EFFECTIVENESS OF NATALAC AS A GALACTOGOGUE - Go

EFFECTIVENESS OF NATALAC AS A GALACTOGOGUE
Corazon Yabes-Almirante, M.D.*
Catherine Hui Tiin N. Lim, M.D. **
Researched done by Sugarpod Naturals/Go-Lacta®
ABSTRACT
An investigation was undertaken to determine the effectiveness of malunggay or Moringa oleifera leaves
(encapsulated into Natalac, each capsule containing 250 mg. of malunggay leaves) as a galactogogue among
normal parturients. A total of 116 normal term pregnant Filipino women were included in the study. These
mothers do not intend to feed milk formula, nofgive their babies solid foods before 4 months of age, and their
babies were of normal gestational age and weighed between 2500 and 5000 grams at birth. Immediately after
delivery, the patients were given capsules which were coded at source: 58 Natalac and 58 placebo. Prolactin
determinations were done within 6 hours, 48 hours after, and 4 months after delivery. Infant suckling was
immediately started after the first extraction for prolactin. The baby's weights were recorded at birth, at 1Week,
at 2 weeks, at 1 month, and at 4 months of age. Data obtained were subjected to statistical test: t-test for ·
difference between means.
Significantly higher prolactin levels were obtained after 48 hours and 4 months from first extraction among
the treatment (Natalac) group at a p level of < 0.01 accompanied by significant weight gains among the babies
at a p level of -;::. 0.01.
Keywords: Galactogogue, Moringa oleifera, Breastfeeding
,., .
....
'. INTRODUCTION
other's milk is the best food for its newborn.
The campaign for breastfeeding is being
pursued by the Department of Health, the
fld Health Organization . (W.H.O.), the United
ionas International Children's Educational Fund
NJ.C.E.F.), and all organizations involved with the
rovement of the health of the mother. and the
'. 1
nt.
reastfeeding is much more ben'eficial to the
. om than bottle feeding . Mothers are convinced
'.>the advantages of breastfeeding but most
: they complain about the inadequacy of milk
from their breasts. 2
nggay (Moringa oleifera) leaves in chicken
. llfish soups have been used by generations of
mothers to enhance breast milk production.
cpanism of action
not been explained but
· .ffective as a galactogogue ( an agent that
.
the secretion of milk). Malunggay
V;e been encapsulated in the form of Natalac
t
Peiinatology, Peiinatal Center, Philippine Children's
iar.
2
"
.•t of Perlnatology,
Center, Philippine
dical Center.
13,t;y:Jt.t NO, 3 JANUARY - MARCH 1996
and one · capsule is equivalent to 250 mg. of
malunggay leaves.
A study of the
of milk
production depends on several processes:
"" 1 '
1. Mammogenesis or development of the mammary
glands - ductal growth and lactoalveolar . growth
through estrogen, progesterone, growth hormone,
· prolactin, and glucocorticoids. 3 • 4• 5
2. Lactogenesis or initiation of milk secretion this depends on a fully developed mammary gland
and .the withdrawal of estrogen and progesterone on
delivery of the baby and placenta. 6 •· 7
3. Galactokinetic hormones - oxytocin is the
most powerful galactokinetic hormone causing
contraction of the myoepithelial cells squeezing out
the milk in the lumina of the alveoli into the ducts.
The stimulus for . oxytocin release Is the suckling of
the infant. Oxytocin release is e5sential for mDk removal.
Frequent suckling and adequate milk Injection
therefore promotes
p.rodµption of milk. The reflex
' release of oxvtocin ls experienced as "milk
let-down." 8 • 9 • 10' · ·
Oxytocin released during suckling affects the
uterus by causing it to contract expelling the lochia
favoring involution. Oxytocin release can be Inhibited
by stressful situations.
4. Galactopolesis - maintenance of established
milk secretion. Prolactin Is the single most Important
265
Researched done by Sugarpod Naturals/Go-Lacta®
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galactopoietic· horn:ione; ·Hans Selyewas:,theJirst to··-· .
realize'thatsucklirig provides' the stimulus that supt}orts" '
lactation. Each suckling episode is associated with a
rapid rise in plasma prolactin. Prolactin levels peak in
20 to 40 minutes and return near the baseline In
4 11 12
about 3 to 4 hours. • •
Frequent nursing is required to maintain the
elevated prolactin on which continued milk secretion
depends. A delay of 1 to 2 days in the Initiation of
nursing results in diminished responsiveness of the
pituitary. Nicotine decreases the amount of Rrolactin
13 14
released in response to the suckling stimulus. •
Drugs that stimulate prolactin release are
reserpine, metoclopramide, sulpiride, and thyrotropin
releasing hormone (TRH). 3
OBJECTIVES
An investigation was undertaken to determine the ---·
effectiveness of malunggay (Natalac) as a galactogogue
among normal patients.
MATERIALS AND METHODS
A total of 116 normal term pregnant Filipino "
patients from Barangay del Remedio in Sail Pablo
City were included in the study which lasted from
November 1994 till September 1995. Selection criteria
for the study were as follows: (1) mothers did not plan
to feed milk formula, (2) solid foods would not be
introduced before 4 months of age, (3) infants were
healthy, were of normal gestational age {38 to 42
weeks gestation) , and weighed 2500 to 5000 grams
at birth; and (4) mothers did not have .any chronic
illness and were not taking any medication on a
regular basis. Informed consent was obtained from
all mothers.
