***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Results Thirty-two studies met the inclusion criteria . Clinical studies were divided into three categories : survey studies ( n=11 ) , safety studies ( n= 8) , and efficacy studies ( n= 13 ) . Six studies were r and omized controlled trials . The most common herbs studied were St. John ’s wort ( Hypericum perforatum L. ) ( n=3 ) , garlic ( Allium sativum L. ) extract ( n=2 ) , and senna ( Cassia senna L. ) ( n=2 ) . Studies were very heterogeneous with regards to study design , herbal intervention , and outcome measures . Overall , poor method ological quality predominated among the studies Asparagus racemosus Willd . has repeatedly been mentioned as a galactogogue in Ayurvedic literature and has been confirmed through animal experiments as well . This r and omized double-blind clinical trial evaluates its galactogogue effect in 60 lactating mothers by measurement of changes in their prolactin hormone level during the study . Several secondary parameters namely mothers ’ weight , babies ’ weight , subjective satisfaction of mothers and well-being and happiness of babies were studied to corroborate the primary findings . The oral administration of the research drug led to more than three-fold increase in the prolactin hormone level of the subjects in the research group as compared to the control group . The primary findings were corroborated by the secondary outcome measures and were found to be statistically significant ( p < 0.05 ) AIMS To investigate the possibility of a dose-response relationship for the use of domperidone in treating insufficient milk supply in mothers of preterm infants , and to quantify the exposure of the breastfed infant to domperidone . METHODS Six preterm mothers received domperidone  ( 30 mg daily or 60 mg daily ) in a double-blind , r and omized , crossover trial . Milk production and serum prolactin were measured before and during the trial , and  domperidone concentration in milk was measured during drug treatment . RESULTS For milk production , two of the mothers were ' nonresponders ' , whereas the other four were ' responders ' and showed a significant increase in milk production from 8.7 + /- 3.1 g h(-1 ) in the run-in phase ( mean + /- SEM ) , 23.6 + /- 3.9 g h(-1 ) for the 30-mg dose ( P = 0.0217 ) and 29.4 + /- 6.6 g h(-1 ) for the 60-mg dose ( P = 0.0047 ) . In all participants , serum prolactin was significantly increased for both doses , but the response was not dose dependent . Median ( interquartile range )  domperidone concentrations in milk over a dose interval at steady-state were 0.28 microg l(-1 ) ( 0.24 - 0.43 ) and 0.49 microg l(-1 ) ( 0.33 - 0.72 ) for the 30-mg and 60-mg doses , respectively . The mean relative infant dose was 0.012 % at 30 mg daily and 0.009 % at 60 mg daily . CONCLUSION In one-third of mothers , domperidone did not increase milk production . In the remainder , milk production increased at both domperidone doses , and there was a trend for a dose-response relationship . The amount of domperidone that transfers into milk was extremely low , and infant exposure via breastfeeding was not considered to be significant Responses of  oxytocin and PRL  to mechanical breast pumping and the influence of physiological indicators of stress were measured at 2 , 4 , and 6 weeks postpartum to determine potential causes of inadequate milk production in 18 women with prematurely delivered , nonnursing ( < 1500 g ) infants .  Median milk production was similar to that reported in breastfeeding mothers , but a third of mothers were producing less than half as much by week 6 . Plasma oxytocin  was similar to that previously reported for breastfeeding mothers . The  oxytocin area under the curve ( AUC ) for breast-pumping sessions ( 70 min ) was correlated at each occasion ( r = 0.37 , 0.58 , and 0.55 , respectively ) with milk yield . Unlike reports of PRL levels in breast-feeding women , PRL AUC declined between weeks 2 and 6 weeks postpartum ( P = 0.03 ) ; significant increases in plasma PRL occurred in response to pumping at 2 and 4 weeks , but not at 6 weeks . Salivary amylase , a measure of alpha-adrenergic activity , was highly negatively correlated on each occasion with PRL AUC ( r = -0.58 , -0.68 , and -0.86 , respectively ) , but not with  oxytocin . Salivary cortisol was negatively correlated to a lesser degree . We hypothesize that deficiencies in preterm lactation are mediated in part upon stress-induced suppression of PRL secretion through an adrenergic mechanism OBJECTIVES The aim of this study was to evaluate whether consumption of maternal herbal tea containing fenugreek had any effects on breast milk production and infants ' weight gain pattern in the early postnatal period . DESIGN AND SUBJECTS Sixty-six ( 66 ) mother-infant pairs were r and omly assigned to 3 groups . Group 1 ( n = 22 ) consisted of mothers who were receiving herbal tea containing fenugreek every day . Group 2 ( n = 22 ) and group 3 ( n = 22 ) were assigned as placebo and controls , respectively . OUTCOME MEASURES Birth weight , loss of birth weight , time of regain of birth weight , amount of breast milk assessed on the third day after delivery were determined . RESULTS Maximum weight loss was significantly lower in infants in group 1 compared to both the placebo and control groups ( p < 0.05 ) . Infants in group 1 regained their birth weight earlier than those in control and placebo groups ( p < 0.05 ) . The mean measured breast milk volume of the mothers who received galactagogue tea was significantly higher than the placebo and control groups ( p < 0.05 ) . CONCLUSIONS Maternal galactagogue herbal tea supplementation seems to be useful for enhancing breast milk production and facilitating infant birth weight regain in early postnatal days The aim