Saturday, November 29, 2008

Breastfeeding, infant jaundice and Chinese herbs

I received an email from a concerned mother inquiring about the effects of Chinese herbs on breastfeeding mothers. Mary was particularly concerned if taking Chinese herbs for postnatal breastfeeding women could cause jaundice in babies.

Below is my reply to Mary:


Dear Mary,

Good day to you. It's always delightful to know more and more people are interested in traditional medicine. And that people realize again how important breastfeeding is.

An invalid idea: "Breastfeeding mothers taking Chinese herbs will cause babies to have jaundice" is an invalid statement or idea.

Physiological or pathological? First of all, many people are messed up with physiological jaundice and pathological jaundice. A physiological one is a normal one which usually begins from day 2 to day 3 and will disappear by itself in one or two weeks. As a matter of fact, physiological jaundice can take place anytime within one or two months. Some simple traditional remedies are sunbathing babies in the early morning, taking mild sugar solution, or phototherapy. A pathological one, of course, is more complicated and needs to deal with depending on the type of pathological changes: viral hepatitis, maternal-fetal blood type incompatibility, other infections or a thyroid problem.

The traditional explanations of having physiological jaundice are:

Possibility 1) Late bowel motion of newborns. For this type, early or more frequent feedings of breast milk to help infants pass the bilirubin in their stools may be recommended.

Possibility 2) Late or lack of breastfeeding by mothers. This jaundice occurs when the baby is not getting enough breast milk, either because of difficulty of breastfeeding or the mother's milk isn't enough yet. For this type, there's nothing wrong with the breast milk itself, it's simply because the baby has not enough to drink.

Possibility 3) Certain substances in milk. In 1% to 2% of babies, their jaundice could be caused by substances in the mother's breast milk. Some substances cause bilirubin to rise. This type usually begins from the first 3 to 5 days, and conditions improve over 1 to 3 months. If it's highly suspect case of such, and the bilirubin level rises toward the need of exchange transfusion, a mother can temporarily stop breastfeeding for 2 days, and resume after the jaundice subsides.

Boosting milk supply: There are certain Chinese herbs that boost a breastfeeding mother's supply of milk and thus allow young mothers who otherwise aren't able to breastfeed to do so. And if jaundice occurs after such cases should we blame it on late breastfeeding or consumption of Chinese herbs? Bear in mind that the newborn was late or not getting good supply of mother's milk at all initially. Could the physiological jaundice have taken place because of late or the lack of breastfeeding? Or the late bowel motion due to late or lack of breastfeeding (Breastfeeding helps first bowel motion)? Or more conveniently, some people will just blame it on the Chinese herbs.

Taking care of postnatal women: There are many postnatal illness or symptoms which have been treated with Chinese herbs. For these highly individual cases, the mother's body type or syndrome must be determined properly through face-to-face consultation before an appropriate therapeutic principle can be drawn on and thus the herbal formula prescribed. Herbs common for postnatal women usually possess the effects of nourishing yin fluid, promoting blood growth and circulation. They tend to strengthen the body constituent, encourage uterus contraction and prevent postnatal infections.

Traditional preparations: Some herbs do get into the breast milk, making milk yellowish in colour, and a few have milk withdrawal effects. Fortunately for us, or as in the wisdom of traditional Chinese medicine, these herbs aren't in the traditional preparation for wellbeings of postnatal women.

Traditional herbal formula for postnatal women's wellbeing are very safe. Many have been used for hundreds of years if not thousands. This is the reason these proven formulas are made into over-the-counters for the ease of availability. For treatments of more specific postnatal illnesses or symptoms, please consult TCM physicians for proper individual prescription.

I hope the info helps. And your effort in helping new moms to breastfeed and live a natural lifestyle is admirable. Keep it up please.

Do let me know if you have any other questions.

John Lew

Tuesday, November 11, 2008

Beat High Blood Pressure naturally

Your herbal resort to lower blood pressure and boost health.

By Kenneth Tan and John Lew

High Blood Pressure

If you’re beset by depression, insomnia, constipation, headaches, dryness in mouth and even a bad temper, all these could be related to a body syndrome which manifests itself also in high blood pressure, says Eu Yan Sang traditional Chinese medicine (TCM) physician John Lew. “There are many different types of body syndromes which show itself through high blood pressure,” he says. “Usually, a consultation with a TCM physician will enable a diagnosis of the body syndrome and thus enable us to prescribe the right herbal remedy for the patient.” Read on to discover which body syndrome you are and how to beat it with an all-natural cure.