- Immediately after delivery, patients were given
capsules, the content of which the researchers do
not know. The capsules have been coded at source:
58 Natalac (NATC-T) and 58 Placebo (NATC-F) . The
administration of these capsules were repeated after
every 12 hours for four months.
Prolactin determination was done by extraction of
4 ml. whole blood from the antecubital vein of the
postpartum women at three stages:
1. within 6 hours of delivery before infants suckling
and capsule intake
.
2. 48 hours after delivery - 30 minutes after infant
suckling
3. 4 months after delivery - 30 minutes after infant
suckling
·
The blood was allowed to stand to effect separation
of serum was extracted
of the serum. About 1
thereafter and subjected to prolactin determination
using the ELISA (Enzyme: linked immunosorbent
assay) technique.
·-....._
266
- - Jrifant ·suckling·, was 's tarted .V'Jithin 6 to 12 hours
·aftE!r delivery for a ' duration of 1o to 15 minutes to
each breast, every 2-1/2 to 3 hours for a total of 8 to
10 times a day. The timing of the appearance of
breast engorgement and milk let-down were
recorded.
The infants' weights were recorded at birth, at 2
weeks, at 1 month, and at 4 months of age .
Data obtained from this double-blind study were
subjected to statistical tests: t-test for difference
between means.
RESULTS
, _ .Table 1 shows the age, parity, type of capsule
taken, and levels of serum prolactin, each of the three
extractions done during the study. While Table 2 lists
..the infants' weights recorded at different periods 'in
the study.
The desired sample -size was 100. To allow for
<attrition,..we recruited 120 subjects. The number of
mothers who remained in the study at 4 months were
116. Four subjects dropped out; one for Infant
mortality, three for transfer of
The average age was 27.53 years with a standard
deviation of 6.4663 for the Natalac or treatment group
and 26.58 years with a standard deviation of 5.6547
for the placebo group. Ten per cent (10%) and 17%
were primiparas while 90% and 83% were multiparas
in the treatment and placebo groups, respectively.
(Table 3)
Breast engorgement occurred 24 hours after
delivery In the majority of patients from both groups:
98.3% for both the treatment and placebo groups
(Table 4) . Milk _let-down for these patients occur.red
after 48 hours (Table 5).
Table 7 shows the mean level$ of serum prolactin
at first, second and third extractions between the two
Prolactin levels were higher in the treatment
group and are significant at a p level of < 0.01 for the
second (t value = 4. 789) and third (t value = 13.27)
extractions. There Were also significant increases of
prolactin values ' during the latter two extractions In
the treatment group as compared to the placebo
group at a p level of <0.01. t values 'obtalned were
5.824 and 5.372 -for differenced·.betWeenthe baseline __
or first extraction with the second and third -.
extractions,.respectively.
A record of the infants' weights at birth; at 1 week, ._
at ·2 weeks, at 1 month, and at 4 months are
on Table 2. Table 6, on the other hahd, contained
statistical data on the infants' weights which revealed _
significantly higher weight gains among the babies
from the treatment group at a p level of < 0.01 . t values were 3,165 at 1 month of infant age and 5,362
at 4 months of age.
JPMA VOL71 NO. 3 JANUARY- MARCH 1996
r
ic··
I
Table I. Maternal Age, Parity, and Serum Prolactln Levels.
Researched done by Sugarpod Naturals/Go-Lacta®
PATlENT
AGE
30
E.C.
20
M.A.
25
B.C.
22
J.J.
22
5. N.V.
18
6. B.A.
27
7. U.P.
24
8. R.J .
28
9. J.A .
19
10. E.B.
22
11. tvl.S.
28
12. J.B .
3(,
11. R.P.
28
14 . R.A.
llJ
15 . R.E.
37
16. T.R.
]2
17. E:B.
41
18. L.M.
28
19. H.Y .
.n
20. C.S .
21. L.G.
D
25
22 . R.R.
23 . F.D. . 29
18
24 . M.A.
27
25. E.T .
20
26. M.B.
ii
27 . M.P.
34
28 . R.R.
23
29. S.D .
26
30. A.{).
24
31. R.P.
'.11
32. M.N .
28
33 . E.V.
34. IU •.
25
32
35. R.M.
36 . L.C.
35
-37. M.O.
:rn
38. S.B.
30
39. R.D.
32
40. c.v.
24
41. C.N .
28
42 . c.c.
25
43 . C.1'-.1.
21
2,3
44. M.C.
25
45. R.B.
26
46, N.M.
,47. EJvL
28
48. G.D.
19
24
49. D.P.
30. M.L.
21
:s I. R.C.
30
52. f\4 .!VI.
2I
25
53 . N.R.
54. R.N.
33
27
55. J.C.
56. C,H.
25
57. E.A.
IS'
58. E.T.
23
59. C.P.
37
1.
2.
3.
4.
JPMA VOL. 71 NO. 3
PARITY
CAPSULES
TAKEN
G3P3
GlPI
GI Pl
GlPI
G2P2
G8P6
GWJ
G2P2
Ci2P2
GIPI
UIPI
Ci2P2
G8P7
G2P2
GIPI
G4P3
G5P5
G5P5
GIP!
