DOI: 10.32322/jhsm.1970122 ISSN: 2636-8579

Association between maternal herbal galactagogue use and infant liver enzyme levels in infants with prolonged jaundice

Ayşe Esra Tapcı, Bahar Çuhacı Çakır, Bahar Öztelcan Gündüz, Aysu Duyan Çamurdan
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Aims: Herbal products are commonly used by breastfeeding mothers to enhance milk production; however, their potential effects on infant liver function remain unclear. This study aimed to investigate the association between maternal use of herbal milk-enhancing products and liver enzyme levels in infants.Methods: This retrospective observational study included infants aged ≤3 months who underwent liver function testing for prolonged neonatal jaundice between January 2020 and June 2024 at a tertiary care center. Maternal use of herbal galactagogues was recorded based on maternal self-report documented in medical records. Between-group comparisons were performed for continuous and categorical liver enzyme outcomes, with effect estimates reported with 95% confidence intervals. Multivariable logistic regression analyses were performed for elevated AST and ALT, and p-values for multiple liver enzyme comparisons were adjusted using the Benjamini-Hochberg procedure.Results: A total of 700 infants were included, of whom 56 (8.0%) were exposed to maternal herbal galactagogue use. Demographic characteristics were comparable between the groups. In unadjusted analyses, median AST and ALT levels were higher in the herbal-exposed group than in the unexposed group (AST: 46.0 vs. 41.0 U/L, p=0.011; ALT: 26.0 vs. 22.0 U/L, p=0.039). Elevated AST was more frequent among exposed infants (26.8% vs. 15.7%; OR 1.97, 95% CI 1.05-3.69), whereas elevated ALT did not differ significantly between groups (51.8% vs. 39.9%; OR 1.62, 95% CI 0.94-2.80). After Benjamini-Hochberg correction across all six liver enzyme comparisons, none remained statistically significant. When correction was restricted to the three continuous enzyme comparisons, the AST difference remained significant (adjusted p=0.033). In multivariable analysis, maternal herbal galactagogue use was associated with higher odds of elevated AST (adjusted OR 1.94, 95% CI 1.03-3.65; p=0.040), but not elevated ALT (adjusted OR 1.60, 95% CI 0.91-2.81; p=0.102). GGT levels did not differ significantly between groups. Conclusion: Maternal herbal galactagogue use was associated with modest differences in infant liver enzyme profiles in this clinically selected population. However, the findings were sensitive to multiple-comparison adjustment, and the observed association with elevated AST requires confirmation given the retrospective design and potential residual confounding. These findings should therefore be considered hypothesis-generating, and prospective studies are needed to clarify the safety and potential hepatic effects of herbal galactagogues during breastfeeding.

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