through two pilot studies which followed the steps described by Portney and Watkins [ 45 ]. The pilot questionnaire was initially circulated among colleagues and lactation consultants, seeking feedback and suggestions. All comments were taken into consideration and the questionnaire was amended following discussion with the research team. The second pilot study was then conducted using the revised questionnaire.
The target population was women who were 18 years or older, breastfeeding or who had breastfed in the 12 months prior to the time of the survey.
To achieve the study objectives, there were no restrictions as to whether the participant was on any medications or had any medical conditions. Women from all cultural or ethnic backgrounds were eligible for the study. Balancing the need to minimise selection bias and maximise response rate, the decision was made to recruit participants through four main avenues to enable a wide range of participant characteristic types to be recruited:.
With written approval from the Australian Breastfeeding Association ABA , breastfeeding women were recruited from local mothers and parenting groups where the primary investigator TFS attended the group meetings. A stratified sampling technique was used to obtain sets of pharmacies within three defined geographical areas: North metropolitan, South metropolitan or regionally based according to postcodes.
The lists of pharmacies were arranged in a random order by attaching a computer generated random number to each record and sorting each list by the number. Permission was sought from a total of 30 randomly selected pharmacies, 10 from each region, to place 10 sets of recruitment forms in each pharmacy.
The pharmacists in-charge were requested to hand out the sets of forms to any women who visited their pharmacy whom they believed could have been eligible for the study.
For example: women who came into the pharmacies with an infant or a young child to purchase any infant-related or breastfeeding-related products, or if they had declared that they were breastfeeding.
This strategy was implemented to advertise the study to the general public. All participants who had expressed interest in participating in the study were provided, either face-to-face or via postal mail, a set of forms consisting of the participant information sheet, the survey questionnaire and a reply paid envelope. The participant information sheet explained that responses would be treated in confidence in order to guarantee anonymity.
Consent was assumed upon return of the completed questionnaire. Participant recruitment and data collection occurred concurrently between February and December The questionnaire comprised four sections. See Additional file 1. This information was collected to explore the association between these factors and the pattern of use of herbal medicines during breastfeeding. Section 3 requested information on the prevalence and pattern of use of herbal medicines during breastfeeding.
The types of questions in the questionnaire determined the response options, which were a mix of open-ended and closed-ended questions using Likert-style scaled responses. Qualitative responses obtained from open-ended questions were identified and coded.
Reasons for use were categorised and coded concurrently with data entry. Upon completion of data entry, all categories were reviewed and reclassified if necessary to ensure consistency in coding and that there was no duplication. These coded responses were then analysed in the same manner as the closed-ended quantitative responses. Quantitative data were summarised using standard descriptive statistics frequencies and percentages for categorical variables; means and standard deviations for variables measured on a continuous scale.
Univariate associations between demographic data and use of CAM were assessed using Chi-square statistics or t-tests, as appropriate. A multivariate logistic regression model was used to identify any factors independently associated with use of CAM. A total of survey forms were distributed and questionnaires were returned, a response rate of The mean [SD] ages of respondents were The characteristics of respondents and factors affecting the use of herbal medicines during breastfeeding are summarised in Table 1.
The number of herbal products used by respondents ranged from none to six, with an average of 1. Of the respondents who took at least one herbal medicine during breastfeeding, 70 Over half A logistic regression model was used to investigate if any respondent characteristics or demographic factors were associated with the decision to use herbal medicines during breastfeeding, with the results shown in Table 2.
The multivariate model shows that respondents with an Asian birthplace were more likely to use herbal medicines, as well as those from middle income families total annual household income of AUD 37, — AUD 80, These factors were the only two which remained after the backwards-elimination model-fitting strategy.
Other variables which were initially included in the model were dropped since they appeared to be not significantly associated with the outcome.
A total of 51 different herbal medicines or ingredients were revealed amongst the survey respondents in this study. The top ten most commonly used herbal medicines during breastfeeding in the descending order of popularity were fenugreek Women were asked to indicate the reasons for use, who recommended the use, and their perceived efficacy of whether the herbal medicine was helpful to address their intended indication.
The proportion of women who perceived the herbal medicine as helpful varied from These findings along with their prevalence are shown in Table 3.
Top ten most commonly used herbal medicines during breastfeeding in descending order of popularity. There were 18 different herbal medicines or ingredients indicated by the respondents specifically as a galactagogue, that is to increase breast milk supply and breastfeeding performance.
Table 4 reports on the top seven most commonly used herbal galactagogues along with their perceived efficacy, in descending order of priority. Participants were asked to state who had recommended the use of each of the specified herbal medicines. Responses were tabulated separately, and grouped into seven main categories as presented in Table 5.
Prescribers and specialists, including general practitioners, gynaecologists and obstetricians were least likely to recommend use of herbal medicines during breastfeeding, as results have shown that only 2. Health food stores and supermarkets were two other common sources of supply, followed by naturopathic clinics, family and friends and the internet.
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