G<iP6
G6P(i
GIP!
G4P4
Ci 11' I
GWJ
GIPI
G2P2
G6P6
G2P2
G2P2
G3P2
G4P3
G2P2
NATC-T
NATC-T
NATC-F
NATC-F
NATC-T
UWJ
'
G2P2
G-lP·I
G.11'3
GIP!
G5P5
GIPI
GJP3
d2P2
GIPI
G3PJ ·
G2P2
G2P2
G3P2
G2P2
G3P3
G2P2
G3P3
GIP!
' G2P2
G4P4
G2P2 ·
G2P2
: G2P2
G2P2
G4P4
NATC-T
NATC-F
NATC-T
NATC-F
NATC-T
NATC-F
NATC-F
NATC-T
'NATC'-T
NATC-T
NATC-T
NATC-F
NATC-F ·.
NATC-F
NATC-F
NATC-T
NATC-T
NATC-F
NATC-F
NATC-T
NATC-T
NATC-F
NATC-F
NATC-F
NATC-T
NATC-F
NATC-T
NATC-F •
NATC-T
NATC-T
NATC-F
NATC-F
NATC-F
NATC-F
NATC-t .
.
NATC,F
NATC-T
NATC-F
NATC-F .
NATC-F
NATC-F
NAtC-F
NATC-F
NATC>F
NATt:-T
' "''"NATC-F
NATC-l'
MARCH 1996
FIRST
' EXTRACJ'lON
_8412 mlU/I
5827 m!U/1
. 3009 rill U/I
7669 mlU/l
5426 mIU/l
3083 11ilU/I
5481 mlU/l
8520 mlU/I
2354 mlU/I
'.15Ci'J mlU/I
4 771 mlUtl
4283 mlU/I
7636 ml U/I
7604 mlU/l
2070 mlU/l
4205 mIU/I
2987 ml U/I
3459 mIU/I
5348 mlU/1
>8800 1.n!Uil ·
5016 mll.Jlt
4420 mIU/I
4804 mlU/I
6451 mlU/I
5063 mlU/I
5221 mlU/I
6621 rn!U/I
>8800 inlU/l
6263 mIU/l
· >8800 mlU/I
3423 mIU/1
4620 mlU/l
8256 mllJ/l
4667 mlU/I
2632 mlU/I
: 106 I mlU/I
4007 mlU/l
5020 mlU/I
2753 m!Uil.
6112 mlU/I
·3350 mlU/I
3988.mlU/I
411JmlU/I'
- 1!41 ml Liii
3469 mlU/l
. '6540 mlU/l
5791 mIU/I
...5504 mIU/l
13 96 ml U/i
158 mlU/1
4442 mIU/i
4522 mIU/I
5667 m!U/I
· 6179 mlU/I
1111u11 '
7925
4087
3308
1272
mlU/I'
m!U/I
mJU/l
mIU/I
SECOND
EXTRACTION
7818 mlU/1
7350 m!U/I
3308 mlU/I
4265 1111011
3589 mIU/1
8332 m!U/I
3360 mlU/1
5954 m!U/I
·685 mIU/l
6549 miU/I
6948 m!U/l
6777 mlU/I
2349 mlU/I
5698 mIU/I
3292 mIU/I
4302 mIU/I
5689 mIU/I
5007 mIU/I
1546 mlU/I
2751 . mTU/l
4161 m!U/I
I 13ll mlU/1
7472 mIU/l
. 5870 mlU/I
6923 m1u11
3609 mIU/l
5572 mIU/l
3811 m!U/l
· 7758 mIU/1
7513 mIU/l
1973 lnIU/1
1673 mlU/1
7952 mIU/I
4869 mlU/I
7203 mIU/I
1686 mlU/l
3958 mIUil
1503 mJU/l
1032m1U/l
5955 miU/1
1884 inlU/l
2526 rnlU/I
3472 mlU/I
1022 mlU/I
· 4908 mIU/I
24'\8 mIU/1
436 m!U/l
480 11tlU/I
1512 mIU/ll
2421 mJU/I
146 i i111U/I
268 m!U/I
3665 nilU/I
748 111IU/l
860 mIU/I
5896 mlU/I
4 i39 mlU/1
.385!m1U/l
3605 mlU/l
TllIRU
CTI 0 N
1431 mlU/I
1797 mlU/I
575 mlU/I
360 m\U/1
176 7 mIU/1
1172 mlU/I
1387 mlU/l
305 mtU/I
· 779 miU/I
dropped out
376 mlU/I
2019 mlU/I
513 mlU/I
116.mlU/I
J 160 mlU/I
2396 mlU/I
2639 mlU/i
1737 mlU/I
448 lnlU/I
316 rnlU/l
502 mlU/l
251 mlU/I
707 mJU/1
209 5 ml U/I
1621 mlU/I
622 mIU/1
770 111\U/I
2568 mIU/I
3232 mIU/l
128 mlU/I
235 mlU/I
451 m!U/I ·
2970 mll.rtl
TJ5 mlU/I
2835 m!U/I ·
300 mlU/l
1371 mlU/I
1975 mlU/1
500 ml U/I
690 mlU/l ·
402 ml U/I
'x6 I m IU/I
265 mlU/I
752 uilU/I
2391 mIU/l ·.
