Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, 01003, USA.
School of Human Nutrition, McGill University, Ste. Anne de Bellevue, QC, H9X 3V9, Canada.
J Ethnopharmacol. 2021 Apr 24;270:113812. doi: 10.1016/j.jep.2021.113812. Epub 2021 Jan 12.
Cross-cultural comparison of plants used during lactation and the postpartum period offers insight into a largely overlooked area of ethnopharmacological research. Potential roles of phytochemicals in emerging models of interaction among immunity, inflammation, microbiome and nervous system effects on perinatal development have relevance for the life-long health of individuals and of populations in both traditional and contemporary contexts.
Delineate and interpret patterns of traditional and contemporary global use of medicinal plants ingested by mothers during the postpartum period relative to phytochemical activity on immune development and gastrointestinal microbiome of breastfed infants, and on maternal health.
Published reviews and surveys on galactagogues and postpartum recovery practices plus ethnobotanical studies from around the world were used to identify and rank plants, and ascertain regional use patterns. Scientific literature for 20 most-cited plants based on frequency of publication was assessed for antimicrobial, antioxidant, anti-inflammatory, immunomodulatory, antidepressant, analgesic, galactagogic and safety properties.
From compilation of 4418 use reports related to 1948 species, 105 plant taxa were recorded ≥7 times, with the most frequently cited species, Foeniculum vulgare, Trigonella foenum-graecum, Pimpinella anisum, Euphorbia hirta and Asparagus racemosus, 81, 64, 42, 40 and 38 times, respectively. Species and use vary globally, illustrated by the pattern of aromatic plants of culinary importance versus latex-producing plants utilized in North Africa/Middle East and Sub-Saharan Africa with opposing predominance. For 18/20 of the plants a risk/benefit perspective supports assessment that positive immunomodulation and related potential exceed any safety concerns. Published evidence does not support a lactation-enhancing effect for nearly all the most-cited plants while antidepressant data for the majority of plants are predominately limited to animal studies.
Within a biocultural context traditional postpartum plant use serves adaptive functions for the mother-infant dyad and contributes phytochemicals absent in most contemporary diets and patterns of ingestion, with potential impacts on allergic, inflammatory and other conditions. Polyphenolics and other phytochemicals are widely immunologically active, present in breast milk and predominately non-toxic. Systematic analysis of phytochemicals in human milk, infant lumen and plasma, and immunomodulatory studies that differentiate maternal ingestion during lactation from pregnancy, are needed. Potential herb-drug interaction and other adverse effects should remain central to obstetric advising, but unless a plant is specifically shown as harmful, considering potential contributions to health of individuals and populations, blanket advisories against postpartum herbal use during lactation appear empirically unwarranted.
对哺乳期和产后期间使用的植物进行跨文化比较，可以深入了解民族药理学研究中一个很大程度上被忽视的领域。植物化学物质在新兴的免疫、炎症、微生物组和神经系统对围产期发育影响的相互作用模型中的潜在作用，对于个体和传统和现代背景下人群的终生健康都具有重要意义。
描绘和解释全球母亲在产后期间摄入药用植物的传统和现代使用模式，以及这些植物对母乳喂养婴儿的免疫发育和胃肠道微生物组以及产妇健康的植物化学活性。
使用已发表的关于催乳剂和产后恢复实践的综述和调查，以及来自世界各地的民族植物学研究，来确定和排名植物，并确定区域使用模式。根据发表频率，对基于 20 种最常被引用植物的科学文献进行了评估，以确定其抗菌、抗氧化、抗炎、免疫调节、抗抑郁、镇痛、催乳和安全性特性。
从与 1948 种物种相关的 4418 种使用报告中汇编，记录了 105 种植物类群≥7 次，最常被引用的物种，如甜茴香（Foeniculum vulgare）、胡芦巴（Trigonella foenum-graecum）、大茴香（Pimpinella anisum）、飞扬草（Euphorbia hirta）和天门冬（Asparagus racemosus），分别被引用 81、64、42、40 和 38 次。物种和用途在全球范围内存在差异，这体现在北非/中东和撒哈拉以南非洲地区使用的具有相反优势的芳香植物和乳胶生产植物之间的模式上。对于 18/20 种植物，风险/收益观点支持评估，即积极的免疫调节和相关潜力超过任何安全问题。发表的证据并不支持几乎所有最常被引用的植物都具有增强泌乳的作用，而大多数植物的抗抑郁数据主要限于动物研究。
在生物文化背景下，传统的产后植物使用为母婴对子提供了适应性功能，并为大多数当代饮食和摄入模式提供了缺乏的植物化学物质，这可能对过敏、炎症和其他疾病产生影响。多酚和其他植物化学物质具有广泛的免疫活性，存在于母乳中，且主要是非毒性的。需要对人乳、婴儿腔和血浆中的植物化学物质进行系统分析，并进行区分哺乳期和孕期母亲摄入的免疫调节研究。草药-药物相互作用和其他不良反应应仍然是产科咨询的核心，但除非特定植物被证明有害，否则考虑到个体和人群健康的潜在贡献，全面禁止哺乳期产后期间使用草药似乎在经验上是没有根据的。