THE PROBLEM 1: Hyperactivity and prone to emotional and irritability when under stress with possible signs of depression. Dizziness and headache, weak knees and back pain, forgetfulness and insomnia are commonly seen symptoms.

THE CAUSE: Your body is lacking in fluid which results in an ‘upsurge of fire’, says Lew. “Imagine a sun shining on a small lake as opposed to a big one. The temperature of the small lake will be much higher than the bigger lake with its larger volume of water,” he says. The outcome is high-blood pressure.

THE SOLUTION: The idea is to replenish the fluids and also reduce the internal heat. Prepared rhizome of rehmannia (Shu Di Huang; 熟地黄) possesses the effect of nourishing the kidney-yin. Dogwood fruit (Shan Zhu Yu; 山茱萸), sour in flavour and warm in nature, is used to nourish the kidney and replenish the liver system, while dried Chinese yam (Shan Yao; 山药) for nourishing the kidney-yin and tonifying the spleen. Oriental water plantain (Ze Xia; 泽泻) helps clear and purge fire. Moutan bark (Dan Pi; 丹皮) cooperates with Dogwood fruit in purging liver fire and Poria (Fu Ling; 茯苓) shares similar effect with dried Chinese yam to excrete dampness from the spleen. To help reduce internal heat and fire, rhizome of anemarrhena (Zhi Mu; 知母), bitter in flavor and cold in property, is added. Phellodendron bark (Huang Bai; 黄柏), also bitter and cold, helps clear heat and purge away fire. If dizziness and headache is severe, Gastrodia tuber (Tian Ma; 天麻) and Uncaria stem with hooks (Gou Teng; 钩藤) are added to calm the emotional liver system and stop spinning wind. If constipation poses a problem, hemp seed (Huo Ma Ren; 火麻仁) and bush-cherry seed (Yu Li Ren; 郁李仁) can be used to moisten the bowels and relieve constipation. If you're easily agitated, double the amount of moutan bark and add white peony root (Bai Shao; 白芍) to nourish the upsurging liver and suppress liver hyperactivity. The above formula has the effects of reducing excitement of the brain, lowering blood pressure and blood sugar, inducing diuresis, and improving the kidney system, etc.

THE PROBLEM 2: Paleness in face, with a weak pulse and a furless tongue. Dizziness, constant mild headache, short breath, frequent night urination and dreaminess are common symptoms. For some, feverish sensation in the palms and soles, lassitude of loins and legs can also be present.

THE CAUSE: Your body is lacking ‘yin’ fluid in kidney and liver. “When these organs are weak, then they are easily bullied by external factors,” says Lew. “This is especially common for people getting into their 50s and 60s.” Also, the functionality ('yang' energy) may also be lacking, causing aversion to coldness, low sex drive and weak knees. Ultimately, the disharmony in the organs also manifests itself in high-blood pressure.

THE SOLUTION: In order to promote an increased 'yin substantial essence' in your liver and kidneys, you’ll need to take dried rhizome of rehmannia (Sheng Di Huang; 生地黄) and dogwood fruit (Shan Zhu Yu; 山茱萸). They're both meant to nourish the kidney and replenish the liver systems. In order to boost up 'yang' warming energy, medicinal indianmulberry root (Ba Ji Tian; 巴戟天), desertliving cistanche (Rou Cong Rong; 肉苁蓉), cassia bark (Rou Gui; 肉桂) and prepared aconite root (Fu Zi; 附子) are used because of their ability to strengthen kidney-yang that helps with cold knees, low sex drive and night urination. Dendrobium stem (Shi Hu; 石斛), Ophiopogon root (Mai Dong; 麦冬) and Schisandra fruit (Wu Wei Zi; 五味子), with their sweet and slightly cold in nature, help to promote body fluid and nourish yin. Schisandra fruit even arrests sweating, seminal emission and calms the mind. To further calm the mind and strengthen digestive system, grassleaved sweetflag rhizome (Chang Pu; 菖蒲), polygala root (Yuan Zhi; 远志) and Poria (Fu Ling; 茯苓) are added. If dry mouth, dry throat and inner body heat is severe, more herbs that help nourish the kidney-yin can be included, such as wolfberry fruit (Gou Qi Zi; 枸杞子) and glossy privet fruit (Nv Zhen Zi; 女贞子). Wolfberry fruit also nourishes the liver system to improve acuity of vision whereas glossy privet fruit also improves eyesight and darken white hairs. If you're plagued with water retention in the lower limbs and chronic aversion to coldness, coupled with pale facial complexion, white atractylodes rhizome (Bai Shu; 白术), oriental water plantain (Ze Xia; 泽泻) and agaric (Zhu Ling; 猪苓) can be added to replenish qi energy and reinforce the spleen system (better digestion and absorption) for inducing diuresis. The above prescription has the efficacies in promoting blood circulation, cooling the mind, lowering blood pressure, strengthening the kidney system and protecting the liver, etc. It can also be modified for climacteric hypertension in women.