851 mlUJI
750 111 IU/l
555 111,IU/I
1206 111 IU/I'
177 mlU/I
261! mfU/I
1 48.mlU/l
690 mlU/l
113 mIU/I
. 886 m!U/I
DROPPE_D OUT
3245. mlU/l
mlU/1
2001 mlU/l
267
i
,
lI
60.
61.
62.
63 .
64.·
65 .
66.
67.
68.
69 .
70.
71.
72 .
73 .
74.
C.M.
E.S.
N.C.
E.L.
E.R.
l.G.
76.
77 .
78.
79 .
80.
81.
82.
83.
84.
85.
86.
87.
88.
89.
90.
9.i.
92.
93 .
l.G.
G3P2
G2P2
G4P3
GIP!
G2P2
GIP!
GIPI
GIPI
GJP3
G4P4
G3P3
G2P2
GIP!
G2P2
G2P2
31
30
35
32
24
28
22
25
28
34
s.c.
M.T.
L.C.
A.A.
J.C.
22
19
15
29
24
211
25
20
32
V.A.
E.S .
M.V.
·M.F.
1:. . 1\1 .IJ .
E.R.
V.M .
nE.
GWJ
G2P2
G2P2
G6P5
G5P·t
G2P2
G3P3
G2P2
G4P4
GIP!
G2P2
G3P3
G2P2
G3P1
G7P7 .
G2P2
G2P2
G2P2
G3P3
G2P2
G2P2
G3P3
G2P2
G6P6
G4P4
GIP!
G3P3
·02p2
G4P4
G2P2
39
A.S.
34
E.J .
J.E.
J.Y.
21
26
44
21
36
28
A.A.
H
J.G.
21
37
19
25
20
21
27
26
28
32
40
38
15
21
22
27
25
2!1
13
S.A.
A.E.
W.R.
s.c.
A.A.
N.M.
R.S.
A.B.
R.V.
95 . B.T.
96. M.C.
97 . B.G.
98. H.R.
99. A.M.
100. P.B.
101. E.M.
102. B.L.
103. M.N.
104. C.G.
105. A.r:.
106. R.H.·
107. V.M.
108 .. E.S.
109. M.T.
110. J.T.
Ill. A.A.
112. C.C.
113. J.S. ·.
114. L.A.
115. M.L.
ll6. B.L.
117. RD.
118. P.S.
I 19. l.T.
120.
G3P.l
02P2
G.2P2
G3P3
·G2P2
.G2P2
G2P2
G3P3
G3P2
GIPI
G2P2
:;.3
27
22
20 .
26
28
30
25
24
36
27
28
23
24
G4f'4
'
G3P3
G2P2
G2P2
G3P3
4750 mIU/l
8317 mJU/l
8283 mIU/I
3169 mIU/l
4511 mlU/I
5073 mIU/1
4443 mlU/I
7664 mIU/l
3896 mIU/l
1405 ml\J/I
7881 mlU/1
1333 mlU/1
4608 mlU/I
2438 miU/I
2945 mill/I
bll-11 mlU/I
75.JI mlU/1
2948 mlU/l
609 mlU/I
285 mlU/I
7160 mJU/I
6266 mIU/l
4735 mIU/I
2383 mIU/l
1420 m!U/I
3809 mlU/l
4245 mIU/I
2919 mIU/l
6449 mlU/I
2261 mIU/l
1548 mIU/l
5346 mIU/l
4880 mIU/I
>8800 mlU/l
5087 mJU/l
6883 mIU/l
5504 mIU/I
7743 mIU/l
4552 mlU/I
5229.mIU/1
7542 mIU/l
5540 mIU/l
6575 mI:lJ/I
8800 ml U/l
3292 m!Uil
26·10 mlU/1
609 I mlU/I
NATC-T
4126 mlU/I
NATC•T ·
·. 6594 mlU/l
NATC-"I:
sooo mIU/l
NATC-T
NATC-T. · ·.. 3021 mIU/l
>8800 nHU/I
NATC-F
3778 mJU/l .
NATC-F .
NATC-F
2493 mll,111
-6134 m!U/I .
: >8800 mIU/I ..
NATC-T
NATC-F
.8769 .mIU/1
5660 mJU/I
NATC·T ·
NATC-F
.. 7665 mIU/I
NATC-F
7945 mllm
NATC-F
6854 mIU/I
NATC-T
NATC-T
NATC-T
NATC-T
NATC-F
NATC-T
NATC-T
NATC-T ·
Nf\TC-T
NATC-F
NATC-F
NATC-r
NATC-F
N/\TC-F
NATC-T·
NATC-T
NATC-T
NATC-T
NATC-F
NATC-T
NATC-T
NATC-F
NATC-T
NATC-F
NATC-T
NATC-T
NATC-F
NATC-T
NATC-F
NATC-T
NATC-T
NATC-T
NATC-T
·. NATC-F .
NATC-F
NATC-F
NATC-T
NATC-T
NATC-T
NATC-T
NATC-T
NATC"F
NATC-F
NATC-T
NATC'-T
5557 mlU/I
7642 mlU/I
7629 m!U/I
2175 mIU/I .
