Malnutrition is one of the major challenges for infants and children throughout the world. Breast feeding is a natural way of providing infants with the essential nutrients and is recommended as a perfect food for newborns. According to the WHO, breast feeding should be initiated within the first hour of birth and should be continued up to six months. Qilla al-Laban is a condition mentioned in Unani medicine in which breast milk production decreases or becomes scanty. It is due to the altered blood quality or quantity, Sū'-i-Mizāj and Ghalaba-i-Akhlat. Muwallid-i-Laban is an agent that promotes the secretion of milk. Synthetic drugs for augmentation of lactation have major safety concerns. Several galactogogues like Satawar, Musli safaid, etc. are being successfully prescribed by Unani physician since ancient times. This chapter describes various galactogogue mentioned in Unani system of medicine for promoting the production and secretion of milk. The dietary recommendations and drugs used to increase milk production are from natural source and chances of adverse effects are minimal.
Top1. Introduction
Malnutrition refers to deficiencies, excesses, or imbalances in a person’s intake of energy and/or nutrients. It includes undernutrition (wasting, stunting and underweight), micronutrient related malnutrition (deficiency or excess of any micronutrient) and overweight, obesity and diet related non communicable diseases (diabetes, cancer etc.) As per latest data 1.9 billion Adults are overweight or obese, while 462 million are underweight all over world. Nearly 47 million children under 5 years of age are wasted, 14.3 million are severely wasted and 144 million are stunted, while 38.3 million are overweight or obese. Around 45% of deaths among children fewer than 5 years of age are linked to undernutrition (WHO, 2020). The World Health Organization (WHO) has recommended exclusive breastfeeding up to six months of age (WHO, 2007; WHO, 2009). Breast milk is complete and balance food for infants and contains antibodies for protection from many childhood ailments. It is the best source of clean and safe food for children. Breast milk provides all nutrients for overall development of the infants and these children are less prone to develop diabetes and other non communicable diseases in later life. Breast milk substitute does not provide required nutrients and energy as well as it is not clean and safe. Globally only 41% of children are exclusively breastfeed for recommended 6 month period and this trend has not changed in two decades (WHO, n.d.).
Breast milk is easy to digest and promotes adequate growth and development in infants. It contains enough water (87%) for the baby's needs of water and nutrients which are well absorbed. Breastfeeding also develops emotional and social bond of the infant with mother (Mother and Child Nutrition, 2020). Suboptimal or non exclusive breastfeeding contributes around 12% mortality in children below 5 years of age (Poshan, 2020). Children who are not breastfed exclusively for initial six months of their life are more prone to gastrointestinal infections, respiratory illness, high mortality (Ip et al., 2009; Jones et al., 2003; Kramer et al., 2003), type II diabetes (Pettitt et al., 1997), and obesity in later life (Kramer, 2010). Several research has provided strong evidence that breast feeding in human decreases the incidence of various infectious diseases (Heinig, 2001) such as bacterial meningitis (Cochi et al., 1986; Istre et al., 1985), diarrhea (Beaudry et al., 1995; Howie et al., 1990; Popkin et al., 1990), respiratory tract infection (Chulada et al., 2003; Lopez-Alarcon et al., 1997; Oddy et al., 2003) and urinary tract infection (Marild et al., 2004; Pisacane et al., 1992). Breast feeding have many beneficial or protective effect such as decreased postpartum bleeding (Chua et al., 1994), decreased menstrual blood loss (Kennedy et al., 1996), decreased risk of breast cancer (Enger et al., 1998; Lee et al., 2003; Newcomb et al., 1994; Tryggvadottir et al., 2001) and ovarian cancer in lactating mother (Rosenblatt & Thomas, 1993).
Several factors play an important role in inhibition of production of breast milk. Preterm labour, illness of mother, endocrine conditions like hypothyroidism, diabetes, and polycystic ovarian syndrome, obesity, anxiety, depression, fear and emotional stress are common causes of suppressed lactation. Galactagogues are food or drugs used to sustain the initiation, continuation, or augmentation of breast milk production. These galactagouges are prescribed to mothers who are not able to feed appropriately due to low production of milk (Abascal & Yarnell, 2008; Mathur & Dhingra, 2009).
According to the Unani system of Medicine milk, semen and blood are different fluids of the body; their composition, texture and other properties differ from each other and produced by different organs but the causes of production of these is common (Arzani, 1924; Jurjani, 2010). The main reason for deficiency of these three body fluids depends upon Mizāj (temperament) and Mādda (active substance) of whole body or Mizāj (temperament) of specific organ for the production of respective fluid (Kabir-al-Din, 2003; Arzani, 1924; Jurjani, 2010). Akhlat (humors) are fluids of the body that serve the functions of nutrition, growth and repair of the organs. The body contains four Akhlat (humors), Dam (sanguine), Balgham (phlegm), Safra’ (yellow bile) and Sawda’ (black bile). Khilt-i-Dam (sanguine) has hot & wet Mizāj (temperament), Khilt-i-Balgham (phlegm) cold & wet, Khilt-i-Safra’ (yellow bile) hot & dry while Khilt-i-Sawda’ (black bile) cold and dry temperament (Ibn Sīnā, 1411).