THE PROBLEM 3: A flushed face, plenty of yellowish or greenish phlegm with an irritated throat, fitful sleep. Fullness sensation in the chest, rapid pulse, yellowish greasy fur and fast slippery pulse can be observed.

THE CAUSE: There is a presence of ‘heat phlegm’ in your body which causes discernible discomforts and also the high-blood pressure. “The problematic ‘heat phlegm’ will also irritate your emotional conditions,” says Lew. Typical symptoms include vertigo, gastric discomfort with acid regurgitation, palpitation, insomnia, bitter taste in mouth and so on.

THE SOLUTION: First, you can use coptis root (Huang Lian; 黄连), which is very cooling in nature, to reduce heat-phlegm. Then, once your phlegm is less heaty, use Poria (Fu Ling; 茯苓) to absorb it and flush it out through bowel movements and urination. Pinellia tuber (Ban Xia; 半夏) lowers adverse flow of qi energy to regulate the stomach. It also eliminates dampness to resolve phlegm. Bamboo shavings (Zhu Ru; 竹茹) clears away heat and resolves phlegm to relieve vertigo. Tangerine peel (Chen Pi; 陈皮) regulates qi energy flow and removes phlegm. Immature citron fruit (Zhi Shi; 枳实) promotes circulation of energy to remove phlegm and renders phlegm downwards for excretion. Fresh ginger (Sheng Jiang; 生姜), jujubae Chinese dates (Da Zao; 大枣) and prepared licorice root (Zhi Gan Cao; 炙甘草) tonify the spleen and regulate the stomach (better digestion and absorption), coordinating the effects of other herbs in this suggested prescription. If the heat-phlegm is persistent and of the excess type, use prepared arisaema (Dan Nan Xing; 胆南星) and scutellaria root (Huang Qin; 黄芩). The bitter taste and cold nature of these herbs is stronger in clearing heat and resolving phlegm. The above prescription has the effect of heat-clearing, phlegm-eliminating, cough and asthma relieving. It's suitable for the syndrome of stagnation of phlegm and heat in the lung system.

THE PROBLEM 4: A lack of energy and presence of wet phlegm with paleness in face and accompanied usually by signs of obesity. Many times dizziness, nausea, chest oppression can be observed. Tongue is whitish and greasy with taut and slippery pulse.

THE CAUSE: “Your digestive system is weak which results in food stagnation and consequently the wet phlegm,” says Lew. “Poor absorption of the food leaves it in the body causing an accumulation of the wet phlegm. Some people have bulky hands and weakness on their lower legs also which causes the blood-pressure to shoot up.”