1651 mIU/I
6030 m!U/1
6022 mIU/I
>8000 mIU/l
3339 mIU/I
2036. mIU/L
3051 mlU/I
I 3!.13 mlU/I
DROPPED OUT
2000 mlU/I
· 1637 mlU/I
57 Hi mLU/1
3053 mlU/I
3305 mlU/l
897 mlU/I
DROPPED OUT
7009 mIU/I
2453 mIU/I
2399 mIU/1
2166 mlU/I
2876 mIU/I
4690 m!U/I
3978 mIU/l
224 1 mJU/l
5191 mIU/l
5898 mJU/I
+326 mIU/l
8649 mIU/l
2588 mIU/l
4479 inIU/l
4595 mlU/l
6878 mJU/I
>8800 mIU/t
· 6893 mIU/l
7888 mJU/l
>8800 mlU'1
3892 mJU/l
4884 imJU/I
8132mlU/l
5492,mTU/I
500 I mlU/I
4336 mlU/l
6 I 76 mlU/l
4856 mIU/l
"6998 mIU/l
2789 mIU/I
5234 mIU/l
. 4116 mIU/I
I851 .niiU/l
5259 m!U/1
7758 m!U/I
. 6004 mJU/I
4610 ml.LJ/l
6042 m!U/I
5255 ml 0/1
4089m!U/I
Researched done''"'·by Sugarpod Naturals/Go-Lacta®
,..' · 268
.
1987 mIU/I
3701 mlU/I
2558 mJU/I
1875 mlU/I
460 mlU/I
2100 mlU/I
2692 .mlU/I
3112 mlU/I
4.732 mlU/I
302 mlU/l
145 ··m IU/I
288 mIU/L
724 mlU/I
1243 mlU/L
4.10 I mlU/I
I 189 mlU/I
2141 mlU/I
· 490 mlU/1
1895 mIU/I
400 mIU/l
3171 mlU/l
363 mlU/I
2455 mlU/1
1329 mlU/I
322 mlU/I
1301 mIU/l
486 mlU/I
3366 mlU/I
1884 mJU/l
2198 mIU/l
1494 mlU/I ·
504 mJU/I
650 mlU/I
mIU/I
·
3098 mlU/I
3550 mlU/l
2899 mlU/l
42l)8 m!U/1
2817 m!U/l
752 mlU/l
801 m!U/1
1939 mlU/I
3048 mlU/1
2948 mlU/I
2.443 ,,,1u11
3788 mlU/I
4216 mlU/I
3223 mlU/l
3126 mlU/l
476.m!U/I.
493 mIUil
li9 mlU/I
155_mJU/1 ·
3878 mlU/I
802 m!U/I
3050 mlU/1
498_mlU/I
628 mlU/I
S20 mlU/I
JPMAVOL 71 N0.3 JANUARY - MARCH 1996
I
II
.
:'j"
'.1
1
t
. .
·I
r· //
.
t·r
/
/
Table II. Records of Infants Weights (Kg).
Researched done by Sugarpod Naturals/Go-Lacta®
PATIENT
1. E.C.
2, M.A.
3. B.C.
4. J.J.
5. N.V.
6 . B.A.
7. B.P.
8. IU.
9. J.A.
10. E.B .
11. tvt.S.
12. J.B.
13 . R.P.
14. ll.A.
15. R.E.
16. T .R.
17. E.B.
1-8. L.M .
19. H.Y.
20.
21. L.G.
22. R.R.
23 . F.D.
24 M .A.
25 . E.T .
26. M.B.
J:6
:u
:u
.·'·-3.0.,
S.D.
A.O.
2.!I
2.7
2.92
2.7
2.5
2. 7
:1. I !I
2. 7
R;P.
3.2
M.N.
2.7
3.4
2.8
2.9
3.0
3. 18
3.22
3.6
E.V.
R.L .
P
'vi.
40. c.v.
41. C.N.
M.C .
46.
G.D.
) . (1
j)i.,,
60. M .L.
51. R.C.
2.7
3.11·
52. M.M ..
53 . N.R.
54 . R.N.
55 . J.C .
J.0
P.C.
60. C.l\t
2.8
3.0
3.18
2.6
3.5
J .6
3.4
2.7
3.0
. 3.11
2.6
3.32
:u
49. D.P.
58. E.T.
3A
2.<i
N .M.
47 . E.M.
56. C.11.
57. E.A.
2.7
3.23 .
2.7
3. 1
2.8
3.3
2.8
2.8
3.2
3. 18
3.1
3.6
3.2
3.2
3.32
3.4
2.8
3.0
3. 18
:.c.
+s. R.H.
4s.
H>
. 3.2
2.8
2.78
2.92
2.7
. 2.5
.3.J
43 . ...:.M.
.++.
2.89
2.38
3.18
3.6
2.5
2.S
3.5
2.8
2.5
4.11
3.0
3.18
4.0
3.5
2.7
. 3.29
2.6
3.8.
3.2
3. 1
2.(1
36. L.C.
J7. M.0 .
38. S.B.
39. R.D.
42.