of the present investigation was to evaluate the clinical efficacy of Xiong-gui-tiao-xue-yin , a traditional Japanese herbal medicine , in stimulating lactation in the postpartum period . We enrolled 82 women who had a normal delivery in Osaka Medical College Hospital , and r and omly assigned them to the following two groups : a group of 41 women who received Xiong-gui-tiao-xue-yin at a dose of 6.0 g/day  ( Group X ) , and a group of 41 women who received ergometrine ( methylergometrine maleate ) at a dose of 0.375 mg/day ( Group E ) . Volume of lactation was determined daily until Day 6 postpartum . Plasma prolactin and oxytocin concentration were measured at Days 1 and 6 postpartum . The results showed that volume of lactation was significantly higher in Group X than in Group E at Days 4 ( p = 0.042 ) , 5 ( p = 0.038 ) , and 6 ( p = 0.046 ) . Significant differences between Groups X and E were noted in plasma prolactin concentration at Days 1 ( 157.9 + /- 78.2 ng/ml and 129.1 + /- 64.8 ng/ml ; p = 0.037 ) and 6 ( 167.5 + /- 95.4 ng/ml and 117.1 + /- 53.6 ng/ml ; p = 0.0042 ) postpartum . On the other h and , at Day 1 , oxytocin concentration was significantly higher in Group E than in Group X ( p = 0.0024 ) . No adverse effects were observed in this study . The results of our study demonstrate the beneficial effects of Xiong-gui-tiao-xue-yin on lactation , with increase in prolactin level without increase in oxytocin level in the postpartum period . Therefore , Xiong-gui-tiao-xue-yin can be expected to improve lactation in women in the postpartum period . Further detailed bio-pharmacological studies and clinical trials to investigate the properties of this drug are warranted Background The use of mother ’s own breast milk during initial hospitalization has a positive impact not only in reducing potential serious neonatal morbidities but also contribute to improvements in neurodevelopmental outcomes .  Mothers of very preterm infants struggle to maintain a supply of breast milk during their infants ’ prolonged hospitalization . Galactogogues are medications that induce lactation by exerting its effects through oxytocin or prolactin enhancement . Domperidone is a potent dopamine D2 receptor antagonist which stimulates the release of prolactin . Small trials have established its ability in enhancing breast milk production . EMPOWER was design ed to determine the safety and efficacy of domperidone in mothers experiencing an inadequate milk supply . Methods / design EMPOWER is a multicenter , double masked , r and omized controlled phase-II trial to evaluate the safety and effectiveness of domperidone  in those mothers identified as having difficulty in breast milk production . Eligible mothers will be r and omized to one of two allocated groups : Group A : domperidone 10 mg orally three times daily for 28 days ; and Group B : identical placebo 10 mg orally three times daily for 14 days followed by domperidone 10 mg orally three times daily for 14 days . The primary outcome will be determined at the completion of the first 2-week period ; the second 2-week period will facilitate answering the secondary questions regarding timing and duration of treatment . To detect an estimated 30 % change between the two groups ( from 40 % to 28 % , corresponding to an odds ratio of 0.6 ) , a total sample size of 488 mothers would be required at 80 % power and alpha = 0.05 . To account for a 15 % dropout , this number is increased to 560 ( 280 per group ) . The duration of the trial is expected to be 36–40 months . Discussion The use of a galactogogue often becomes the measure of choice for mothers in the presence of insufficient breast milk production , particularly when the other techniques are unsuccessful . EMPOWER is design ed to provide valuable information in guiding the practice s for this high-risk group of infants and mothers . The results of this trial will also inform both mothers and clinicians about the choices available to increase and maintain sufficient breast milk . Trial registration Clinical Trials.gov Identifier : A multicentric , r and omized , doubleblind , placebo controlled parallel study was design ed to observe a rise in serum prolactin ( PRL ) levels ( primary outcome variable ) . The other variables studied included weight gain of infant , decrease in volume and frequency of supplementary feeds in those mothers who were From the Departments of Pharmacology and Pediatrics , Maulana Azad Medical College , New Delhi 110 002 and the Department of Pediatrics , Kalawati Saran Children 's Hospital , New Delhi 110 001 BACKGROUND AND AIM OF THE WORK The authors have previously reported the use of Silymarin ( a Silybum marianum st and ardized extract ) as a promoter of milk production in cows . Due to the important psychological impact of hypogalactia in women after delivery , we evaluated the role of Silymarin as a safe and effective galactogogue for human species . METHODS 50 healthy women during lactation were enrolled in order to verify the galactogogue role played by an oral treatment with micronized Silymarin ( 420 mg/day ) in comparison with an undistinguishable placebo product . RESULTS Women orally treated for 63 days with Silymarin showed a clear galactagogue role for the product with an increase of 85.94 % of the daily milk production  ( placebo : + 32.09 % ) . No drop out , nor unwanted effects were reported in both groups . Compliance and tolerability were also very good . CONCLUSIONS Silymarin may be considered as a safe and effective herbal product that can be orally administered in order to improve the daily milk production in healthy women after delivery , without affecting milk quality 
    Output:
    
Given the insufficiency of evidence from these trials , no recommendation is made for the use of herbs as galactogogues .