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Drugs and Lactation Database (LactMed)

Related Articles Drugs and Lactation Database (LactMed) Book. 2006 Authors: Abstract Acupuncture at traditional Chinese medicine (TCM) sites used to treat low milk supply has been claimed to cause release of prolactin and oxytocin, although published studies have found mixed results on serum prolactin. In one study, acupuncture did not affect prolactin hyperresponsiveness after stimulation with metoclopramide in women with amenorrhea-galactorrhea syndrome. Galactorrhea has been reported following acupuncture for pain treatment. No adverse effects on milk production were seen among lactating women who received acupuncture for postpartum sciatica.[1] Acupuncture has been well described in TCM for treating insufficient milk supply,[2][3] and is also recommended in some Western countries.[4] Numerous studies found acupuncture at CV 17 (also referred to as Ren 17 or Shanzong; located at the center of the sternum), SI 1 (Shaoze; on the little finger), and ST 18 (Rugen; lower breast margins) to benefit women with a low postpartum milk supply. These studies generally do not meet current evidence-based guidelines, partly because of the extreme difficulty in double-blinding and placebo-controlling acupuncture studies. However, 2 studies did find a better response to electroacupuncture applied at a traditional site for lactation stimulation (SI 1) than electroacupuncture applied at a site unrelated to milk production (LI 1). None of the studies reported to date have made an attempt to optimize maternal nursing technique before acupuncture. Although less studied, acupressure at milk acupuncture sites has had similar effects. Galactogogues should never replace evaluation and counseling on modifiable factors that affect milk production.[5] Acupuncture therapy has been used to treat breastfeeding for milk stasis (engorgement). Randomized, nonblinded studies in an outpatient Swedish lactation clinic compared routine care (including oxytocin spray) to routine care plus acupuncture at 2 or 3 points for treating milk stasis.[6][7] A meta-analysis concluded that women who received acupuncture were less likely to develop an abscess, had less severe symptoms on day five, and had a lower rate of fever than women in the usual care group However, there is insufficient evidence from published trials to justify widespread implementation.[8] A survey of 50 Swedish maternity units in 2007 found that 60% of hospitals used acupuncture to treat milk stasis, 18% used acupuncture to treat mastitis, and 2.2% each used it for painful breastfeeding or to improve milk supply. The authors felt that this extensive use was not justified based on the limited evidence for most of these uses.[9] Auricular therapy uses stimulation of acupoints on the ear corresponding to various anatomical sites and functions of the body for the diagnosis, treatment, an prevention of disease. A systematic review of 26 studies on auricular therapy to increase milk supply included 3691 patients All studies applied vaccaria seed to press on ear acupoints. Overall, studies found a positive effect on milk production, onset of lactation, serum prolactin, breast fullness, neonate states, and frequency of newborn urination and defecation. No adverse effects were reported.[10] PMID: 30000950