2.89
2.27
3.18
3.6
2. 27
2.5
3.5
2.8
2.5
3.0
:u ll
4.0
3.0
2.7,
3. 18
27. M.P.
28 . R.R.
3-;,
ONE WEEK .
·1.0
c.s.
'.'9 .
30.
31.
32.
J3.
34.
HIRTH
WEIGHT
2.6
3.32
-
3.4
3.4
3. 1
Z.5
. 3.1
2.51
3.3
2.11
...
2.'J
3.0
""- ·
3.1
JANUARY- MARCH 1996
TWO
WEEKS
3.32
3. 18
3.18
3 .6
2.7
2.7
3.9
2.9
2.7
4.0
3.0
3.43
4.ll
:u
2.95
4.D9
2:7
4.09
3.2
3. 1
3.2.
3.2
2.9
3. 18
3.35
3. 18
2.6
2.92
3.6
2.11
3,5
2.85 ·
3.7
3.4
3.5
3.32
. 3.3
3.8
3.4
3.4
3.5
2.8
3.2
J .32
2.7
J.5
3.89
3.6
2.9
3.1
3.2
2.7
3.32
3.5
ONE
MONTH
4.54
4.54
4.09
4.54.
3.6
3.5
4.5
3.3
3.0
4.2
3.5
4.54
4.8
4.0
H>9
4.54
4.0
5.9
3.6
4.2
4.2
3.8
3.3
4.54
4.54
3.75
2.9·
3.6
4.54
3.1
J.8
3.2
4.6
3.3
4.6
4.0
4.0
3.8
4,56
4.5
4.1
4:0
3.2
3.8
4.0
3. 1
4.0
4.2
4.4
3.3
3.7
3.6
3.2
4. 1
4.o
FOUR .
· MONTHS
5;15 ·
8.1:1
5.0
5.45
1:1.3
5.8
7.4
5.0
4.11
EXPIRED
4.5
Ill.II
6.2
5.2
9.0
. 8.0
5.8
10.5
·. 4.8
4.9
5. 1
5.0
4.8.
I().()
9.0
4.9
4.2
5.8
1.o.. o
5.0
6
5.1
8.0
5.0
8.0
5.i
6.9
6:8
7.11
:
5.6
6.0
6.2
5.0
5.0
6.8
5.0
6.2 .
6.8
7.4
5.0
5.7
5.6'
5.0
6. 1
6:5
l
·. l
i
STOPPED
2.8
3.7
3.1
3.IK
3.2
5.5
4.11
3.7
6.6
6.0
6:3
3.11 ·
269
'l
t
)
·+
;
,
..
.-
l/
//
I
'
61.
62.
63 .
64.
65.
66.
67.
68.
69.
70.
7 1.
72.
73.
74 .
75.
76.
E.S.
N.C.
E.L.
E.R.
l.G.
3. 1
3.3
2.6
2.8
2.98
3.02
2.52
3. 18
2.5
. 3.0
3.06
2.7
3.1
2.8
3.0
2.r.
2.27
3.32
2.75
v ;4
3.6
2.86
2.86
3. 1
3. 77
J .O
14
3.2'.I
2.111
2.7
s.c.
M.T.
L.C.
A.A.
J.C.
V.A.
E.S.
M.V.
M.F.
M.D.
l.G.
77. E.R.
78. V.M.
-.
79 .
80:
81.
82.
83 .
84 .
$5 .
86.
87 ..
88.
89.
90.
91.
92.
93.
94.
95.
96.
97.
G.E.
A.S.
E.J.
J.E.
S.A.
E.A.
W.R.
J.Y.
A.A.
J.G.
s.c.
A.A.
N.M.
R.S.
2.')
3.3
'.l.4
2.7
2. 7
3.4
A.B.
R.V.
B.T.
M.C.
13.G.
98 ... H,R.
99. A.M.
2.!JS
100. P.B.
IOI. E.M.
102: B.L.
103. h1.N.
·:t... ;·
104. C.G.
lb5. A.F.
106. R.H.
107 . . V.M.
108. E.S.
109. M.T.
110. J.T.
11 1. A.A.
112. c.c.
113 . J.S.
114. L.A.
115. ML.
l16. B.L.
i 17. R.D.
118. P.s.·
119. 1.T.
120. G.G.
;or
1·
'
3. 18
3. 1
2.7
2.7
. 3.2
3.4
3.1
3.3
2.7
3.i3
3.32
2.95
J. I
2.78
2.7
3.3 5
3.23
3. 11\
2.7
2.7
,.3.4
3.1
'!l'.O
3.0
3.32
2.7
2.9
3.0
3.02
2.53
3.2
2.5
3.0
3.12
2.7
3.0
2.8
3.0
2.6
2.27
3.3
3.7
3.6
2.9
3. 1
3.2
3.2
2.8
3.23
2.8
3.2
3. 18
2.8
3.3
2.9
4.0
4.3
3.4
3.7
4.0
3.8
3.1
3.7
3.3
3.5
3.8·
6.5
7.0
6 .0
6.5
Ci.4
5.3
6.6
5.0
5.4
'
..•
;
i
..j
5. 5
l"
. STOPPED
:u
2.8
2.4
3.5
3.R
3.5
4.0
3.2
2.9
4.0
5.7
1
:·J
i
5.9
6.S
5.4 .
