HERBS IN PREGNANCY AND LACTATION: A REVIEW APPRAISAL

HERBS IN PREGNANCY AND LACTATION: A REVIEW APPRAISAL

Poonam Shinde*, Pankaj Patil and Vinod Bairagi

Department of Pharmacognosy and Phytochemistry, K.B.H.S.S. Trust’s Institute of Pharmacy, Malegaon- 423105, Dist- Nashik, Maharashtra, India

ABSTRACT

Pregnancy can be the most paranormal and exciting time for expectant mother. Nature provides us with many tools for supporting both the mother and baby through this time of growth and renewal, to strengthen the spirits and body to promote a healthy pregnancy and birthing process. Pregnant and lacting mother need to be educated on the need for caution when using herbs during pregnancy and lactation particularly in view of lack of complete information. The women self administer herbal medicines both before and after pregnancy often without any recognition of their potential hazards. The use of herbal supplements in pregnancy and lactation is likely to be relatively high and its importance ascertains what supplements women are taking. Pregnancy and lactation care providers should be aware of common herbal supplements used by women and of evidence regarding potential benefits or harm.  Midwives and obstetricians have an obligation to facilitate women’s wishes without condemnation, but this must be tempered with accurate information to ensure that use of herbal remedies in pregnancy and breastfeeding is not only appropriate but also safe if use with proper caution. The herbs listed in this review are recommended by experienced herbalist and have been used safely by women for centuries.

Uterine stimulant

INTRODUCTION: Herbs are not pharmaceutical medications. Herbs are part of whole plants, not isolated or not synthesized chemicals. Herbal effects have to do with the synergistic action of nature’s formulation. Drugs and herbs are used differently but both can be extremely beneficial when used appropriately. During pregnancy, drug ingestion may not affect only mother, it may cross the placenta also adversely affect the unborn fetus, causing congenital malformation and other deleterious effect. Some herbs are unsafe during pregnancy because they can induce uterine contractions that could lead to miscarriage, a premature birth or injury to the fetus. Others herbs are harmful during pregnancy because they can cause high blood pressure, birth defects or even death.

Although herbs have served us well for centuries as seasonings and natural remedies, these herbs to avoid during pregnancy are potentially harmful to mothers and developing babies ¹. The use of herbal medicines in pregnancy is extremely fashionable although there is very little real evidence of safety ².

The incidence of use by expectant mother is unconfirmed, but is usually associated with prior knowledge, and has been quoted as varying between 7% and 55% with Echinacea and ginger most frequently used ³. Although the majority of women discontinue taking herbal medicines once they are aware of their pregnancies, many others commence taking them on advice of their maternity care providers ⁴.

However, while pregnant women recognize the potential of dangers of inappropriate drug use, they fail to appreciate that the chemicals in herbal medicines also have the power, if used incorrectly, to trigger abnormal pathology through toxicity. There appears to be in an implicit belief that, because herbal remedies are natural, they are autonomically safe ⁵ but important is that pregnant women do not view them as a panacea for all their symptoms, without understanding that there is that a complex patho-physiology and pharmacology involved.

There is limited data on the extent of women’s use of herbal medicines during pregnancy, despite the fact that knowledge of the potential benefits or harms of many of these herbs is sparse, particularly with respect to their pregnancy and lactation.

The present study suggests that there is need for improved education of health care professionals and consumers, as well as quality control legislation and further well-designed studies to establish safety and efficacy of various herbal remedies for pregnant and lacting mother.

Herbs that safe during pregnancy: During the first trimester of pregnancy (the first 13 weeks), the baby’s organs are developing rapidly. It is during this time that fetus is most vulnerable to the harmful effects of external factors. All food, liquids, medications and other substances that the mother ingests pass through the placenta to the developing fetus ⁶.

In general, the safest herbs to use during pregnancy are those considered food or tonic herb. These herbs are used as food and can be eaten on daily basis without toxic concerns. They may be taken in capsule form or used as a tea or infusion.

Although herbs are not necessarily needed by all women during pregnancy, the following herbs are recommended by experienced herbalists and have been used safely by women for centuries ⁷.

TABLE 1: HERBS THAT SAFE DURING PREGNANCY ^8-11

Herbs that avoid in pregnancy ¹²:

1. Herbs traditionally used to stimulate menstruations (Emmemnagogue’s): These may stimulate the smooth muscle of the uterus and may  thus pose a risk of reliable abortifacient  viz. Angelica, celadine, bearberry, motherwort, southernwood, black cohosh, Ephedra, mugwort tansy, blue cohosh, feverfew.
2. Alkaloid containing herbs: Alkaloids are a diverse group of chemical plant constituents that have a wide range of pharmacological impact upon the body. Sometimes these compounds have very potent and have been isolated as medication or have been identified as the active ingredients. These are best avoided in pregnancy. Viz. Autumn crocus, broom comfrey mandrake, barberry, coffee, blood root, goldenseal.
3. Oil containing plants and essential oil: Some essential oil is potentially very dangerous to the pregnancy if taken internally during pregnancy. All essential oils should be treated with great respect and appropriately diluted for the intended use. Sometimes the whole plant use in moderation is relatively safe, but exceptions to this exist and it is best to avoid any ingestion of following plants; Arbore vitae, Juniper, Pennyroyal, Nutmeg.
4. Anthraquinones Laxative: These compounds are very potent stimulators of bowel peristalsis. Overstimulation of bowel or inflammations of the bladder are known to irritate the uterus in sensitive women and cause premature labor; Alder buckthorn, Cascara sagrada, Purging buckthorn, Senna.
5. Herb thought to have an effect on the hormonal system. Viz. Ginseng, Liquorice.

TABLE 2: HERBS ARE UNSAFE IN PREGNANCY AND LABOUR ^13-15

Lactation: Although the benefits of breastfeeding may be self evident, they are also increasingly demonstrated by science. Benefits include the superior nutritional composition of breast milk ¹⁶, reduce incidence of feeding intolerance and necrotizing enter colitis in preterm infants ¹⁷, and enhanced resistance to infectious diseases ¹⁸. There is also a significant psychological benefit for both mother and infant. It is beyond the scope of this article to explore the myriad of ways botanical medicine could be safely used by breastfeeding women. Some constituents of herbs are excreted in breast milk and are, therefore ingested by a nourishing baby. Some of the herbs on list are included because they contain constituents that may be harmful to mother or baby. Other herbs should be avoided because they are traditional antilactagogues used during weaning and can reduce breast milk production.

TABLE 3: HERBS USED DURING LACTATION

TABLE 4: HERBS AVOIDED DURING LACTATION ^19-22

Depending on circumstances, these herbs ingest combination in the form of pills, tablet, granules, tincture and decoction (tea). Some of the treatment plans involve using single herb combination regularly, while other suggests using two or even three different formula.

CONCLUSION: In present study showed herbs can provide substantial relief for common complaints and concerns that arise during pregnancy, childbirth and lactation, the power of herbs should be respected, in short they should be used with caution. However, many herbs may be contraindicated on the basis of very limited findings, erroneous reports, or by association with a problem rather than a proven causal effect. Good diet, exercise, a healthful lifestyle, a positive outlook and strong social support are the cornerstones of an optimal childbearing experience.

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    How to cite this article:

    Sethi S, Harikumar SL and Nirmala: A Review on advances in Colon Targeted Drug Delivery System. Int J Pharm Res Sci. 3(9); 3001-3006.

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