THE SOLUTION: To improve the digestive system and resolve inner dampness and phlegm. Also, it is important to cut down on your salt intake because it promotes water retention, leading to heavier legs and higher blood pressure. To further lower your blood pressure, cut out alcohol, teas and cigarettes which weaken your digestive system. Regular exercise of 45 minutes a day will quickly improve your blood pressure readings as well. For herbal remedy, the principle is to dry dampness to resolve abundance of phlegm. Pinellia tuber (Ban Xia; 半夏) eliminates dampness to resolve phlegm and lowers the adverse flow of qi energy to arrest nausea. Gastrodia tuber (Tian Ma; 天麻) resolves phlegm and calms spinning wind that caused by stagnated liver system to relieve vertigo. These two herbs are essential in the treatment of vertigo with headache due to wind-phlegm syndrome (body type). Atractylodes rhizome (Bai Shu; 白术), strengthens the spleen system (digestion and absorption) to eliminate dampness and phlegm. Poria (Fu Ling; 茯苓) further strengthens the spleen to excrete dampness. Tangerine peel (Chen Pi; 陈皮) regulates qi energy flow and removes phlegm. Fresh ginger (Sheng Jiang; 生姜), jujubae Chinese dates (Da Zao; 大枣) and licorice root (Gan Cao; 甘草) tonify the spleen and regulate the stomach (better digestion and absorption), coordinating the effects of other herbs in the prescription. For condition with sticky phlegm, add fritillary bulb (Bei Mu; 贝母) and prepared arisaema (Dan Nan Xing; 胆南星) to resolve more phlegm and nourish the lung system. The prescription helps improve digestion and absorption and thus gets rid of stagnated phlegm inside the body. Syndrome marked by up-stirring of wind-phlegm can be treated by this modified formula.

THE PROBLEM 5: Bad temper, constant flushed face, slight constipation, yellowish urine, bitterness in mouth, acid reflux, deep red tongue, taut and forceful pulse. Dizziness and headache and probably head distension are common symptoms.

THE CAUSE: An upsurge of liver ‘fire’ which is caused by keeping late nights or/and eating plenty of spicy foods. “The hours of 1am to 3am is when your liver detoxes your blood while the time of 11pm to 1am is when your gall bladder system clears the secretions and blockages,” says Lew. “When these two organs are deprived of their regular bio-rhythm, the stagnation will result in upsurge of liver-yang or fire and there all the above symptoms and your pulse will also toughen like a guitar string which indicates increased blood pressure.”

THE SOLUTION: The first priority is to purge excessive fire from the liver and gallbladder systems. Removing damp-heat is next. Now, in order to purge excessive fire in the liver and gallbladder and clear damp-heat, gentian root (Long Dan Cao; 龙胆草), scutellaria root (Huang Qin; 黄芩) and capejasmine fruit (Zhi Zi; 栀子) are selected. They are extremely bitter in flavor and cold in nature. Oriental water plantain (Ze Xia; 泽泻), fiveleaf akebia stem (Mu Tong; 木通) and plantain seed (Che Qian Zi; 车前子) have the effect of removing heat and inducing diuresis to dispel damp-heat. Dried rhizome of rehmannia (Sheng Di Huang; 生地黄) and Chinese angelica root (Dang Gui; 当归) nourish yin and blood so as to soothe the liver. Also, bupleurum root (Chai Hu; 柴胡) should be included as it soothes the liver and regulates the qi circulation in the liver and gallbladder systems. It further induces the efficacy of all the herbs into the liver and gallbladder. Licorice root (Gan Cao; 甘草)) coordinates the effects of various herbs and prevents the stomach from being hurt by the bitter and cold property of most herbs. For constipation, rhubarb (Da Huang; 大黄) can be added to purge heat and loosen the bowels. For severe headache and vertigo, add gastrodia tuber (Tian Ma; 天麻), uncaria stem with hooks (Gou Teng; 钩藤) and nacre (Zhen Zhu Mu; 珍珠母) to calm the emotional liver system and stop spinning wind on the head (vertigo). For dry mouth and thirsty tongue, add dendrobium stem (Shi Hu; 石斛), Ophiopogon root (Mai Dong; 麦冬) and figwort root (Xuan Shen; 玄参) to promote yin fluid build-up and clear heat. The formula has the effect of bringing down the heat, tranquilizing the mind, relieving inflammation, inducing diuresis, promoting the functions of gallbladder and liver systems, and decreasing blood pressure.

Tips (Overall):
1) For most cases, standard suggested range of daily dosage for each herbs can be referred to when prescribing the herbs.
2) You can boil the herbs in traditional ways or by opting for condensed extracted powder of each herbs which can be taken orally without boiling.
3) Cases presented are typical or representatives of obvious body types. Most of the people belong to combination of two or three body types, depending on degree of severity. And there are other body types mixed with other diseases. Please consult a physician of TCM for proper diagnosis of body syndromes (types) and other diseases.

1) This solution of High Blood Pressure appears in Malegrams Balance, on page 52 and page 54 of Men's Health magazine, November 2008, Malaysia.