4.11
6.5
.
STOPPED
2.7
3.6
2.86
2.86
3.0
3.7
3.0
3.6
3.2
2.81
2.7
2.8
3.2
3.3
.2.6
2.7
3.3
3.0
3. 18
3.1
2.7
2.7
3. 1
3.35
3. 1
3.2
2.86
3.23
3.4
3.U
3.0
?. ,';18
l.69
3.3
3.29.
3. 18
2.6
2.11
3.3
'3.1
2.9
3.0
3.8
3.32
3.26
3.4
4:2
3.2
3.77
3.38
2.9
2.84
3. 1
3.6
3.6
2.9
2.76
3.6
3.32
3.32
.· 3.6
3. 18
.3. 1
3. 5
'3.-t
3:6
3:6
3. 1
3.4
3.66
3.32
3.2
2.95
2.77
3.6
3.4
3.32
2.8
2.95
3.5
3.3
3. 1
3.3
4.0
3.8
3.4
4.0
4.7
3.5
4.5
3.69
3.6
3.6
3.8
4.3
.4.0
3.4
3.2
4.6
J .58
3.7
4.2
J..t
3.2
3.8
4.2
4.0
4.1
3.5
3.6
" 3.75
J .6
4.0
3.18
3.2
4.0
1.46
3.6
3.2
3. 1
4.0
3.8
3.5
5.7
6.5
5.11
3.69
6.4
7.4
5. 5
11.7
6.0
5.8
5.6
6 .3
. 7.0
.6.7
5.0
. 5.0
7.9
6.4 .
.. 6.5
Ci. 9
5.7.
5.0
6.2
7.0
. 6.5.·
6.8
5'.5 .
. . 6.6
6.9
Ci.2
6.5
5.0
5. 1
. 6.4
. .6.0
6.4
5.2
5.11
Ci.3
5.7'
5.6
"' Researched done by Sugarpod Naturals/Go-Lacta®
270
.,
.,l
5.5
JPMAVOL 71 NQ;:3 JANUARY - MARCH.. 996
...
..
,.
:"J
...
....{
"
Table 3. Age and Parity Distribution
Treatment group
Placebo group
Mean Age
Primipara
Multi para
27.53years
26.58 years
6 (10%)
10 (17%)
52 {90%)
48 {83%)
48 Hours
>48 Hours
1 (1 .7%)
1 (1.7%)
0(0%)
0(0%)
48Hours
72 Hours
96 Hours
57 (98.3%)
57 {98.3%)
1 (1.7%)
1 (1.7%)
0(0%)
0(0%)
Table 4. Breast Engorgement
24 Hours
Treatment group . 57 (98.3%)
Placebo group
57 (98.3%)
Table 5. Milk Let-down
Treatment group
Placebo group
Table 6. Statistical Analysis of Infants' Weights (kg.)
Birth Weight
One Week
Two Weeks
One Month
Four Months
Treatment Group
Mean
s.o.
Placebo Group
Mean
S.D.
tvaiue
3.001
2.964
3.237
3.897
6.646
0.3545
0.5207
0.5645
0.7184
1.7908
3.041
3.041
3.205
3.563
5.304
0.3309
0.3314
0.3353
0.7949
1.2036
-0.63
-0.96
0.381
2.414 .
. 4.817
0.029%
5.506%
17.04% '
74.41%
2.84%
4.3261'%
23.04%
35. 726%
-0.76
1.163
3.165
5.362
PERCENTAGE WEIGHT GAIN:
B.W. to 1 week
B.W. to 2 weeks
RW:to 1 month
B.W. to 4 months
-1 .3%
7.944%
30.31%
123.6%
13.27%
15.649%
22:863%
61 .51%
Table 7. Statistical Analysis of Serum Prolactln Levels (mlU/I
lst Extraction
2nd Extraction
3rd Extraction
Treatment Group
Mean
S.D.
Tratment Group
Mean
S.D.
t value
4808
5236
2389
2258.4
2252.4
1019.7
5134
3398
504.1
2304.4
1939.5
412.64
-0.78
4.789
13.27
2132.4
2178.1
-1735
-4630
1932.5
2328.9
5.824
5.372
Difference Between
1st and 2nd
428.2
-2418
women take malunggay (Morlnga oleifera) leaves in
chicken or shellfish\ soups to help them lactate well.
The mechanism of action has not been explained but
It was effective as a galactogogue and has been used
by generations of nursiny mothers especially those
with inadequate lactation.
'
..
Lactogenesis, on the other hand, is initiated In the
postpartum period by a fall in plasma progesterone in
the presence of maintained prolactin cohcentrations. 15
Initiation of the process does not depend-on suckling
of the infant although the rate of milk secretion after
the third or fourth day postpartum declines if milk
16
removal is not practiced at regular intervals.
A
study by de Carvalho et al in 1985, showed that
frequent milk expression was associated with a
significantly greater milk production than infrequent
expression. He concluded that a low-cost, noninvasive
method of enhancing milk production by mothers ·Of
nonnursing, prematurely delivered infants was to
17
encourage frequent milk expression.
This was also
the conclusion of Hopkinson et al in 1988 when he
conducted a study on milk volume produced by
women aged .20 to 38 years who delivered at 28 to 30
week's gestation. Optimal milk production was
associated with five or more milk expressions per day
and pumping durations that exceeded 100 minutes
18
.
perday. ·
.·
This current study demonstrated the lactatlonenhancing effect of malunggay (Natalac capsules)
leaves as evidenGed by the significantly greater
Increase in maternal serum prolactin levels and
percentages of gains · in the infants' weights among
the patients belonging to the treatment or
Natalac-treated group,. Majority of our patients .were
free from any form of anxiety or stress which may
result in inadequate milk production. Nevertheless,
there was one subject from each of. the treatment and
placebo group:> who had breast engorgement and
milk let-down a day later than the rest. These two
mothers admitted to have had slight emotional stress
secondary to family problems.
Practical advice, psychological support from close
female relatives, and the help and encouragement of
health workers are essential measures for successful
breast feeding. This is supported by findings of recent
research studies.
CONCLUSION
We have found that malunggay (Natalac)
capsules do enhance lactation among breastfeeding
Researched done by Sugarpod Naturals/Go-Lacta®mothers and there were no reported adverse effects
from the study. In addition, public education, personal
advice, and friendly support from health workers and
counsellors who have special understanding and
... Lactagogues or galactogogues are special foods,
s!<ills are most effective if they work with Individual
iriks, .or herbs which people believe
increase a
mothers, and if they help their colleagues to learn the
.
milk supply. In many parts of the Philippines,
same skills.
/
271:
.. ,
'•
ACKNOWLEDGEMENT
8.
Fuchs, A.R., Dawood, M.Y. Release of oxytocln and
prolactin by suckling in rabbits throughout lactation.
Endocrinology 114:462, 1984.
We would like to thank the San Pablo City Health
Office, under the administration of Dr. Job Brion and
his staff, for their utmost cooperation and willingness
to participate in this research project. Natalac capsules
were provided by Tynor Health Supplement Division ( a
dMsion of tynor Drug House, Incorporated); manufactured
by Gruppo Medica, Incorporated marketed and
distributed by Metropolitan Pharmaceutical Products,
Incorporated.
9.
Uncoln, D.W. Neuroendocrine· control of milk injection. J
Re prod Fertil 2: 571, 1982.
10.
Howie, P.W., McNeilly A.S., The Relationship between
suckling-induced prolactin response and lactogenesis. J.
Clln Endocrlnol Metab. 50:670, 1980.
11 .
Tyson, J.E., Hwang, P. Studies of prolactin secretion during
human pregnancy.. Am J Obstet Gynecol 113:14, 1972.
BIBLIOGRAPHY
12.
Selye, H., Collip, J.B. Nervous and hormonal factors in
lactation. Endocrinology. 18:237, 1934.
13.
Vlo, F., Smoking during pregnancy and lactation and its
effects on breast-milk volume. Am J Clin Nutr 1991;
54:1011-16.
14.
Nyboe, AA, Lund-Ardensesn, C. et al. Suppressed prolactin
but normal neurophysin levels in cigarette smoking
Clin. endocrinol (Oxf) 1982,
breastfeeding women,
17:363-8.
15.
Neville, M.C. Regulation of mammary development and
lactation. In: Neville, M:C., Neifert, M.R., eds. Lactation,
Physiology, Nutrition, and Breastfeeding.
New York:
Plenum presis, 1983: 103-40.
16.
Woolridge, M.W., Greaseley, V.
The initiation of
factatlon:the effect of early versus delayed contact for
suckling on milk intake in the first week post-partum. Early
/
Hum Dev. 1985; 12:269-78.
17.
de Carvalho, M. Anderson, D.M.
Frequency of Milk
Expression and Milk Production by Mothers of Nonnursing
'Premature Neonates. AJDC, Vol. 139, 1985.
18.
Hopkinson, J.M. Schanler, R.J. Milk Production by
Mothers of Premature Infants. Pediatrics. 1988:81 :815,20.
1.
Department of Health, Philippines. "Helping Mothers to
Breastfeed," published by UNICEF, 1991 .
2.
UNICEF.
A Global Priority,• published by
UNICEP. New York, U.S.A. 1990.
3.
Fuchs, A.R. Physiology and Endocrinology of Lactation in
Obstetrics: Gabbe, S. Niebyl J.R., Swipson J.L. eds. 1991.
pages 175-201 .
4.
Neill, J.D.: Prolactin: Its secretion and .control: In E;
Knobil, WH Sawyer (eds.): Handbook of Physiology and
Endocrinology, Section 7, Vol. 4 American Physiological
Society, Washington D.C. 1974. pp 469-478.
5.
Haslam, S.Z. Gale J.J. Estrogen receptor. activation in
normal mammary gland. Endocrinology 114: 1163, 1984.
6.
Cowie, AT., Tindal, S.J.
Edward, London , 1972.
7.
The Physiology of Lactation,
Neville, M.C., Allen; J.C. Studies in human lactation: milk
volume dur!ng weaning and lactogenesis. Am J Clln Nutr
1991, 54:81-92.
·.
Researched done by Sugarpod Naturals/Go-Lacta®
**********
272
JPMA VOL. 71 NO. 3. JANUARY-MARCH 1996